Department of Microbiology and Immunology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Khaghani St., Shariati Ave., P.O Box: 19395/1495, Tehran, Iran.
Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Inflamm Res. 2019 Jan;68(1):25-38. doi: 10.1007/s00011-018-1185-0. Epub 2018 Sep 3.
Multiple sclerosis (MS) is a chronic and autoimmune disease of the central nervous system (CNS), mainly characterized by inflammatory demyelination, which manifests as relapses and diffuse damage and brain volume loss, both accounting for neurodegeneration, and therefore, physical disability. MS typically affects young adults and is commonly diagnosed in the early years by acute relapses, which then followed through partial or complete remission period. The clinical course of MS is characterized as four major classifications, including relapsing-remitting (RRMS), primary progressive (PPMS), progressive relapsing (PRMS), and secondary progressive (SPMS).
This review provides comprehensive overview of the current treatments and future innovative approaches in the treatment of MS.
Currently, there is no definite cure for MS. The treatment of MS has mainly been based on the prescription of immunosuppressive and immune-modulating agents. However, a number of disease-modifying treatments (DMTs) have been designed that reduce the attack rate and delay progression and mainly target inflammation settings in these patients. Although remarkable advancements have occurred in the therapy of MS, the rate of progressive disability and early mortality is still worrisome. Recently, a monoclonal antibody (ocrelizumab) was demonstrated to be beneficial in a clinical trial of primary progressive MS. Furthermore, novel treatment strategies concentrating on the remyelination or neuroprotection are under evaluation.
In spite of prosperous experiences in MS therapy, the future research, hopefully, will bring substantial improvements in the understanding and approaches of MS therapy.
多发性硬化症（MS）是一种中枢神经系统（CNS）的慢性自身免疫性疾病，主要表现为炎症性脱髓鞘，表现为复发和弥漫性损伤以及脑容量损失，两者均导致神经退行性变，从而导致身体残疾。MS 通常影响年轻人，通常在急性复发的早期被诊断出来，然后经历部分或完全缓解期。MS 的临床病程特征为四大分类，包括复发缓解型（RRMS）、原发进展型（PPMS）、进展复发型（PRMS）和继发进展型（SPMS）。
本综述提供了 MS 治疗的当前治疗方法和未来创新方法的全面概述。
目前，MS 没有明确的治愈方法。MS 的治疗主要基于免疫抑制剂和免疫调节剂的处方。然而，已经设计了许多疾病修饰治疗（DMT），这些治疗可以降低攻击率并延迟进展，主要针对这些患者的炎症环境。尽管 MS 的治疗取得了显著进展，但进行性残疾和早期死亡率仍然令人担忧。最近，一项临床试验表明，单克隆抗体（ocrelizumab）对原发性进展型 MS 有益。此外，正在评估集中于髓鞘再生或神经保护的新型治疗策略。
尽管 MS 治疗经验丰富，但未来的研究有望在 MS 治疗的理解和方法上带来实质性的改进。
