Multiple sclerosis: current state

Cover Page


Cite item

Full Text

Abstract

Etiology of multiple sclerosis has both genetic and environmental components. The current conception is that multiple sclerosis pathogenesis comprises an initial inflammatory phase, followed by a phase of demyelination and last, a neurodegenerative phase. The mechanisms of inflammatory reactions, axonal loss and reparative changes have been discussed. There are two schemes of treatments: the escalating approach and the induction therapy. One of the main principles of disease modifying therapy of MS is treat-early approach. Results of interferon’s-b and glatiramer acetate comparison as first-line MS therapy have been described. The use immunosuppressive agents and future developments of MS therapy have been discussed.

 

About the authors

A. V. Peresedova

Research Center of Neurology

Email: a.v.pesedova@mail.ru
Россия, Moscow

I. A. Zavalishin

Research Center of Neurology

Author for correspondence.
Email: a.v.pesedova@mail.ru
Россия, Moscow

References

  1. Завалишин И.А., Переседова А.В., Стойда Н.И. и др. Сравнительный анализ эффективности иммуномодулирующей терапии рассеянного склероза ребифо-22 мкг, бетафероном и копаксоном (результаты 3 лет лечения). Журнал неврологии и психиатрии им. С.С. Корсакова 2007; 4 («Рассеянный склероз»): 99–105.
  2. Arnold D.L., Campagnolo D., Panitch H. et al. Glatiramer acetate after mitoxantrone induction improves MRI markers of lesion volume and permanent tissue injury in MS. J. Neurol. 2008; 255(10): 1473–1478.
  3. Ascherio A. Epstein–Barr virus in the development of multiple sclerosis. Expert Rev. Neurotherapeutics 2008; 8 (3): 331–333.
  4. Baranzini S.E., Wang J., Gibson R.A. et al. Genome-wide association analysis of susceptibility and clinical phenotype in multiple sclerosis. Hum. Mol. Genet. 2009; 18 (4): 767–778.
  5. Brown K.A. Factors modifying the migration of lymphocytes across the blood-brain barrier. Int. Immunopharmacol. 2001; 1: 2043–2062.
  6. Buckle G.J. Functional magnetic resonance imaging and multiple sclerosis: the evidence for neuronal plasticity. J. Neuroimaging 2005; 15 (Suppl. 4): 82S–93S.
  7. Capobianco M., Rizzo A., Malucchi S. et al. Glatiramer acetate is a treatment option in neutralising antibodies to interferonМbetaМpositive patients. Neurol. Sci. 2008; 29 (Suppl. 2): S227–229.
  8. Christensen T. Association of human endogenous retroviruses with multiple sclerosis and possible interactions with herpes viruses. Rev. Med. Virol. 2005; 15; 179–211.
  9. Christensen T. Human Herpesviruses in MS. Int. MS J. 2007; 14 (2): 41–47.
  10. Christensen T. The role of EBV in MS pathogenesis. Int. MS J.2006; 13: 52–57.
  11. Clausen J. Endogenous retroviruses and MS: using ERVs as disease markers. Int. MS J. 2003; 10: 22–28.
  12. Comi G. Induction vs. escalating therapy in multiple sclerosis: practical implications. Neurol. Sci. 2008; 29 (Suppl. 2): S253–255.
  13. Compston A. Mechanisms of axon-glial injury of the optic nerve. Eye 2004; 18 (11): 1182–1187.
  14. Compston A., Coles A. Multiple sclerosis. Lancet 2008; 372 (9648):1502–1517.
  15. Confavreux C., Vukusic S. Multiple sclerosis: a degenerative disease? Bull. Acad. Natl. Med. 2008; 192 (3): 483–491.
  16. Coyle P.K. Early treatment of multiple sclerosis to prevent neurologic damage. Neurology 2008; 71 (24, Suppl. 3): S3–7.
  17. Dong C., Flavell R.A. Cell fate decision: T-helper 1 and 2 subsets in immune responses. Arthritis Res. 2000; 2: 179–188.
  18. Filippi M., Bozzali M., Rovaris M. et al. Evidence for widespread axonal damage at the earliest clinical stage of multiple sclerosis. Brain 2003; 126: 433–437.
  19. Filippi M., Rocca M.A. Cortical reorganisation in patients with MS.J. Neurol. Neurosurg. Psychiatry 2004; 75 (8): 1087–1089.
  20. Filippi M., Rocca M.A. Disturbed function and plasticity in multiple sclerosis as gleaned from functional magnetic resonance imaging. Curr. Opin. Neurol. 2003; 16 (3): 275–282.
  21. Fong J.S., RaeбGrant A., Huang D. Neurodegeneration and neuroprotective agents in multiple sclerosis. Recent Pat. CNS Drug Discov. 2008; 3 (3): 153–165.
  22. Freedman M.S. Induction vs. escalation of therapy for relapsing multiple sclerosis: the evidence. Neurol. Sci. 2008; 29 (Suppl. 2): S250–252.
  23. Goodin D.S., Cohen B.A., O’Connor P. et al. Assessment: the use of natalizumab (Tysabri) for the treatment of multiple sclerosis (an evidence-based review): report of the Therapeutics and Technology AssesМ sment Subcommittee of the American Academy of Neurology. Neurology 2008; 71 (10): 766–773.
