Wanscher B, Sørensen P S
Rigshospitalet, København.
Ugeskr Laeger. 1994 Oct 24;156(43):6353-8.
Multiple sclerosis is a demyelinating disease of unknown origin. Immunological processes are thought to be of pathophysiological importance. Immunosuppressive treatment has been tried with various drugs in order to influence the immunological process. Steroid hormones are able to reduce the duration of an acute attack, but have no influence on the long-term progression. Cyclophosphamide can reduce disease activity a little, but has severe side effects. Azathioprine may reduce the frequency of acute attacks and disease progression a little. Cyclosporine A in the treatment of multiple sclerosis is only effective in doses so high that the side effects are unacceptable. Plasmapheresis in combination with immunosuppressive treatment is shown to stabilize the disease in some experiments. Intravenous polyclonal immunoglobulin has shown promising results in the treatment of other immunologically based diseases, and is a potentially beneficial treatment in multiple sclerosis. At Rigshospitalet, ongoing clinical trials will evaluate the efficacy of plasmapheresis and polyclonal immunoglobulin.
多发性硬化症是一种病因不明的脱髓鞘疾病。免疫过程被认为具有病理生理学重要性。为了影响免疫过程,人们尝试使用各种药物进行免疫抑制治疗。类固醇激素能够缩短急性发作的持续时间,但对疾病的长期进展没有影响。环磷酰胺可以稍微降低疾病活动度,但有严重的副作用。硫唑嘌呤可能会稍微降低急性发作的频率和疾病进展。环孢素A用于治疗多发性硬化症时,只有在剂量高到副作用无法接受的情况下才有效。在一些实验中,血浆置换联合免疫抑制治疗显示可使疾病稳定。静脉注射多克隆免疫球蛋白在治疗其他基于免疫的疾病中已显示出有前景的结果,并且在多发性硬化症中是一种潜在有益的治疗方法。在里格霍斯皮塔尔,正在进行的临床试验将评估血浆置换和多克隆免疫球蛋白的疗效。