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多发性硬化症的历史、病理生理学及药物干预概述

An Overview of the History, Pathophysiology, and Pharmacological Interventions of Multiple Sclerosis.

作者信息

Dighriri Ibrahim M, Aldalbahi Ahood A, Albeladi Fatimah, Tahiri Asimah A, Kinani Elaf M, Almohsen Rand A, Alamoudi Nouf H, Alanazi Abeer A, Alkhamshi Sultan J, Althomali Noha A, Alrubaiei Sultan N, Altowairqi Faisal K

机构信息

Department of Pharmacy, King Abdulaziz Specialist Hospital, Taif, SAU.

Department of Medicine, PHC Al-Qassim Health Cluster, Buraidah, SAU.

出版信息

Cureus. 2023 Jan 2;15(1):e33242. doi: 10.7759/cureus.33242. eCollection 2023 Jan.

Abstract

Multiple sclerosis (MS) is an immune-inflammatory disease that attacks and damages myelinated axons in the central nervous system (CNS) and causes nontraumatic neurological impairment in young people. Historically, Lidwina of Schiedam documented the first MS case. After that, Augustus d'Este wrote for years about how his MS symptoms worsened. Age, sex, genetics, environment, smoking, injuries, and infections, including herpes simplex and rabies, are risk factors for MS. According to epidemiology, the average age of onset is between 20 and 40 years. MS is more prevalent in women and is common in Europe and America. As diagnostic methods and criteria change, people with MS may be discovered at earlier and earlier stages of the disease. MS therapy has advanced dramatically due to breakthroughs in our knowledge of the disease's etiology and progression. Therefore, the efficacy and risk of treatment medications increased exponentially. Management goals include reducing lesion activity and avoiding secondary progression. Current treatment approaches focus on managing acute episodes, relieving symptoms, and reducing biological activity. Disease-modifying drugs such as fingolimod, interferon-beta, natalizumab, and dimethyl fumarate are the most widely used treatments for MS. For proof of the efficacy and safety of these medications, investigations in the real world are necessary.

摘要

多发性硬化症(MS)是一种免疫炎症性疾病,它侵袭并损害中枢神经系统(CNS)中的有髓轴突,导致年轻人出现非创伤性神经功能障碍。历史上,斯希丹的利德维娜记录了首例MS病例。此后,奥古斯塔斯·德·埃斯特多年来一直在记录他的MS症状是如何恶化的。年龄、性别、遗传、环境、吸烟、损伤以及感染(包括单纯疱疹和狂犬病)都是MS的风险因素。根据流行病学数据,MS的平均发病年龄在20至40岁之间。MS在女性中更为普遍,在欧美地区较为常见。随着诊断方法和标准的变化,MS患者可能在疾病的越来越早阶段被发现。由于我们对该疾病病因和进展的认识取得突破,MS治疗有了显著进展。因此,治疗药物的疗效和风险呈指数级增长。管理目标包括减少病灶活动和避免继发进展。目前的治疗方法侧重于管理急性发作、缓解症状和降低生物活性。诸如芬戈莫德、干扰素-β、那他珠单抗和富马酸二甲酯等疾病修正药物是MS最广泛使用的治疗方法。为了证明这些药物的疗效和安全性,有必要在现实世界中进行研究。

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