van Oosten B W, Truyen L, Barkhof F, Polman C H
Department of Neurology, Free University Hospital, Amsterdam, The Netherlands.
Drugs. 1995 Feb;49(2):200-12. doi: 10.2165/00003495-199549020-00005.
A growing amount of evidence suggests that a disturbance of immunological function is of importance in the pathogenesis of multiple sclerosis. This is reflected in the drugs used to slow progression and to treat relapses. Immunosuppressive drugs such as azathioprine, cyclophosphamide and cyclosporin might have some potential to slow down progression of multiple sclerosis, but their use is limited by potentially serious adverse effects. Recently, it was shown that interferon-beta-1b can diminish the exacerbation rate in multiple sclerosis without leading to unacceptable adverse effects. Nevertheless, symptomatic treatment remains of crucial importance in the management of multiple sclerosis patients. Spasticity, depression, fatigue and urinary, paroxysmal and sensory symptoms can all be alleviated to some extent with pharmacological interventions, although rehabilitation procedures and psychosocial consultations are no less important. Further therapeutic approaches to multiple sclerosis will be directed at either the specificity of the immune response or the grade of activation of the immune response. Magnetic resonance imaging techniques will play an important role in the evaluation of efficacy of new therapeutic agents.
越来越多的证据表明，免疫功能紊乱在多发性硬化症的发病机制中具有重要作用。这在用于减缓疾病进展和治疗复发的药物中得到了体现。免疫抑制药物，如硫唑嘌呤、环磷酰胺和环孢素，可能有一定潜力减缓多发性硬化症的进展，但其使用受到潜在严重不良反应的限制。最近研究表明，β-1b干扰素可降低多发性硬化症的发作率，且不会导致不可接受的不良反应。然而，对症治疗在多发性硬化症患者的管理中仍然至关重要。痉挛、抑郁、疲劳以及泌尿、阵发性和感觉症状，通过药物干预均可在一定程度上得到缓解，尽管康复程序和社会心理咨询同样重要。针对多发性硬化症的进一步治疗方法将针对免疫反应的特异性或免疫反应的激活程度。磁共振成像技术在评估新治疗药物的疗效方面将发挥重要作用。
