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β干扰素在多发性硬化症中的免疫治疗:COVID-19 大流行期间经典药物的新视角。

Beta interferons as immunotherapy in multiple sclerosis: a new outlook on a classic drug during the COVID-19 pandemic.

机构信息

From the Department of Clinical Neurosciences, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.

Department of Neurology, Colentina Hospital, Bucharest, Romania.

出版信息

QJM. 2021 Dec 20;114(10):691-697. doi: 10.1093/qjmed/hcaa348.

Abstract

Beta interferons (IFN-β) are pleiotropic cytokines with antiviral properties. They play important roles in the pathogenesis of multiple sclerosis (MS), an incurable immune-mediated disorder of the central nervous system. The clinical expression of MS is heterogeneous, with relapses of neuroinflammation and with disability accrual in considerable part unrelated to the attacks. The injectable recombinant IFN-β preparations are the first approved disease-modifying treatments for MS. They have moderate efficacy in reducing the frequency of relapses, but good long-term cost-efficacy and safety profiles, so are still widely used. They have some tolerability and adherence issues, partly mitigated in recent years by the introduction of a PEGylated formulation and use of 'smart' autoinjector devices. Their general impact on long-term disability is modest but could be further improved by developing accurate tools for identifying the patient profile of best responders to IFN-β. Here, we present the IFN-β-based immunomodulatory therapeutic approaches in MS, highlighting their place in the current coronavirus disease (COVID-19) pandemic. The potential role of IFN-β in the treatment of COVID-19 is also briefly discussed.

摘要

β干扰素(IFN-β)是一种具有抗病毒特性的多功能细胞因子。它们在多发性硬化症(MS)的发病机制中发挥着重要作用,MS 是一种无法治愈的中枢神经系统免疫介导疾病。MS 的临床表现具有异质性,存在神经炎症的复发和残疾的累积,在很大程度上与发作无关。可注射的重组 IFN-β制剂是首批获批用于 MS 的疾病修正治疗药物。它们在降低复发频率方面具有中等疗效,但具有良好的长期成本效益和安全性,因此仍被广泛使用。它们存在一些耐受性和依从性问题,近年来通过引入聚乙二醇化制剂和使用“智能”自动注射器设备,这些问题在一定程度上得到了缓解。它们对长期残疾的总体影响是适度的,但通过开发识别对 IFN-β反应最佳的患者特征的准确工具,可能会进一步改善。本文介绍了 MS 中基于 IFN-β的免疫调节治疗方法,强调了它们在当前冠状病毒病(COVID-19)大流行中的地位。还简要讨论了 IFN-β 在 COVID-19 治疗中的潜在作用。

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