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Boĭko A.N.
KGBUZ "Krasnoiarskiĭ kraevoĭ Tsentr po profilaktike i bor'be so SPID i infektsionnymi zabolevaniiami"
Khachanova N.V.
Burdenko Neurosurgical Institute, Moscow, Russia
Mel'nikov M.V.
Kafedra obshcheĭ khirurgii Sankt-Peterburgskoĭ gosudarstvennoĭ meditsinskoĭ akademii im. I.I. Mechnikova
Evdoshenko E.P.
Sankt-Peterburgskoe GBUZ "Gorodskaia klinicheskaia bol'nitsa #31", Sankt-Peterburgskiĭ gorodskoĭ Tsentr rasseiannogo skleroza i autoimmunnykh zabolevaniĭ, Sankt-Peterburg
Spirin N.N.
Kafedra nervnykh bolezneĭ i meditsinskoĭ genetiki s kursom neĭrokhirurgii Iaroslavskoĭ gosudarstvennoĭ meditsinskoĭ akademii
Vasil’ev A.V.
State budgetary healthcare facility «Chelyabinsk Regional Clinical Hospital», Chelyabinsk, Russian Federation
Rozenson O.L.
Merck KGaA, Moscow, Russia
New directions of immunocorrection in multiple sclerosis
Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(2): 103‑109
Read: 9344 times
To cite this article:
Boĭko AN, Khachanova NV, Mel'nikov MV, et al. . New directions of immunocorrection in multiple sclerosis. S.S. Korsakov Journal of Neurology and Psychiatry.
2020;120(2):103‑109. (In Russ.)
https://doi.org/10.17116/jnevro2020120021103
Multiple sclerosis is a central nervous system disease with autoimmune and neurodegenerative mechanisms of development. This disease can lead to severe disability and neurological defects. Although its etiology and pathogenesis remain unclear, research data show that multiple sclerosis is a multifactorial disease, the development of which depends on environmental factors, as well as a genetic predisposition. The impact of these factors lead to the death of neural cells, accompanied by demyelination of nerves and neuronal dysfunction. Therapy of multiple sclerosis is based on the use of anti-inflammatory and immunomodulating substances, however, there are certain disadvantages associated with the constant use of these drugs and a possible change in dosage over time. This review discusses the pathogenesis of multiple sclerosis and the role of various subpopulations of immune cells in the development of diseases, as well as existing approaches to therapy. It is noted that immunoreconstitution therapy has advantages over immunomodulation and immunosuppression maintenance therapy for some patients. Thus, short courses of therapy provide more adequate treatment for patients and lower risks of adverse events associated with chronic immunosuppression. The review also discusses the data of clinical studies on the immunoreconstitution therapy drugs, such as alemtuzumab, ocrelizumab and cladribine. It is noted that nowadays the exact mechanisms underlying this type of therapy remain unclear. In this regard, further studies are needed to explain the therapeutic effects. It is assumed that patients with a high risk of multiple sclerosis progression are the optimal group of patients for the early use of selective immunoreconstitution therapy. Thus, immunoreconstitution therapy may be the treatment of choice for many patients with highle active multiple sclerosis.
Authors:
Boĭko A.N.
KGBUZ "Krasnoiarskiĭ kraevoĭ Tsentr po profilaktike i bor'be so SPID i infektsionnymi zabolevaniiami"
Khachanova N.V.
Burdenko Neurosurgical Institute, Moscow, Russia
Mel'nikov M.V.
Kafedra obshcheĭ khirurgii Sankt-Peterburgskoĭ gosudarstvennoĭ meditsinskoĭ akademii im. I.I. Mechnikova
Evdoshenko E.P.
Sankt-Peterburgskoe GBUZ "Gorodskaia klinicheskaia bol'nitsa #31", Sankt-Peterburgskiĭ gorodskoĭ Tsentr rasseiannogo skleroza i autoimmunnykh zabolevaniĭ, Sankt-Peterburg
Spirin N.N.
Kafedra nervnykh bolezneĭ i meditsinskoĭ genetiki s kursom neĭrokhirurgii Iaroslavskoĭ gosudarstvennoĭ meditsinskoĭ akademii
Vasil’ev A.V.
State budgetary healthcare facility «Chelyabinsk Regional Clinical Hospital», Chelyabinsk, Russian Federation
Rozenson O.L.
Merck KGaA, Moscow, Russia
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