Department of Experimental and Clinical Physiology, Medical University of Warsaw, Warszawa, Poland.
Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warszawa, Poland.
Pharmacol Rep. 2017 Aug;69(4):702-708. doi: 10.1016/j.pharep.2017.02.017. Epub 2017 Feb 22.
Multiple sclerosis (MS) is a disease of suspected autoimmune origin leading to neurodegeneration. The disease pathomechanism is considered to be primarily based on neuroinflammation directed against myelin antigens caused by autoreactive T cells. MS etiology remains still unknown, which makes it difficult to create an efficient therapy, therefore, MS treatment targets mechanisms involved in disease pathology. In this review, we present the mechanism of action of three newly registered drugs for MS. Dimethyl fumarate (DMF) is an agent presenting a broad spectrum of action. Its main activity is based on activating the nuclear factor E2 dependent pathway leading to antioxidant enzyme synthesis. DMF in general suppresses the pro-inflammatory immune activity and exerts a neuroprotective action. Teriflunomide is a more focused drug, acting as an inhibitor of pyrimidines synthesis, important for rapidly dividing cells such as activated lymphocytes. Similarly, alemtuzumab, an anti-CD52 antibody, causes depletion of mainly lymphocytes. Since in MS pathology, T and B cells are involved, this mode of action is promising.
多发性硬化症（MS）是一种疑似自身免疫性疾病，导致神经退行性病变。该疾病的发病机制被认为主要基于针对髓鞘抗原的自身反应性 T 细胞引起的神经炎症。MS 的病因仍然未知，这使得难以创建有效的治疗方法，因此，MS 的治疗靶点是涉及疾病病理的机制。在这篇综述中，我们介绍了三种新注册的 MS 药物的作用机制。富马酸二甲酯（DMF）是一种具有广泛作用的药物。其主要活性是基于激活核因子 E2 依赖性途径，导致抗氧化酶的合成。DMF 通常抑制促炎免疫活性并发挥神经保护作用。特立氟胺是一种更具针对性的药物，作为嘧啶合成的抑制剂，对活化淋巴细胞等快速分裂的细胞很重要。同样，阿仑单抗，一种抗 CD52 抗体，导致主要是淋巴细胞耗竭。由于在 MS 病理中涉及 T 和 B 细胞，这种作用模式很有前途。
