Department of Neurology, Technische Universität München, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
Institut für Klinische Neuroimmunologie, Ludwig-Maximilians Universität München, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
Lancet Neurol. 2015 Apr;14(4):406-19. doi: 10.1016/S1474-4422(14)70305-9.
Multiple sclerosis is a chronic disease of the CNS that leads to substantial disability in most patients. The early phase is characterised by relapses and the later phase by progressive disability. Results from immunological, genetic, and histopathological studies and treatment trials have shown that the immune system plays a key part in the disease course. Findings from animal models and immunological studies of patients with multiple sclerosis suggest a change in the involvement of the immune system during disease initiation and progression. These findings suggest that a peripheral immune response targeting the CNS drives the disease process during the early phase, whereas immune reactions within the CNS dominate the progressive phase. These concepts for the differential involvement of immune responses in the early and progressive phase of this disease have important implications for future research in the pathogenesis and treatment of multiple sclerosis.
多发性硬化症是一种中枢神经系统的慢性疾病，大多数患者因此导致严重残疾。早期以复发为特征，晚期以进行性残疾为特征。免疫学、遗传学和组织病理学研究以及治疗试验的结果表明，免疫系统在疾病过程中起着关键作用。来自动物模型和多发性硬化症患者免疫研究的结果表明，免疫系统在疾病开始和进展过程中的参与发生了变化。这些发现表明，针对中枢神经系统的外周免疫反应在早期阶段驱动疾病过程，而中枢神经系统内的免疫反应则主导进行性阶段。这些关于免疫反应在疾病早期和进展阶段的不同参与的概念，对多发性硬化症发病机制和治疗的未来研究具有重要意义。