  24. Hemmer B., Archelos J.J., Hartung HбP. New concepts in the immunopathogenesis of multiple sclerosis. Nat. Rev. Neurosci. 2002; 3: 291–301.
  25. Hohlfeld R. Biotechnological agents for the immunotherapy of multiple sclerosis. Principles, problems and perspectives [Invited review]. Brain 1997; 120: 865–916.
  26. Le Page E., Leray E., Taurin G. et al. Mitoxantrone as induction treatment in aggressive relapsing remitting multiple sclerosis: treatment response factors in a 5 year follow-up observational study of 100 conseМ cutive patients. J. Neurol. Neurosurg. Psychiatry 2008; 79 (1): 52–56.
  27. MartinezбForero I., Pelaez A., Villoslada P. Pharmacogenomics of multiple sclerosis: in search for a personalized therapy. Expert Opin. Pharmacother. 2008; 9 (17): 3053–3067.
  28. Menge T., Weber M.S., Hemmer B. et al. Disease-modifying agents for multiple sclerosis: recent advances and future prospects. Drugs 2008; 68 (17): 2445–2468.
  29. Mikol D.D., Barkhof F., Chang P. et al. Comparison of subcutaneous interferon beta-1a with glatiramer acetate in patients with relapsing multiple sclerosis (the REbif vs Glatiramer Acetate in Relapsing MS Disease [REGARD] study): a multicentre, randomised, parallel, open-label trial. Lancet Neurol. 2008; 7 (10): 903–914.
  30. Neuhaus O., Archelos J.J., Hartung H.бP. Immunomodulation in multiple sclerosis: from immunosuppression to neuroprotection. TRENDS Pharmacol. Sci. 2003; 24 (3): 131–138.
  31. Neumann H., Cavalie A., Jenne D., Wekerle H. Induction of MHC class I genes in neurons. Science 1995; 269: 549–552.
  32. Oksenberg J.R., Baranzini S.E., Sawcer S., Hauser S.L. The genetics of multiple sclerosis: SNPs to pathways to pathogenesis. Nat. Rev. Genet. 2008; 9 (7): 516–526.
  33. Polman C.H., O’Connor P.W., Havrdova E. et al. A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. N. Engl. J. Med. 2006; 354 (22): 2387–2389.
  34. Pozzilli C., Antonini G., Bagnato F. et al. Monthly corticosteroids decrease neutralizing antibodies to IFNbeta1 b: a randomized trial in multiple sclerosis. J. Neurol. 2002; 249 (1): 50–56.
  35. Ramagopalan S.V., Deluca G.C., Degenhardt A., Ebers G.C. The genetics of clinical outcome in multiple sclerosis. J. Neuroimmunol. 2008; 183–199; 201–202.
  36. Reddy H., Narayanan S., Arnoutelis R. et al. Evidence for adaptive functional changes in the cerebral cortex with axonal injury from multiple sclerosis. Brain 2000; 123: 2314–2320.
  37. Rieckmann P., Maurer M. Anti-inflammatory strategies to prevent axonal injury in multiple sclerosis. Curr. Opin. Neurol. 2002; 15: 361–370.
  38. Rocca M.A., Filippi M. Functional MRI in multiple sclerosis. J. Neuroimaging 2007; 17 (Suppl. 1): 36S–41S.
  39. Rose J.W., Foley J., Carlson N. Monoclonal antibody treatments for multiple sclerosis. Curr. Neurol. Nerosci. Rep. 2008; 8 (5): 419–426.
  40. Steinman L. Multiple sclerosis: a two-stage disease. Natl. Immunol. 2001; 2: 762–764.
  41. Torkildsen O., Nyland H., Myrmel H., Myhr K.M. Epstein-Barr virus reactivation and multiple sclerosis. Eur. J. Neurol. 2008; 15 (1): 106–108.
  42. Trapp B.D., Ransohoff R.M., Fisher E., Rudick R.A. Neurodegeneration in multiple sclerosis: relationship to neurological disability. Neuroscientist 1999; 5: 48–57.
  43. Wegner C., Filippi M., Korteweg T. et al. Relating functional changes during hand movement to clinical parameters in patients with multiple sclerosis in a multi-centre fMRI study. Eur. J. Neurol. 2008; 15 (2): 109–110.
  44. Wilkins A., Scolding N. Protecting axons in multiple sclerosis. Mult. Scler. 2008; 14 (8): 1013–1025.
  45. Yong V.W. Differential mechanisms of action of interferon-β and glatiramer acetate in MS. Neurology 2002; 59: 802–808.
  46. Zaffaroni M., Rizzo A., Baldini S.M. et al. Induction and addon therapy with mitoxantrone and interferon beta in multiple sclerosis. Neurol. Sci. 2008; 29 (Suppl. 2): S230–232.
  47. Zipoli V., Potaccio E., Hakiki B. et al. Intravenous mitoxantrone and cyclophosphamide as second-line therapy in multiple sclerosis: an open-label comparative study of efficacy and safety. J. Neurol. Sci. 2008; 266 (1–2): 25–30.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2009 Peresedova A.V., Zavalishin I.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-83204 от 12.05.2022.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies