Glatirameracetat und Mitoxantron in der Behandlung der Multiplen Sklerose

Zusammenfassung

Glatirameracetat (GLAT) als Copaxone^® in Deutschland im Handel, ist ein myelinbasisches Analogon, das im Tierversuch eine experimentell allergische Enzephalomyelitis (EAE) supprimiert. Es bindet an MHC-Moleküale von Antigen-präasentierenden Zellen mit Myelinproteinen (MBP, PLP) und induziert eine Verschiebung von TH1-zu TH2-Reaktionen. Nach mehreren offenen Pilotstudien mit Hinweisen auf therapeutische Wirksamkeit wurde durch doppelblinde, kontrollierte, randomisierte Studien am Menschen die Wirksamkeit von GLAT bei der Multiplen Sklerose (MS) nachgewiesen. Mitoxantron (Mx) ist ein synthetisches Antrachinon, das die DNS-Replikation hemmt und die Messenger-RNS-Synthese blockiert. Es supprimiert die Bildung von B-Lymphozyten und CD4-positiven Helferzellen. Im Tierexperiment unterdrüackt es die Entwicklung einer EAE. Bei MS-Patienten verbessert Mx v. a. in Kombination mit Methylprednisolon sowohl klinische als auch MRT-Parameter.

Summary

Glatirameracetate (with the trademark Capaxone^® in Germany) is a myelinbasic analogon which suppresses the developping of experimental autoimmune encephalomyelitis (EAE) in animal experiments. It binds to the major histocompatibility complex (MHC) molecules of antigen-presenting cells and induces a shift from TH1-to TH2-cells. GLAT has shown therapeutic efficacy in MSpatients in double blinded randomised controlled clinical studies with reduction of the annual rate of exacerbating and of GD-enhancing lesions in MRT. Mitoxantron (Mx) is a synthetic antrachinone, which inhibits the DNA replication and blocks the synthesis of messenger RNA. It suppresses the development of B-lymphozytes and of CD4 positive helper cells. In animal experiments it inhibits the development of EAE. In MS-patients Mx improves both clinical and MRI indices of disease activity, in particular in combination with methylprednisolone.

Schlüsselwörter

Glatirameracetat - Mitoxantron - Multiple Sklerose (MS)

Keywords

Glatirameracetate - Mitoxantron - Multiple Sclerosis (MS)

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