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首页> 外文期刊>Annual Review of Medicine >New therapeutic approaches for multiple sclerosis.
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New therapeutic approaches for multiple sclerosis.

机译:多发性硬化症的新治疗方法。

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摘要

Although several therapies exist for multiple sclerosis (MS), the most common inflammatory demyelinating disease of the central nervous system (CNS), there remains a large unmet clinical need for more effective immunomodulatory treatments in this category of diseases and for interventions that address their neurodegenerative component, which is currently untreated. Progress in our understanding of the immunology of MS over the past 30 years has recently synergized with novel computational methods and emerging high-throughput technologies that characterize variations in DNA, RNA, proteins, and metabolites to usher in a period of intense pathophysiologic investigation. These efforts are beginning to define subsets of patients with different forms of demyelinating disease. This partitioning of patients will prove valuable as we begin to tailor immunotherapy to the underlying pathophysiologic processes of individual patients using current therapies, emerging treatments, and rational combinations of all of these treatments. Preventing the entry of lymphocytes into the CNS and modifying the nature of the immune response are treatment approaches that work in the inflammatory component of MS but have little or no effect on neurodegeneration. Two challenges confront us: to develop cocktails of therapies that shift the immune homeostasis of patients with MS toward a healthy profile, and to identify and modulate the activity of targets within the neurodegenerative component of MS.
机译:尽管存在多种治疗多发性硬化症(MS)的方法,多发性硬化症是中枢神经系统最常见的炎症性脱髓鞘疾病,但对于此类疾病以及解决其神经退行性疾病的干预措施,仍存在大量未满足的临床需求,需要更有效的免疫调节治疗组件,目前尚未处理。在过去30年中,我们对MS免疫学的理解进展与新的计算方法和新兴的高通量技术(具有表征DNA,RNA,蛋白质和代谢产物变异的特征)协同作用,从而迎来了激烈的病理生理学研究时期。这些努力开始确定患有不同形式脱髓鞘疾病的患者亚组。随着我们开始使用当前疗法,新兴疗法以及所有这些疗法的合理组合,针对个体患者的潜在病理生理过程进行免疫治疗,这种患者划分将被证明是有价值的。防止淋巴细胞进入中枢神经系统并改变免疫反应的性质是在MS的炎症成分中起作用但对神经变性几乎没有影响的治疗方法。我们面临着两个挑战:开发多种疗法,使MS患者的免疫稳态趋于健康,并鉴定和调节MS神经退行性成分内靶标的活性。

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