Miller A
Division of Neurology, Maimonides Medical Center, Brooklyn, NY 11219, USA.
South Med J. 1997 Apr;90(4):367-75. doi: 10.1097/00007611-199704000-00001.
Extensive research is under way to develop pharmacotherapeutic agents that will prevent the exacerbations and the progression of neurologic disability associated with multiple sclerosis (MS). The most intensive research strategy has involved agents intended to limit demyelination by reducing inflammation and modifying the immune response. In this category are interferon beta-1b, the first compound approved for use outside of clinical trials; interferon beta-1a; and copolymer 1. Experimental agents include other interferons, methotrexate, linomide, monoclonal antibodies, T-cell receptor peptides, and 2-chlorodeoxyadenosine. Although they have been used effectively to treat exacerbations of MS, corticosteroids and corticotropin are now under evaluation as disease-modifying agents. A second strategy, enhancing remyelination by limiting demyelination and oligodendrocyte injury, is represented by protein growth factors. A third therapeutic approach, improving conduction in demyelinated fibers, is represented by the potassium channel blockers 4-aminopyridine and 3,4-diaminopyridine.
目前正在进行广泛的研究，以开发能够预防与多发性硬化症（MS）相关的病情加重和神经功能障碍进展的药物治疗剂。最密集的研究策略涉及旨在通过减轻炎症和调节免疫反应来限制脱髓鞘的药物。这一类药物包括β-1b干扰素（第一种在临床试验之外被批准使用的化合物）、β-1a干扰素和共聚肽1。实验性药物包括其他干扰素、甲氨蝶呤、来诺米德、单克隆抗体、T细胞受体肽和2-氯脱氧腺苷。尽管皮质类固醇和促肾上腺皮质激素已被有效地用于治疗MS病情加重，但目前正在评估它们作为疾病改善剂的作用。第二种策略是通过限制脱髓鞘和少突胶质细胞损伤来促进髓鞘再生，以蛋白质生长因子为代表。第三种治疗方法是改善脱髓鞘纤维的传导，以钾通道阻滞剂4-氨基吡啶和3,4-二氨基吡啶为代表。
