Sapko Klaudia, Jamroz-Wiśniewska Anna, Rejdak Konrad
Department of Neurology, Medical University of Lublin, 20-059 Lublin, Poland.
J Clin Med. 2022 Jun 10;11(12):3342. doi: 10.3390/jcm11123342.
Multiple sclerosis (MS) is a widely known inflammatory, demyelinating disease of the central nervous system. The pathogenesis of progressive multiple sclerosis (PMS) is a complex, multi-level process that causes therapeutic difficulties. Along with variables such as age and duration of the disease, pathogenetic mechanisms change from inflammatory to neurodegenerative processes. Therefore, the efficacy of available anti-inflammatory drugs approved for the treatment of PMS, such as ocrelizumab or siponimod, is limited in time. In search of innovative solutions, several research studies have been conducted to evaluate the effectiveness of drugs with neuroprotective or remyelinating effects in PMS, including biotin, ibudilast, simvastatin, alpha-lipoic acid, clemastine, amiloride, fluoxetine, riluzole, masitinib, opicinumab, and lamotrigine. The current review includes those compounds, which have entered the clinical phase of assessment, and the authors discuss future prospects for successful PMS treatment.
多发性硬化症(MS)是一种广为人知的中枢神经系统炎性脱髓鞘疾病。进行性多发性硬化症(PMS)的发病机制是一个复杂的、多层面的过程,这导致了治疗上的困难。随着年龄和病程等变量的变化,发病机制从炎症过程转变为神经退行性过程。因此,已获批用于治疗PMS的现有抗炎药物,如奥瑞珠单抗或西普尼莫德,其疗效在时间上是有限的。为了寻找创新解决方案,已经开展了多项研究来评估具有神经保护或髓鞘再生作用的药物在PMS中的有效性,这些药物包括生物素、异丁司特、辛伐他汀、α-硫辛酸、氯马斯汀、阿米洛利、氟西汀、利鲁唑、马西替尼、奥匹珠单抗和拉莫三嗪。本综述纳入了那些已进入评估临床阶段的化合物,作者们讨论了成功治疗PMS的未来前景。