The Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
Annu Rev Med. 2012;63:389-404. doi: 10.1146/annurev-med-042910-135833. Epub 2011 Sep 1.
Concepts of multiple sclerosis (MS) have shifted from the traditional view of a T cell-mediated, demyelinating disease of the white matter to include a broad range of immunopathogenic mechanisms, axonal damage, and widespread gray matter pathology. The cause of MS remains unknown, but recent epidemiological work has focused on genetic factors; environmental factors such as vitamin D, sunlight, and Epstein-Barr virus; and the controversial theory of chronic cerebrospinal venous insufficiency. Revised criteria facilitate making the diagnosis of MS. Emerging therapies are rapidly expanding treatment options, including both parenterally administered and oral medications. Strategies to preserve tissue, promote repair, and restore function are under development, and it is anticipated that they will provide better options for patients with progressive disease.
多发性硬化症（MS）的概念已经从传统的 T 细胞介导的、白质脱髓鞘疾病的观点转变为包括广泛的免疫发病机制、轴突损伤和广泛的灰质病理学。MS 的病因仍然未知，但最近的流行病学研究集中在遗传因素上；环境因素，如维生素 D、阳光和爱泼斯坦-巴尔病毒；以及慢性脑脊髓静脉功能不全的争议理论。修订后的标准有助于 MS 的诊断。新兴的治疗方法正在迅速扩大治疗选择，包括肠外和口服药物。保存组织、促进修复和恢复功能的策略正在开发中，预计它们将为进展性疾病患者提供更好的选择。
