[New directions of immunocorrection in multiple sclerosis]

Area of Science:

• Neuroimmunology
• Central Nervous System Diseases

Background:

• Multiple sclerosis (MS) is a multifactorial CNS disease involving autoimmune and neurodegenerative processes.
• Genetic and environmental factors contribute to MS pathogenesis, leading to neural cell death, demyelination, and dysfunction.
• Current therapies, including anti-inflammatory and immunomodulating drugs, have limitations and potential side effects with long-term use.

Purpose of the Study:

• To review the pathogenesis of multiple sclerosis (MS).
• To examine the role of immune cells in MS development.
• To discuss existing and emerging therapeutic approaches, focusing on immunoreconstitution therapy.

Main Methods:

• Literature review of multiple sclerosis pathogenesis and therapy.
• Analysis of clinical studies on immunoreconstitution therapy agents (alemtuzumab, ocrelizumab, cladribine).

Main Results:

• Immunoreconstitution therapy shows promise for MS treatment, offering potential advantages over conventional immunomodulation and immunosuppression.
• Short courses of immunoreconstitution therapy may provide adequate treatment with fewer adverse events compared to chronic immunosuppression.
• Alemtuzumab, ocrelizumab, and cladribine are examples of drugs used in immunoreconstitution therapy.

Conclusions:

• Immunoreconstitution therapy may be a preferred treatment for select patients with highly active multiple sclerosis, particularly those at high risk of progression.
• Further research is needed to elucidate the precise mechanisms of action for immunoreconstitution therapy.
• Early application of selective immunoreconstitution therapy could be beneficial for patients with high MS activity.