Río Jordi, Montalbán Xavier
Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (CEM-Cat), Hospital Universitari Vall d'Hebron, Barcelona, España.
Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (CEM-Cat), Hospital Universitari Vall d'Hebron, Barcelona, España.
Med Clin (Barc). 2014 Dec;143 Suppl 3:3-6. doi: 10.1016/S0025-7753(15)30002-6.
Multiple sclerosis is a multifocal demyelinating disease leading to progressive neurodegeneration caused by an autoimmune response in genetically predisposed individuals. In the last few years, the knowledge and management of this disease has been revolutionized by a series of findings. The present article reviews pathological features of the disease, in which cortical involvement is increasingly implicated, and aspects related to novel pathogenic mechanisms, such as the role of the microbiota in the genesis of multiple sclerosis, as well as recent contributions from the fields of epidemiology and genetics. Also reviewed are the latest diagnostic criteria, which currently allow a much earlier diagnosis, with clear therapeutic implications.
多发性硬化症是一种多灶性脱髓鞘疾病,在具有遗传易感性的个体中,由自身免疫反应导致进行性神经退行性变。在过去几年中,一系列研究结果彻底改变了对该疾病的认识和治疗方法。本文综述了该疾病的病理特征,其中越来越多地涉及皮质受累,以及与新的致病机制相关的方面,如微生物群在多发性硬化症发病中的作用,以及流行病学和遗传学领域的最新研究成果。还综述了最新的诊断标准,这些标准目前能够实现更早的诊断,具有明确的治疗意义。