Faculty of Pharmacy, Al-Quds University, P.O. Box 20002 Jerusalem, Palestinian Territory, Occupied.
Curr Top Med Chem. 2020;20(26):2391-2403. doi: 10.2174/1568026620666200924114827.
Growing concern about neurodegenerative diseases is becoming a global issue. It is estimated that not only will their prevalence increase but also morbidity and health burden will be concerning. Scientists, researchers and clinicians share the responsibility of raising the awareness and knowledge about the restricting and handicapping health restrains related to these diseases. Multiple Sclerosis (MS), as one of the prevalent autoimmune diseases, is characterized by abnormal regulation of the immune system that periodically attacks parts of the nervous system; brain and spinal cord. Symptoms and impairments include weakness, numbness, visual problems, tingling pain that are quietly variable among patients. Amyotrophic Lateral Sclerosis (ALS) is another neurodegenerative disease that is characterized by the degeneration of motor neurons in the brain and spinal cord. Unlike MS, symptoms begin with muscle weakness and progress to affect speech, swallowing and finally breathing. Despite the major differences between MS and ALS, misdiagnosis is still influencing disease prognosis and patient's quality of life. Diagnosis depends on obtaining a careful history and neurological examination as well as the use of Magnetic Resonance Imaging (MRI), which are considered challenging and depend on the current disease status in individuals. Fortunately, a myriad of treatments is available now for MS. Most of the cases are steroid responsive. Disease modifying therapy is amongst the most important set of treatments. In ALS, few medications that slow down disease progression are present. The aim of this paper is to summarize what has been globally known and practiced about MS and ALS, as they are currently classified as important growing key players among autoimmune diseases. In terms of treatments, it is concluded that special efforts and input should be directed towards repurposing of older drugs and on stem cells trials. As for ALS, it is highlighted that supportive measurements and supplementary treatments remain essentially needed for ALS patients and their families. On the other hand, it is noteworthy to clarify that the patient-doctor communication is relatively a cornerstone in selecting the best treatment for each MS patient.
对神经退行性疾病的日益关注正在成为一个全球性问题。据估计,这些疾病不仅发病率会增加,而且发病率和健康负担也令人担忧。科学家、研究人员和临床医生都有责任提高对这些疾病相关的限制和致残健康限制的认识和了解。多发性硬化症 (MS) 是一种常见的自身免疫性疾病,其特征是免疫系统异常调节,周期性攻击神经系统的某些部位;大脑和脊髓。症状和损伤包括虚弱、麻木、视力问题、刺痛,这些症状在患者之间差异很大。肌萎缩侧索硬化症 (ALS) 是另一种神经退行性疾病,其特征是大脑和脊髓中的运动神经元退化。与 MS 不同,症状始于肌肉无力,并逐渐影响言语、吞咽,最终影响呼吸。尽管 MS 和 ALS 之间存在重大差异,但误诊仍在影响疾病预后和患者的生活质量。诊断取决于获取详细的病史和神经系统检查,以及使用磁共振成像 (MRI),这些检查被认为具有挑战性,并且取决于个体的当前疾病状况。幸运的是,现在有许多治疗多发性硬化症的方法。大多数病例对类固醇有反应。疾病修正治疗是最重要的一组治疗方法之一。在 ALS 中,目前存在几种减缓疾病进展的药物。本文的目的是总结全球对 MS 和 ALS 的了解和实践,因为它们目前被归类为自身免疫性疾病中重要的新兴关键参与者。就治疗而言,结论是应该特别努力和投入,重新利用旧药物和进行干细胞试验。对于 ALS,需要强调的是,支持性措施和补充性治疗仍然是 ALS 患者及其家属的基本需要。另一方面,值得澄清的是,医患沟通相对而言是为每个 MS 患者选择最佳治疗方法的基石。