Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-2533Eco-Vector38010.17816/psaic380ReviewsОбзорыUnknownMultiple sclerosis: current stateСовременное состояние проблемы рассеянного склерозаPeresedovaA. V.ПереседоваA. В.
Russian Federation
a.v.pesedova@mail.ruZavalishinI. A.ЗавалишинИ. A.
Russian Federation
a.v.pesedova@mail.ruResearch Center of NeurologyФГБНУ «Научный центр неврологии»1403200931434707022017Copyright ©; 2009, Peresedova A.V., Zavalishin I.A.Copyright ©; 2009, Peresedova A.V., Zavalishin I.A.2009Peresedova A.V., Zavalishin I.A.Peresedova A.V., Zavalishin I.A.https://creativecommons.org/licenses/by/4.0https://annaly-nevrologii.com/pathID/article/view/380

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.

Мультифакториальная теория этиологии рассеянного склероза предполагает взаимодействие экзогенных факторов внешней среды и генетической предрасположенности. Концепция патогенеза этого заболевания в настоящее время включает выделение начальной воспалительной фазы, сопровождающейся фазой демиелинизации, а затем фазой нейродегенерации. В статье рассматриваются механизмы иммуно-воспалительных реакций, аксонального повреждения и репаративных изменений при рассеянном склерозе. Сейчас обсуждаются две схемы его терапии: эскалационная и индукционная. Одним из основных принципов является раннее назначение лечения, модулирующего течение болезни. Приведены результаты сравнительного анализа клинической эффективности иммуномодулирующих препаратов первой линии (интерфероны-бета и глатирамера ацетат). Обсуждаются использование цитостатических препаратов и перспективы патогенетической терапии рассеянного склероза.

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