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多发性硬化及其模型实验性自身免疫性脑脊髓炎研究中的新发现和旧争议。

New findings and old controversies in the research of multiple sclerosis and its model experimental autoimmune encephalomyelitis.

机构信息

Department of Immunology, The Weizmann Institute of Science, Rehovot, Israel.

出版信息

Expert Rev Clin Immunol. 2013 May;9(5):423-40. doi: 10.1586/eci.13.21.

Abstract

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the CNS that is heterogeneous in its clinical manifestation and progression, as well as in its pathological mechanisms. Animal models, in particular the various forms of experimental autoimmune encephalomyelitis, have been highly valuable for studying both disease pathology and drug development. Novel technologies, such as advanced imaging systems, as well as systematic research of CNS biopsies and postmortem samples from MS patients, have brought major progress in disease understanding. Consequently, in addition to the sclerotic demyelinated plaques in the white matter, changes in normal-appearing white matter tissue ('pre-plaque') and gray matter pathology are currently regarded as central disease components. This review aims to provide current insights on several central aspects in MS research. In particular, the interplay between inflammation and neurodegeneration mediating the disease, and therapeutic strategies attempting to induce immunomodulation and neuroprotective repair processes, are discussed.

摘要

多发性硬化症(MS)是一种中枢神经系统的炎症性脱髓鞘疾病,其临床表现和进展以及病理机制存在异质性。动物模型,特别是各种形式的实验性自身免疫性脑脊髓炎,对于研究疾病病理学和药物开发具有重要价值。新技术,如先进的成像系统,以及对 MS 患者的中枢神经系统活检和尸检样本的系统研究,为疾病的认识带来了重大进展。因此,除了在白质中有硬化性脱髓鞘斑块外,正常外观的白质组织(“斑块前”)和灰质病理学的变化目前被认为是中枢疾病的组成部分。这篇综述旨在提供 MS 研究的几个中心方面的最新见解。特别是,讨论了介导疾病的炎症和神经退行性变之间的相互作用,以及试图诱导免疫调节和神经保护修复过程的治疗策略。

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