Gaitán María I, Marquez Rocio V, Ayerbe Jeremias, Reich Daniel S
National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Department of Neurology, Italian Hospital of Buenos Aires, Argentina.
Mult Scler. 2024 Dec;30(5_suppl):48-60. doi: 10.1177/13524585241301303.
This comprehensive review aims to explore imaging outcome measures targeting compartmentalized inflammation in Phase 2 clinical trials for multiple sclerosis (MS). The traditional primary imaging outcomes used in Phase 2 MS trials, new or enhancing white matter lesions on MRI, target the effects of peripheral inflammation, but the widespread inflammation behind a mostly closed blood-brain barrier is not captured. This review discusses several emerging imaging technologies that could be used as surrogate markers of compartmentalized inflammation, targeting chronic active lesions, meningeal inflammation, and innate immune activation within the normal-appearing white matter and gray matter. The integration of specific imaging outcomes into Phase 2 trials can provide a more accurate assessment of treatment efficacy, ultimately contributing to the development of more effective therapies for MS.
本综述旨在探讨在多发性硬化症（MS）的2期临床试验中针对局灶性炎症的成像结局指标。MS 2期试验中使用的传统主要成像结局指标，即MRI上新发或强化的白质病变，针对的是外周炎症的影响，但未涵盖大多封闭血脑屏障后的广泛炎症。本综述讨论了几种新兴的成像技术，这些技术可作为局灶性炎症的替代标志物，针对慢性活动性病变、脑膜炎症以及正常白质和灰质内的固有免疫激活。将特定成像结局指标纳入2期试验可更准确地评估治疗效果，最终有助于开发更有效的MS治疗方法。
