Fortschritte in der Pathogeneseforschung der Multiplen Sklerose

Zusammenfassung

In dieser Übersichtsarbeit stellen wir die in den letzten Jahren erzielten Fortschritte im Verständnis der Multiplen Sklerose (MS) dar. Aus molekularen, pathologischen, immunologischen und tierexperimentellen Studien resultierten neue Erkenntnisse zur Pathogenese, die durch bildgebende Verfahren und klinische Studien ergänzt wurden. 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 moderner Immuntherapien in vielen Fällen die Krankheit früh stabilisiert werden. Bei der primär progredienten Verlaufsform sind unsere pathogenetischen Fortschritte leider deutlich begrenzt, vor allem auch durch den limitierten Zugang zu Gewebeproben und Fehlen adäquater Modelle. Die weitere Entwicklung neurobiologisch-protektiver Strategien soll gezielt das Überleben von Gliaund Nervenzellen fördern.

Summary

In this article, recent advances in the research on pathogenesis of multiple sclerosis (MS) will be summarized. New evidence from molecular histopathology, immunology and experimental models are discussed with a focus on neurodegenerative aspects; in addition evidence from imaging and recent clinical studies is analysed. During the last decade, important advances in immunotherapy have been achieved, which proved especially useful for patients with relapsing remitting MS. Limitations are given for primary progressive MS, due to the lack of suitable tissue specimens and experimental models. The pathogenetic insights presented here may open new avenues for novel immunotherapies and lead to an individualized MS therapy in the future. Neuroprotective treatment strategies aim at the protection of glial and neuronal cells.

Schlüsselwörter

Multiple Sklerose - Lymphozyten - Immuntherapie - molekulare Pathologie - Neuroprotektion

Keywords

Multiple sclerosis - lymphocytes - immunotherapy - molecular pathology - neuroprotection

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