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多发性硬化症

Multiple sclerosis.

作者信息

Cotsapas Chris, Mitrovic Mitja, Hafler David

机构信息

Department of Neurology, Yale School of Medicine, New Haven, CT, United States.

Department of Neurology, Yale School of Medicine, New Haven, CT, United States.

出版信息

Handb Clin Neurol. 2018;148:723-730. doi: 10.1016/B978-0-444-64076-5.00046-6.

Abstract

Multiple sclerosis is a potentially progressive, autoimmune neurologic disorder of the central nervous system, resulting from an autoimmune attack on central nervous system white matter. It is a leading cause of neurologic symptoms in young adults, with no known cure. Emerging disease-modifying therapies aim to control symptoms, with increasingly sophisticated immune function modulation. Though several environmental exposures increase the risk of developing the disease, a large fraction of overall risk is heritable and can be attributed to hundreds of common genetic variants influencing gene regulation in specific immune subsets. Here, we review the history of the disease, the realization that risk is heritable, and the recent revelation of hundreds of genetic variants driving this risk by international consortia studying tens of thousands of patients. Finally, we discuss how these results are revealing the specific pathobiology of multiple sclerosis and how this knowledge is transforming drug discovery.

摘要

多发性硬化症是一种潜在进展性的自身免疫性中枢神经系统神经疾病,由针对中枢神经系统白质的自身免疫攻击引起。它是年轻成年人神经症状的主要原因,目前尚无已知的治愈方法。新兴的疾病修正疗法旨在通过日益复杂的免疫功能调节来控制症状。尽管几种环境暴露会增加患该病的风险,但总体风险的很大一部分是可遗传的,可归因于数百种影响特定免疫亚群基因调控的常见基因变异。在此,我们回顾该疾病的历史、对风险具有遗传性的认识,以及国际财团通过研究数万名患者最近揭示的数百种导致这种风险的基因变异。最后,我们讨论这些结果如何揭示多发性硬化症的具体病理生物学,以及这些知识如何改变药物研发。

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