What do we know about the mechanism of action of disease-modifying treatments in MS?
Multiple sclerosis (MS), a chronic inflammatory disorder of the central nervous system (CNS), 2 results in damage to axons and their surrounding myelin sheath. The exact cause of inflammation remains unclear, but an autoimmune response directed against CNS antigens is suspected. MS can affect the brain, optic nerve and spinal cord, thus causing many neurological symptoms. These can include limb numbness or weakness, sensory or motor changes, ataxia, blurry vision, painful eye movements, bladder and bowel dysfunction, decreased memory, fatigue and effective disorders. This article will include a concise overview of the pathogenesis of MS in order to set the stage for subsequent discussion of the mechanisms of action of disease-modifying treatments, and whether these should influence our treatment choices. Although the exact pathogenesis of MS is not fully understood, current knowledge has already led to the development of effective treatments, namely interferon (IFN) 3 and glatiramer acetate, both of which have been shown to reduce relapse rates, while IFN 3- 1 a also reduces confirmed disability progression. Further increases in our understanding of the pathogenesis of MS are likely to assist in the identification of new targets for disease-modifying therapies and in the optimisation of current treatments..
Hartung
Hans-Peter
HP
Heinrich-Heine University, Moorenstrasse 4, 40225 Duesseldorf, Germnay. hans-peter.hartung@uni-duesseldorf.de
Bar-Or
Amit
A
Zoukos
Yannis
Y
D000938:Antigen-Presenting Cells / Q000187:drug effects; D016207:Cytokines / Q000378:metabolism; D000068717:Glatiramer Acetate; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007249:Inflammation / Q000188:drug therapy / Q000503:physiopathology; D016899:Interferon-beta / Q000737:chemistry / Q000627:therapeutic use*; D008213:Lymphocyte Activation / Q000187:drug effects; D008264:Macrophages / Q000187:drug effects; D015201:Meta-Analysis as Topic; D008954:Models, Biological; D009000:Monocytes / Q000187:drug effects; D009103:Multiple Sclerosis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010455:Peptides / Q000627:therapeutic use*
D016207:Cytokines; D007166:Immunosuppressive Agents; D018696:Neuroprotective Agents; D010455:Peptides; D000068717:Glatiramer Acetate; D016899:Interferon-beta