双阴性光学神经炎:在稳定10年后,有可能中止治疗
1Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Neurologia, Grupo de Neuroimunologia, São Paulo SP, Brazil.
Arquivos de neuro-psiquiatria
|February 4, 2026
概括
患有双重阴性神经炎光学谱障碍 (DS-NMOSD) 的稳定患者可能不需要终身免疫治疗. 可以考虑谨慎的,个性化的治疗中断,特别是对于那些持续缓解的人来说,以避免长期风险.
科学领域:
- 神经免疫学 神经免疫学
- 神经学 神经学
- 临床医学 临床医学
背景情况:
- 双阴性脑神经炎光学谱系障碍 (DS-NMOSD) 呈现异质的表型,包括单相和复发性过程.
- 由于复发的担忧,DS-NMOSD经常被处方终身免疫疗法,这可能导致不必要的长期不良影响和成本.
- 与水素4 (AQP4) 阳性NMOSD相比,DS-NMOSD的独特病理生理机制挑战了现有的治疗-停药数据的直接应用.
研究的目的:
- 评估稳定双阴性神经炎光学谱障碍 (DS-NMOSD) 患者终身免疫治疗的必要性.
- 根据缓解持续时间和复发风险,探索DS-NMOSD中治疗中断的可能性.
- 在DS-NMOSD中为免疫疗法管理提供临床决策信息.
主要方法:
- 对双重阴性神经炎光学谱障碍 (DS-NMOSD) 的临床表型和复发模式的审查.
- 分析典型的复发时间,并确定低复发风险的潜在指标.
- 考虑现有的数据和临床实践,关于在NMOSD中中止治疗.
主要成果:
- 大约三分之一的DS-NMOSD患者表现出单相性疾病过程.
- 在DS-NMOSD中复发的中位时间约为3.4年 (范围:0-7年).
- 持续缓解超过10年可能表明患有复发风险较低的患者子组.
结论:
- 对所有DS-NMOSD患者来说,终身免疫疗法可能不是普遍要求的,特别是那些持续缓解的患者.
- 应考虑对稳定的DS-NMOSD患者进行个性化和谨慎的治疗中断,以共享决策为指导.
- 需要进行进一步的前性研究,以确定DS-NMOSD治疗中断的最终指南.
相关概念视频
01:53RNA Stability
35.7K
Intact DNA strands can be found in fossils, while scientists sometimes struggle to keep RNA intact under laboratory conditions. The structural variations between RNA and DNA underlie the differences in their stability and longevity. Because DNA is double-stranded, it is inherently more stable. The single-stranded structure of RNA is less stable but also more flexible and can form weak internal bonds. Additionally, most RNAs in the cell are relatively short, while DNA can be up to 250 million...
35.7K
03:18Nuclear Stability
23.3K
Protons and neutrons, collectively called nucleons, are packed together tightly in a nucleus. With a radius of about 10−15 meters, a nucleus is quite small compared to the radius of the entire atom, which is about 10−10 meters. Nuclei are extremely dense compared to bulk matter, averaging 1.8 × 1014 grams per cubic centimeter. If the earth’s density were equal to the average nuclear density, the earth’s radius would be only about 200 meters.
To hold positively charged protons together...
To hold positively charged protons together...
23.3K
01:28Stability
419
The time response of a linear time-invariant (LTI) system can be divided into transient and steady-state responses. The transient response represents the system's initial reaction to a change in input and diminishes to zero over time. In contrast, the steady-state response is the behavior that persists after the transient effects have faded.
The stability of an LTI system is determined by the roots of its characteristic equation, known as poles. A system is stable if it produces a bounded...
The stability of an LTI system is determined by the roots of its characteristic equation, known as poles. A system is stable if it produces a bounded...
419
02:04Fixing Double-strand Breaks
14.8K
The double-stranded structure of DNA has two major advantages. First, it serves as a safe repository of genetic information where one strand serves as the back-up in case the other strand is damaged. Second, the double-helical structure can be wrapped around proteins called histones to form nucleosomes, which can then be tightly wound to form chromosomes. This way, DNA chains up to 2 inches long can be contained within microscopic structures in a cell. A double-stranded break not only damages...
14.8K
01:14Stability of structures
531
In mechanical engineering, the stability of systems under various forces is critical for designing durable and efficient structures. One fundamental way to explore these concepts is by analyzing systems like two rods connected at a pivot point, O, with a torsional spring of spring constant k at the pivot point. This system is similar in appearance to a scissor jack used to change tires on a car. In this case, the arms of the linkage (equivalent to the rods in this system) are entirely vertical,...
531
01:24Pole and System Stability
975
The transfer function is a fundamental concept representing the ratio of two polynomials. The numerator and denominator encapsulate the system's dynamics. The zeros and poles of this transfer function are critical in determining the system's behavior and stability.
Simple poles are unique roots of the denominator polynomial. Each simple pole corresponds to a distinct solution to the system's characteristic equation, typically resulting in exponential decay terms in the system's...
Simple poles are unique roots of the denominator polynomial. Each simple pole corresponds to a distinct solution to the system's characteristic equation, typically resulting in exponential decay terms in the system's...
975