Ransohoff Richard M, Hafler David A, Lucchinetti Claudia F
Biogen Idec, 14 Cambridge Centre, Cambridge, MA 02142, USA.
Departments of Neurology and Immunobiology, Yale School of Medicine, 15 York Street, New Haven, CT 06520, USA.
Nat Rev Neurol. 2015 Mar;11(3):134-42. doi: 10.1038/nrneurol.2015.14. Epub 2015 Feb 17.
Multiple sclerosis (MS) has been thought to be a complex and indecipherable disease, and poorly understood with regards to aetiology. Here, we suggest an emphatically positive view of progress over several decades in the understanding and treatment of MS, particularly focusing on advances made within the past 20 years. As with virtually all complex disorders, MS is caused by the interaction of genetic and environmental factors. In recent years, formidable biochemical, bioinformatic, epidemiological and neuroimaging tools have been brought to bear on research into the causes of MS. While susceptibility to the disease is now relatively well accounted for, disease course is not and remains a salient challenge. In the therapeutic realm, numerous agents have become available, reflecting the fact that the disease can be attacked successfully at many levels and using varied strategies. Tailoring therapies to individuals, risk mitigation and selection of first-line as compared with second-line medications remain to be completed. In our view, the MS landscape has been comprehensively and irreversibly transformed by this progress. Here we focus on MS therapeutics-the most meaningful outcome of research efforts.
多发性硬化症（MS）一直被认为是一种复杂且难以理解的疾病，其病因也鲜为人知。在此，我们着重对几十年来在MS的理解和治疗方面取得的进展持积极肯定的态度，尤其关注过去20年里取得的进步。与几乎所有复杂疾病一样，MS是由遗传和环境因素相互作用引起的。近年来，强大的生化、生物信息学、流行病学和神经影像学工具已被应用于MS病因的研究。虽然目前对该疾病的易感性已有相对较好的解释，但疾病进程并非如此，仍然是一个突出的挑战。在治疗领域，已有多种药物可供使用，这反映出该疾病可以在多个层面并采用多种策略成功进行治疗。针对个体量身定制治疗方案、降低风险以及选择一线药物而非二线药物等工作仍有待完善。我们认为，这一进展已全面且不可逆转地改变了MS的局面。在此，我们将重点关注MS治疗——研究工作最有意义的成果。
