Martin Roland, Sospedra Mireia, Rosito Maria, Engelhardt Britta
Neuroimmunology and Multiple Sclerosis Research Section, Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
Theodor Kocher Institute, University of Bern, Bern, Switzerland.
Eur J Immunol. 2016 Sep;46(9):2078-90. doi: 10.1002/eji.201646485.
Multiple sclerosis (MS) is the most common inflammatory disorder of the central nervous system (CNS) in young adults. When MS is not treated, it leads to irreversible and severe disability. The etiology of MS and its pathogenesis are not fully understood. The recent discovery that MS-associated genetic variants code for molecules related to the function of specific immune cell subsets is consistent with the concept of MS as a prototypic, T-cell-mediated autoimmune disease targeting the CNS. While the therapeutic efficacy of the currently available immunomodulatory therapies further strengthen this concept, differences observed in responses to MS treatment as well as additional clinical and imaging observations have also shown that the autoimmune pathogenesis underlying MS is much more complex than previously thought. There is therefore an unmet need for continued detailed phenotypic and functional analysis of disease-relevant adaptive immune cells and tissues directly derived from MS patients to unravel the immune etiology of MS in its entire complexity. In this review, we will discuss the currently available MS treatment options and approved drugs, including how they have contributed to the understanding of the immune pathology of this autoimmune disease.
多发性硬化症（MS）是年轻成年人中最常见的中枢神经系统（CNS）炎性疾病。若不进行治疗，MS会导致不可逆转的严重残疾。MS的病因及其发病机制尚未完全明确。最近发现，与MS相关的基因变异编码的分子与特定免疫细胞亚群的功能相关，这与MS是一种针对CNS的典型T细胞介导的自身免疫性疾病的概念相符。虽然目前可用的免疫调节疗法的治疗效果进一步强化了这一概念，但在MS治疗反应中观察到的差异以及其他临床和影像学观察结果也表明，MS潜在的自身免疫发病机制比以前认为的要复杂得多。因此，迫切需要对直接来自MS患者的与疾病相关的适应性免疫细胞和组织进行持续详细的表型和功能分析，以全面揭示MS的免疫病因。在这篇综述中，我们将讨论目前可用的MS治疗方案和获批药物，包括它们如何有助于理解这种自身免疫性疾病的免疫病理学。
