Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA.
Department of Neurology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Curr Opin Neurol. 2022 Jun 1;35(3):262-270. doi: 10.1097/WCO.0000000000001063.
To discuss recent changes in the multiple sclerosis (MS) treatment algorithm and to present therapies currently in MS clinical trials.
High efficacy disease modifying therapies are optimally beneficial when used in the early, inflammatory phase of MS. Bruton's tyrosine kinase has emerged as an important therapeutic target for both relapsing and progressive forms of MS. Multiple therapies targeting remyelination failed to provide conclusive evidence of broad therapeutic benefit; however, more targeted approaches offer hope that myelin repair might be achieved resulting in specific clinical improvements. Strategies targeting chronic Epstein-Barr virus infection and dysbiosis of the gut microbiome are the first to link microbial risk factors for MS and therapeutic interventions.
A striking number of diverse treatments under investigation bodes well for development of better and more effective therapies in MS.
讨论多发性硬化症（MS）治疗方案的最新变化，并介绍目前在 MS 临床试验中的治疗方法。
高效的疾病修正治疗在 MS 的早期炎症阶段使用时效果最佳。布鲁顿酪氨酸激酶已成为治疗复发和进行性 MS 的重要治疗靶点。多种针对髓鞘再生的治疗方法未能提供广泛治疗益处的确凿证据；然而，更有针对性的方法带来了希望，即髓鞘修复可能实现，从而带来特定的临床改善。针对慢性 EBV 感染和肠道微生物组失调的策略是首次将 MS 的微生物危险因素与治疗干预联系起来。
大量正在研究的不同治疗方法预示着 MS 更好、更有效的治疗方法的发展。
