Shmidt T E
Zh Nevrol Psikhiatr Im S S Korsakova. 2012;112(9 Pt 2):123-8.
The two-phase model of the pathogenesis of multiple sclerosis (MS) is discussed in the aspect of inflammation and neurodegeneration processes. In the first phase, there are inflammation processes with frequent exacerbations and remissions and multiple lesions on MRI. An axonal lesion (neurodegeneration) is seen in this stage, even in the very beginning, i.e. in the stage of clinically isolated syndrome. The possibilities of treatment of neurodegenerative changes, in particular, with glatiramer acetate (GA) or copaxon, are reviewed. Copaxon induces a switch from Th1-cells to GA-specific Th2-lymphocyte production which can produce neurotrophic factors. Clinical and MRI data as well as experimental results supporting the neuroprotective effect of this drug are presented.
从炎症和神经退行性变过程方面探讨了多发性硬化症（MS）发病机制的两阶段模型。在第一阶段，存在炎症过程，频繁出现病情加重和缓解，且MRI上有多个病灶。即使在最初阶段，即在临床孤立综合征阶段，也能观察到轴突损伤（神经退行性变）。本文综述了治疗神经退行性变的可能性，特别是使用醋酸格拉替雷（GA）或考帕松进行治疗。考帕松可诱导从Th1细胞向能产生神经营养因子的GA特异性Th2淋巴细胞产生转变。文中展示了支持该药物神经保护作用的临床和MRI数据以及实验结果。
