Nessler Jasmin N, Tipold Andrea
Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.
Front Vet Sci. 2024 Oct 15;11:1465689. doi: 10.3389/fvets.2024.1465689. eCollection 2024.
Meningoencephalitis of unknown origin (MUO) represents an umbrella term for inflammatory, non-infectious central nervous system (CNS) diseases in dogs. Current therapeutic approaches, involving long-term glucocorticosteroid use, often fail to provide adequate relief or cure, and the effectiveness of additional immunosuppressive medications remains uncertain. Future advancements in MUO treatment may benefit from patient-specific therapies, potentially enhancing treatment precision, efficacy, and minimizing side effects. However, significant challenges impede this progress, including ambiguity in MUO subtype classification, uncertainties regarding the autoimmune nature vs. infectious triggers, and the lack of reliable diagnostic biomarkers. Clinical heterogeneity and overlapping signs with other encephalopathies further complicate diagnosis and treatment. This review gives an overview about diagnostic findings and immunological features of MUO. It advocates for a more overall characterization of MUO by using a polythetic system to better characterize MUO subtypes, identify immunological treatment targets, and establish a conceptual foundation for future therapeutic trials. Addressing these themes may lead to more effective and less burdensome treatments, improving the quality of life for dogs afflicted with MUO and their owners.
不明原因脑膜脑炎（MUO）是犬类炎症性、非感染性中枢神经系统（CNS）疾病的统称。目前的治疗方法，包括长期使用糖皮质激素，往往无法提供充分缓解或治愈效果，且其他免疫抑制药物的有效性仍不确定。MUO治疗的未来进展可能受益于针对个体患者的疗法，这有可能提高治疗的精准度、疗效，并将副作用降至最低。然而，重大挑战阻碍了这一进展，包括MUO亚型分类不明确、自身免疫性质与感染触发因素的不确定性，以及缺乏可靠的诊断生物标志物。临床异质性以及与其他脑病的体征重叠进一步使诊断和治疗复杂化。本综述概述了MUO的诊断结果和免疫特征。它主张通过使用多性状系统对MUO进行更全面的表征，以更好地描述MUO亚型、确定免疫治疗靶点，并为未来的治疗试验奠定概念基础。解决这些问题可能会带来更有效且负担更小的治疗方法，改善患有MUO的犬及其主人的生活质量。
