Update on neuromyelitis optica spectrum disorder.
Update on neuromyelitis optica spectrum disorder.
复制标题
视神经脊髓炎谱系障碍的研究进展。
DOI：
10.1097/icu.0000000000000703
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发表时间：
2020-11
影响因子：
3.7
通讯作者：
Levy M
中科院分区：
文献类型：
--
作者：
Holroyd KB;Manzano GS;Levy M
视神经肌病是一种自身免疫性疾病，可引起视神经炎和横肌萎缩。袭击会造成严重的神经损伤，导致失明和瘫痪。对这种疾病的免疫发病机制的理解导致了诊断和治疗的重大突破。在过去的18个月里，已经发表了三项成功的3期临床试验，使用靶向方法预防复发。在过去的18个月里，发表了流行病学、影像学、生活质量和急性复发治疗和预防方面的最新资料。流行病学研究正在根据患者对水通道蛋白-4（AQP 4）和髓鞘少突胶质细胞糖蛋白（MOG）的抗原特异性来区分患者，这两种抗原越来越多地被认为是独立的免疫学病症。通过MRI和光学相干断层扫描成像作为区分NMOSD与其他疾病的工具继续发展。这是特别相关的，因为最近的临床试验显示AQP 4血清阳性和血清阴性患者之间的反应差异。测试用于预防NMOSD复发的三种药物是依库珠单抗、inebilizumab和satralizumab。所有这些试验都是世界范围的、安慰剂对照的、双盲的研究，证明了每种方法都有明显的益处。NMOSD的最新研究已经改善了诊断和批准的治疗方法。
Neuromyelitis optica spectrum disorder is an autoimmune disease that caused optic neuritis and transverse myelitis. Attacks can cause severe neurological damage leading the blindness and paralysis. Understanding of the immunopathogenesis of this disease has led to major breakthroughs in diagnosis and treatment. In the past 18 months, three successful phase 3 clinical trials have been published using targeted approaches to preventing relapses. Updates in epidemiology, imaging, quality of life and treatment for acute relapse and prevention have been published in the past 18 months. Epidemiology studies are distinguishing patients based on their antigen specificity for aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG), which are increasingly recognized as separate immunological conditions. Imaging by MRI and optical coherence tomography continue to be developed as tools to distinguish NMOSD from other diseases. This is especially relevant as the recent clinical trials showed differences in response between AQP4 seropositive and seronegative patients. The three drugs that were tested for prevention of NMOSD relapses were eculizumab, inebilizumab and satralizumab. All of the trials were worldwide, placebo-controlled, double-masked studies that demonstrated a clear benefit with each approach. Recent research in NMOSD has resulted in improved diagnosis and approved treatments.