两阶段理论认为炎症继之变性可解释进展性多发性硬化症的发病机制，该理论终结的开端。
Beginning of the end of two-stage theory purporting that inflammation then degeneration explains pathogenesis of progressive multiple sclerosis.
作者信息
Steinman Lawrence, Zamvil Scott S
机构信息
aDepartment of Neurology and Neurologic Sciences, Interdepartmental Program in Immunology, Stanford University, Stanford bDepartment of Neurology and Program in Immunology, University of California, San Francisco, California, USA.
出版信息
Curr Opin Neurol. 2016 Jun;29(3):340-4. doi: 10.1097/WCO.0000000000000317.
PURPOSE OF REVIEW
The review discusses future directions in research on multiple sclerosis and neuromyelitis optica, as long-held beliefs about these diseases are undermined with data from recent clinical trials.
RECENT FINDINGS
Results of clinical trials for registration (phase 3) were reported in the last year. Anti-inflammatory approaches, such as daclizumab high-yield process targeting IL-2 receptor, and ocrelizumab targeting CD20 B cells, confirmed a beneficial role of immune suppression in relapsing-remitting disease. And now for the first time achieving the primary end point in primary progressive multiple sclerosis was attained with ocrelizumab.
SUMMARY
The results in the past year challenge the long-held belief that relapsing-remitting disease is inflammatory, whereas progressive forms of the disease are 'less inflammatory' and more 'degenerative.'
综述目的
随着近期临床试验数据对这些疾病长期以来的认知提出挑战，本文综述了多发性硬化症和视神经脊髓炎的未来研究方向。
近期发现
去年报告了注册临床试验（3期）的结果。抗炎方法，如靶向白细胞介素-2受体的高产量达利珠单抗以及靶向CD20 B细胞的奥瑞珠单抗，证实了免疫抑制在复发缓解型疾病中的有益作用。奥瑞珠单抗首次在原发性进行性多发性硬化症中达到主要终点。
总结
过去一年的结果挑战了长期以来的观念，即复发缓解型疾病具有炎症性，而疾病的进展形式“炎症性较低”且更具“退行性”。
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