Multiple sclerosis-a quiet revolution.
Multiple sclerosis-a quiet revolution.
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DOI：
10.1038/nrneurol.2015.14
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发表时间：
2015-03
期刊：
影响因子：
--
通讯作者：
Lucchinetti CF
中科院分区：
文献类型：
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作者：
Ransohoff RM;Hafler DA;Lucchinetti CF
多发性硬化症（MS）被认为是一种复杂且难以解释的疾病，并且对其病因知之甚少。在此，我们强烈建议对几十年来在理解和治疗多发性硬化症方面取得的进展持积极的态度，特别是关注过去 20 年来取得的进展。与几乎所有复杂疾病一样，多发性硬化症是由遗传和环境因素相互作用引起的。近年来，强大的生化、生物信息学、流行病学和神经影像学工具已被用于多发性硬化症病因的研究。虽然目前对该疾病的易感性已得到相对较好的解释，但病程尚未得到解决，并且仍然是一个突出的挑战。在治疗领域，已有多种药物可供使用，这反映出可以在多个层面上并使用不同的策略成功地攻击该疾病。针对个体的治疗方案、风险缓解以及一线药物与二线药物的选择仍有待完成。我们认为，这一进展已经全面且不可逆转地改变了微软的格局。在这里，我们重点关注多发性硬化症治疗——研究工作中最有意义的成果。
Multiple sclerosis (MS) has been thought to be a complex and indecipherable disease, and poorly understood with regards to aetiology. Here, we suggest an emphatically positive view of progress over several decades in the understanding and treatment of MS, particularly focusing on advances made within the past 20 years. As with virtually all complex disorders, MS is caused by the interaction of genetic and environmental factors. In recent years, formidable biochemical, bioinformatic, epidemiological and neuroimaging tools have been brought to bear on research into the causes of MS. While susceptibility to the disease is now relatively well accounted for, disease course is not and remains a salient challenge. In the therapeutic realm, numerous agents have become available, reflecting the fact that the disease can be attacked successfully at many levels and using varied strategies. Tailoring therapies to individuals, risk mitigation and selection of first-line as compared with second-line medications remain to be completed. In our view, the MS landscape has been comprehensively and irreversibly transformed by this progress. Here we focus on MS therapeutics—the most meaningful outcome of research efforts.