Fortschritte in Pathogeneseforschung und Therapie der Multiplen Sklerose

Zusammenfassung

In dieser Übersichtsarbeit stellen wir die in den letzten Jahren erzielten Fortschritte bei der Erforschung der Multiplen Sklerose dar und diskutieren sie kritisch. Aus klinischen, bildgebenden, pathologischen, immunologischen und tierexperimentellen Studien resultierten neue Erkenntnisse zur Pathogenese und Therapie der MS. Schwerpunkte liegen insbesondere auf neurodegenerativen Aspekten der Erkrankung sowie auf therapierelevanten Befunden, die bereits zu einer deutlichen Verbesserung der Immuntherapie im letzten Jahrzehnt führten. Vor allem bei der schubförmig verlaufenden MS kann seit der Einführung der Immunmodulation mit Interferonen und Glatiramerazetat in vielen Fällen die Krankheit durch adäquate und frühe Behandlung langfristig stabilisiert werden. In naher Zukunft sind neue Immuntherapeutika, aber wahrscheinlich auch individualisierte Behandlungsansätze zu erwarten. Die weitere Entwicklung neurobiologisch-protektiver Strategien soll gezielt das Überleben von Glia- und Nervenzellen fördern.

Abstract

In this article, recent advances in the research on pathogenesis and therapy of multiple sclerosis (MS) will be summarized. New evidence from clinical studies, imaging, histopathology and experimental models are discussed with a focus on neurodegenerative aspects and evidence from recent therapeutic studies. During the last decade, important advances in immunotherapy have been achieved, which proved especially useful for patients with relapsing remitting MS. The introduction of interferons and glatiramer acetate into MS therapy often leads to a stabilization of the disease course if administered adequately and early. The pathogenetic insights presented here may open new avenues for innovative immunodulatory approaches and lead to an individualized MS therapy in the future. Neuroprotective treatment strategies aim at the protection of glial and neuronal cells.

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