衰老对多发性硬化症患者治疗考虑因素的影响
Gabrielle Macaron1,2,3,4, Catherine Larochelle1,2,3, Nathalie Arbour1,2,3
1Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.
Frontiers in neurology
|July 24, 2023
概括
多发性硬化症 (MS) 现在影响到更多的老年人,疾病在50岁左右恶化,独立于炎症. 老龄化影响MS病理生理学,治疗疗效,增加风险,需要量身定制的治疗策略.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 老年学是一门学科.
背景情况:
- 全球人口正在老龄化,导致多发性硬化症 (MS) 流行病学转向老年人群.
- 在55-65岁之间,MS患病率达到顶峰,观察到与年龄相关的病理生理变化.
- 在MS的第五个十年左右,残疾恶化似乎独立于先前的疾病活动.
研究的目的:
- 审查老龄化对MS病理生物学和临床进展的影响.
- 讨论伴随性疾病和混因素在老年人MS症状恶化的作用.
- 检查对患有多发性硬化症的老年个体的当前治疗考虑.
主要方法:
- 对老年人群中多发性硬化现有研究的审查.
- 分析MS病理生理学的年龄相关变化.
- 在老年多发性硬化患者中评估疾病修饰疗法 (DMT) 的治疗疗效和不良影响.
主要成果:
- 随着年龄的增长,多发性硬化症的病理生理学从活跃的脱髓化转变为慢性燃烧的病变.
- 衰老会降低中枢神经系统 (CNS) 组织储备和复髓化能力,从而影响复发的恢复.
- 随着年龄的增长,DMT的疗效可能会下降,老年人面临更高的副作用和并发症风险.
结论:
- 衰老显著改变了MS的进展和对治疗的反应.
- 伴随性疾病和中枢神经系统性降低使老年多发性硬化患者的临床恶化解释复杂化.
- 个性化治疗策略,包括潜在的DMT停药,对于管理患有多发性硬化症的老年人至关重要.
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