Clinical advances in multiple sclerosis and amyotrophic lateral sclerosis treatment: A review

Marquelle Zerecero-Morcksharpe, Elisa García-Vences
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Abstract

Neurodegenerative diseases are clinical manifestations that depend on the anatomy and function of the affected areas. Amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS) are some of these diseases, but they are also autoimmune and their etiology makes treatments limited and of little therapeutic efficacy. Currently, some clinical research advances can be pillars for the development of new treatments for these diseases. Therefore, the objective of this review is to describe the latest clinical advances in ALS and MS as well as their results in clinical recovery in randomized clinical trials, meta-analyzes, and full-text systematic reviews conducted in humans and rats, published in English and Spanish in the last 5 years, using PubMed, SciELO, and Cochrane. For clinical trials to be included, they had to provide a detailed breakdown of randomization methods, diagnostic criteria, intervention details, and efficacy evaluation. The results show that, so far, available medications, like riluzole and edaravone for ALS and fingolimod, dimethyl fumarate, and IFN β-1b for MS, only prolong the life of the patient. Among these drugs are also glutamate neurotransmitter antagonists, immunomodulators and even antioxidants; each of them showed significant improvement in the reviewed trials. Similarly, other non-pharmaceutical treatments, as the 600-mg dose of curcumin in the diet for ALS, showed improvement of the patients’ conditions. Regarding MS, more studies should be carried out on autotransplantation with adiposederived mesenchymal stem cells (AdMSCs) to investigate the potential therapeutic benefit of this technique in phases prior to secondary-progressive (SPMS).
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多发性硬化症和肌萎缩侧索硬化治疗的临床进展综述
神经退行性疾病是依赖于受累部位解剖和功能的临床表现。肌萎缩性侧索硬化症(ALS)和多发性硬化症(MS)是其中的一些疾病,但它们也是自身免疫性疾病,其病因使治疗受到限制,治疗效果甚微。目前,一些临床研究的进展可以成为开发这些疾病的新疗法的支柱。因此,本综述的目的是描述近5年来在PubMed、SciELO和Cochrane上以英文和西班牙文发表的在人类和大鼠中进行的随机临床试验、荟萃分析和全文系统评价中ALS和MS的最新临床进展及其在临床恢复方面的结果。对于纳入的临床试验,他们必须提供随机化方法、诊断标准、干预细节和疗效评估的详细分类。结果表明,到目前为止,可用的药物,如治疗渐冻症的利鲁唑和依达拉曲,治疗多发性硬化症的芬戈莫德、富马酸二甲酯和IFN β-1b,只能延长患者的生命。这些药物还包括谷氨酸神经递质拮抗剂、免疫调节剂甚至抗氧化剂;在回顾的试验中,他们每个人都表现出显著的改善。同样,其他非药物治疗,如在ALS患者的饮食中加入600毫克的姜黄素,也显示出患者病情的改善。对于多发性硬化症,应该开展更多的脂肪源性间充质干细胞(AdMSCs)自体移植研究,以在继发性进展(SPMS)之前的阶段调查该技术的潜在治疗益处。
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