中国现代神经疾病杂志 ›› 2020, Vol. 20 ›› Issue (10): 843-847. doi: 10.3969/j.issn.1672-6731.2020.10.001

• 专论 • 上一篇    下一篇

2 视神经脊髓炎谱系疾病靶向治疗策略

管阳太   

  1. 200127 上海交通大学医学院附属仁济医院神经内科
  • 收稿日期:2020-10-15 出版日期:2020-10-25 发布日期:2020-10-30
  • 作者简介:管阳太,Email:yangtaiguan@hotmail.com

Targeted therapy for neuromyelitis optica spectrum disorders

GUAN Yang-tai   

  1. Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Received:2020-10-15 Online:2020-10-25 Published:2020-10-30

摘要:

视神经脊髓炎谱系疾病(NMOSDs)具有高复发率、高病残率特点,随着复发次数的增加,神经功能障碍越来越严重。采用糖皮质激素冲击治疗、静脉注射免疫球蛋白或血浆置换疗法以减轻炎症反应、改善神经功能是急性期的主要治疗原则;预防缓解期复发的药物则以硫唑嘌呤等免疫抑制剂为主,而CD19单克隆抗体、补体C5靶向药物、白细胞介素-6受体靶向抗体和APRIL/TACI靶向治疗等免疫抑制剂则可显著减少疾病复发,部分靶向药物已批准用于临床。本文拟就NMOSDs靶向药物进行评述,以期提升对NMOSDs治疗策略的认识。

关键词: 视神经脊髓炎谱系疾病(非MeSH词), 免疫疗法, 免疫抑制剂, 综述

Abstract:

Neuromyelitis optica spectrum disorders (NMOSDs) have the characteristics of high relapse rate and high disability rate. The neurological deficits would become more and more serious with increasing relapse. Using corticosteroids pulse therapy, intravenous immunoglobulin or plasma exchange to reduce inflammation and inhibit neurological dysfunction is the main treatment principle of NMOSDs in the acute phase; drugs to prevent relapse of NMOSDs are mainly immunosuppressants, such as azathioprine, and targeted agents, such as CD19 monoclonal antibody, C5 complement, interleukin-6-receptor targeted antibodies and a proliferation-inducing ligand (APRIL)/transmembrance activator and calcium-modulator and cyclophilin ligand interactor (TACI) targeted therapy. Some targeted agents have been approved for clinical use. This article intended to review the targeted agents for NMOSDs patients for the purpose of improving the understanding of therapeutic strategies of NMOSDs.

Key words: Neuromyelitis optica spectrum disorders (not in MeSH), Immunotherapy, Immunosuppressive agents, Review