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跳出缺血框框思考:多发性硬化症药物在缺血性卒中治疗中的应用进展

Thinking outside the Ischemia Box: Advancements in the Use of Multiple Sclerosis Drugs in Ischemic Stroke.

作者信息

Aloizou Athina-Maria, Siokas Vasileios, Pateraki Georgia, Liampas Ioannis, Bakirtzis Christos, Tsouris Zisis, Lazopoulos George, Calina Daniela, Docea Anca Oana, Tsatsakis Aristidis, Bogdanos Dimitrios P, Dardiotis Efthimios

机构信息

Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece.

Multiple Sclerosis Center, B' Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.

出版信息

J Clin Med. 2021 Feb 7;10(4):630. doi: 10.3390/jcm10040630.

Abstract

Ischemic stroke (IS) is a major cause of death and disability, despite early intervention. Thrombo-inflammation, the inflammatory process triggered by ischemia, is a concept that ties IS with multiple sclerosis (MS), under the wider 'umbrella' of neuroinflammation, i.e., the inflammation of the nervous tissue. Drawing from this, numerous studies have explored the potential of MS disease-modifying drugs in the setting of IS. In this review, we present the available studies and discuss their potential in ameliorating IS outcomes. Based on our search, the vast majority of the studies have been conducted on animals, yielding mostly positive results. Two clinical trials involving natalizumab showed that it does not confer any benefits, but four human studies regarding fingolimod have showcased its potential in improving recovery prospects. However, concerns on safety and other issues are raised, and basic questions still need to be answered.

摘要

缺血性中风(IS)是导致死亡和残疾的主要原因,尽管有早期干预措施。血栓炎症是由缺血引发的炎症过程,在更广泛的神经炎症(即神经组织的炎症)“保护伞”下,是一个将缺血性中风与多发性硬化症(MS)联系起来的概念。据此,众多研究探索了多发性硬化症疾病修正药物在缺血性中风中的应用潜力。在本综述中,我们展示了现有研究,并讨论了它们在改善缺血性中风预后方面的潜力。基于我们的检索,绝大多数研究是在动物身上进行的,大多取得了积极结果。两项涉及那他珠单抗的临床试验表明它没有带来任何益处,但四项关于芬戈莫德的人体研究显示了其在改善恢复前景方面的潜力。然而,人们对安全性和其他问题提出了担忧,一些基本问题仍有待解答。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eda4/7914575/c190b5d7be4b/jcm-10-00630-g001.jpg

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