Neue therapeutische Konzepte bei der Multiplen Sklerose

Zusammenfassung

Die Multiple Sklerose (MS) ist die in unseren Breitengraden häufigste chronisch entzündliche Erkrankung des zentralen Nervensystems (ZNS), die bereits im jungen Erwachsenenalter zu deutlichen neurologischen Behinderungen führen kann. Obwohl eine ursächlich kurative Behandlung der MS nicht möglich ist, konnten in den letzten Jahren aus der grundlagenorientierten MS-Forschung neue therapeutische Konzepte entwickelt werden. Neuesten Erkenntnissen nach sind bereits in Anfangsstadien der MS ausgeprägte entzündlich-neurodegenerative Veränderungen vorhanden. Das Ausmaß der neuronalen Schädigung wird als ein wesentlicher Faktor für die tatsächlichen neurologischen Defizite der Patienten angesehen. Gleichzeitig legen klinische und experimentelle Befunde nahe, dass bestimmte Unterformen der MS immunologisch abgegrenzt werden können, so z. B. die Neuromyelitis optica (Devic-Syndrom). Der folgende Ausblick umreißt die wichtigsten Erkenntnisse zu diesen Bereichen und stellt neue Substanzen einschließlich oraler Therapieverfahren vor, die sich teilweise in fortgeschrittenen klinischen Studien bewährt haben und bald praktische Relevanz in der MS-Therapie gewinnen könnten.

Summary

Multiple sclerosis (MS) is one of the most important causes for sustained neurological deficits in young adults and still an incurable disorder. Thus, current research in MS aims at a better understanding of disease pathology in order to identify new therapeutic targets. According to recent findings, the inflammatory neurodegenerative process may lead to sustained neurological damage from the earliest phases of disease on and are responsible for fixed neurological deficits of patients. Moreover, immunological and histopathological data indicate that certain subsets of MS could be regarded as own disease entities, as this may be the case for neuromyelitis optica (Devic’s syndrome). Here we describe the current model of disease pathology and discuss new therapeutic strategies including oral remedies which have shown efficacy in advanced clinical studies and might open up a new avenue of MS therapy.

Schlüsselwörter

Multiple Sklerose - Pathogenese - Therapie - Antikörper

Keywords

Multiple sclerosis - pathogenesis - therapy - antibody

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