Department of Neurology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.
Front Immunol. 2023 Nov 29;14:1290666. doi: 10.3389/fimmu.2023.1290666. eCollection 2023.
Disease-modifying therapies for relapsing multiple sclerosis reduce relapse rates by suppressing peripheral immune cells but have limited efficacy in progressive forms of the disease where cells in the central nervous system play a critical role. To our knowledge, alemtuzumab, fumarates (dimethyl, diroximel, and monomethyl), glatiramer acetates, interferons, mitoxantrone, natalizumab, ocrelizumab, ofatumumab, and teriflunomide are either limited to the periphery or insufficiently studied to confirm direct central nervous system effects in participants with multiple sclerosis. In contrast, cladribine and sphingosine 1-phosphate receptor modulators (fingolimod, ozanimod, ponesimod, and siponimod) are central nervous system-penetrant and could have beneficial direct central nervous system properties.
用于治疗复发型多发性硬化症的疾病修正疗法通过抑制外周免疫细胞来降低复发率，但在中枢神经系统细胞起关键作用的进行性疾病形式中疗效有限。据我们所知，阿仑单抗、富马酸二甲酯、富马酸二羟甲酯、富马酸单甲酯、干扰素、米托蒽醌、那他珠单抗、奥瑞珠单抗、奥法妥木单抗和特立氟胺要么仅限于外周，要么研究不足，无法在多发性硬化症患者中确认对中枢神经系统的直接作用。相比之下，克拉屈滨和鞘氨醇 1-磷酸受体调节剂（芬戈莫德、奥扎尼莫德、泊尼莫德和西尼莫德）具有穿透中枢神经系统的能力，并且可能具有有益的直接中枢神经系统特性。
