生物可用的中枢神经系统疾病修饰疗法用于多发性硬化症
Hans-Peter Hartung1,2,3,4, Bruce A C Cree5, Michael Barnett2
1Department of Neurology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
Frontiers in immunology
|January 1, 2024
概括
多发性硬化症 (MS) 的疾病修饰疗法主要向外围免疫细胞,在进展性MS中有效性有限. 然而,某些疗法,如克拉德里宾和斯芬戈1-酸盐受体调节剂,对直接的中枢神经系统影响有希望.
科学领域:
- 神经免疫学 神经免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 多发性硬化症 (MS) 疗法通常向外围免疫细胞,在中枢神经系统 (CNS) 病理关键的渐进形式中表现出有限的疗效.
- 目前用于复发性多发性硬化症的疾病修饰疗法 (DMT) 主要针对外围影响进行研究,但对中枢神经系统直接影响的证据不足.
研究的目的:
- 评估现有和新型DMT在多发性硬化症中对中枢神经系统产生直接有益影响的潜力.
- 确定穿透血脑屏障并可能调节中枢神经系统居民免疫细胞的多发性硬化疗法.
主要方法:
- 对各种MS DMT的药理动力学和药理动力学特性现有文献的审查.
- 对研究DMT穿越血脑屏障并与中枢神经系统居民免疫细胞相互作用的能力的分析.
主要成果:
- 大多数已批准的MS DMT (alemtuzumab, fumarates,glatiramer acetates,干扰素,mitoxantrone,natalizumab,ocrelizumab,ofatumumab,teriflunomide) 仅限于外周作用或缺乏已确认的直接中枢神经系统影响.
- 克拉迪和斯芬戈1-酸盐 (S1P) 受体调节剂 (fingolimod,ozanimod,ponesimod,siponimod) 透中枢神经系统,并有可能产生直接的中枢神经系统介导的治疗效益.
结论:
- 像克拉迪宾和S1P受体调节剂这样的疗法代表了一类有前途的多发性硬化症治疗方法,因为它们具有直接影响中枢神经系统的能力.
- 需要进一步的研究,以充分阐明这些疗法对中枢神经系统的直接影响,并优化它们在渐进性多发性硬化症中的使用.
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