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多发性硬化症:当前药物治疗及新兴治疗前景的叙述性综述。

Multiple sclerosis: a narrative overview of current pharmacotherapies and emerging treatment prospects.

机构信息

Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland.

Biomedical Physics Division, Faculty of Physics, University of Warsaw, Warsaw, Poland.

出版信息

Pharmacol Rep. 2024 Oct;76(5):926-943. doi: 10.1007/s43440-024-00642-0. Epub 2024 Aug 23.

Abstract

Multiple sclerosis (MS) is a chronic autoimmune disease characterized by pathological processes of demyelination, subsequent axonal loss, and neurodegeneration within the central nervous system. Despite the availability of numerous disease-modifying therapies that effectively manage this condition, there is an emerging need to identify novel therapeutic targets, particularly for progressive forms of MS. Based on contemporary insights into disease pathophysiology, ongoing efforts are directed toward developing innovative treatment modalities. Primarily, monoclonal antibodies have been extensively investigated for their efficacy in influencing specific pathological pathways not yet targeted. Emerging approaches emphasizing cellular mechanisms, such as chimeric antigen receptor T cell therapy targeting immunological cells, are attracting increasing interest. The evolving understanding of microglia and the involvement of ferroptotic mechanisms in MS pathogenesis presents further avenues for targeted therapies. Moreover, innovative treatment strategies extend beyond conventional approaches to encompass interventions that target alterations in microbiota composition and dietary modifications. These adjunctive therapies hold promise as complementary methods for the holistic management of MS. This narrative review aims to summarize current therapies and outline potential treatment methods for individuals with MS.

摘要

多发性硬化症(MS)是一种慢性自身免疫性疾病,其特征是中枢神经系统内脱髓鞘、随后轴突丢失和神经退行性变的病理过程。尽管有许多疾病修饰疗法可有效治疗这种疾病,但仍需要确定新的治疗靶点,特别是对于进行性多发性硬化症。基于对疾病病理生理学的当代见解,正在努力开发创新的治疗方式。主要是,单克隆抗体已被广泛研究,以评估其在影响尚未靶向的特定病理途径方面的功效。强调细胞机制的新兴方法,如针对免疫细胞的嵌合抗原受体 T 细胞疗法,正引起越来越多的关注。对小胶质细胞的认识不断发展,以及铁死亡机制在多发性硬化症发病机制中的参与,为靶向治疗提供了进一步的途径。此外,创新的治疗策略不仅限于传统方法,还包括针对微生物组组成变化和饮食改变的干预措施。这些辅助治疗方法有望作为多发性硬化症整体管理的补充方法。本综述旨在总结当前的治疗方法,并概述多发性硬化症患者的潜在治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b142/11387431/08de2e562fd1/43440_2024_642_Fig1_HTML.jpg

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