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引用次数: 0
摘要
尽管慢性炎症性脱髓鞘多发性神经病(CIDP)和其他常见自身免疫性神经病(AN)的治疗取得了进展,但仍有许多患者对现有疗法的反应并不令人满意。从其他自身免疫性疾病,尤其是多发性硬化症(MS)和神经性脊髓炎视网膜频谱病变(NMOSD)中提取疾病修饰疗法(DMTs)的再利用是一种很有前景的策略,它可能会加速为自身免疫性神经病变提供新的治疗选择。由于这些疾病的发病机制具有相似性,而且治疗 MS 和 NMOSD 患者积累了丰富的上市后经验,因此这种方法似乎很有吸引力。一些研究不仅探讨了DMTs在AN动物模型中的疗效,也探讨了DMTs在一些CIDP患者中的疗效,这些研究也加强了这一想法。我们在此回顾了已获批准的多发性硬化症治疗药物的现有临床前和临床数据,以了解这些药物对自闭症,尤其是 CIDP 的适用性。有希望的治疗方法似乎是B细胞导向和补体靶向策略,如抗CD20/抗CD19制剂、布鲁顿酪氨酸激酶抑制剂和抗C5制剂,因为它们在外周发挥效应。这是一项重大优势,因为与多发性硬化症相比,它们在外周的作用足以产生显著的免疫调节效果。
Repurposing MS immunotherapies for CIDP and other autoimmune neuropathies: unfulfilled promise or efficient strategy?
Despite advances in the treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and other common autoimmune neuropathies (AN), still-many patients with these diseases do not respond satisfactorily to the available treatments. Repurposing of disease-modifying therapies (DMTs) from other autoimmune conditions, particularly multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), is a promising strategy that may accelerate the establishment of novel treatment choices for AN. This approach appears attractive due to homologies in the pathogenesis of these diseases and the extensive post-marketing experience that has been gathered from treating MS and NMOSD patients. The idea is also strengthened by a number of studies that explored the efficacy of DMTs in animal models of AN but also in some CIDP patients. We here review the available preclinical and clinical data of approved MS therapeutics in terms of their applicability to AN, especially CIDP. Promising therapeutic approaches appear to be B cell-directed and complement-targeting strategies, such as anti-CD20/anti-CD19 agents, Bruton's tyrosine kinase inhibitors and anti-C5 agents, as they exert their effects in the periphery. This is a major advantage because, in contrast to MS, their action in the periphery is sufficient to exert significant immunomodulation.
期刊介绍:
Therapeutic Advances in Neurological Disorders is a peer-reviewed, open access journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of neurology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in neurology, providing a forum in print and online for publishing the highest quality articles in this area.