多发性硬化的发病机制和药物治疗的最新进展

doi:10.12092/j.issn.1009-2501.2026.01.009

摘要/Abstract

摘要：

多发性硬化症（multiple sclerosis，MS）是一种中枢神经系统（central nervous system，CNS）的慢性炎症性脱髓鞘疾病。多发性硬化症是一个全球性问题，可表现出肌肉无力、无法行走等运动症状以及认知障碍、神经心理症状、疼痛等非运动症状。多发性硬化症的发病机制复杂，涉及自身免疫反应、遗传因素和环境因素等多个方面。近年来，药物治疗仍属于多发性硬化症一线治疗方式。本综述归纳了多发性硬化症可能的发病机制和药物治疗进展，提出了一些未来可能的研究方向，为探讨多发性硬化症发病机制和治疗提供新思路。

关键词: 多发性硬化, 动物模型, 发病机制, 药物治疗

Abstract:

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS). As a global health concern, MS manifests with motor symptoms such as muscle weakness and ambulatory dysfunction, along with non-motor symptoms including cognitive impairment, neuropsychological manifestations, and pain. The pathogenesis of MS remains intricate and not fully elucidated. In recent years, pharmacological treatments have remained the first-line therapeutic approach for MS. This review summarizes current understanding of potential pathogenic mechanisms and advances in pharmacotherapeutic interventions for MS, while proposing potential future research directions to provide novel perspectives for investigating the pathogenesis and treatment of this disease.

Key words: multiple sclerosis, animal model, pathogenesis, drug therapy

中图分类号:

R744.5

施雅妍, 王钰, 旷炜, 余守洋. 多发性硬化的发病机制和药物治疗的最新进展[J]. 中国临床药理学与治疗学, 2026, 31(1): 78-87.

Yayan SHI, Yu WANG, Wei KUANG, Shouyang YU. The latest progress in the pathogenesis of multiple sclerosis and drug therapy[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(1): 78-87.

图/表 3

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多发性硬化模型	建模方式	应用	参考文献
复发缓解型EAE	对SJL/J 小鼠皮下注射髓鞘蛋白多肽 PLP_139-151以诱导EAE	复发缓解型多发性硬化	[9]
进行性EAE	对 C57BL/6J 小鼠皮下注射髓鞘少突胶质细胞糖蛋白肽 MOG_35-55 以诱导EAE	原发性进展型多发性硬化继发进行型多发性硬化	[10]
TEMV诱导的模型	将TMEV注射到 SJL/J 小鼠脑内	原发性进展型多发性硬化	[6]
Cuprizone 诱导的模型	用 0.2% Cuprizone喂养 C57BL/6 小鼠 6 周	脱髓鞘和髓鞘再生过程	[11]
溶血卵磷脂诱导的模型	直接注射1 μL 1%的LPC至C57BL/6小鼠的脑内	脱髓鞘和髓鞘再生过程	[12]

多发性硬化模型	建模方式	应用	参考文献
复发缓解型EAE	对SJL/J 小鼠皮下注射髓鞘蛋白多肽 PLP_139-151以诱导EAE	复发缓解型多发性硬化	[9]
进行性EAE	对 C57BL/6J 小鼠皮下注射髓鞘少突胶质细胞糖蛋白肽 MOG_35-55 以诱导EAE	原发性进展型多发性硬化继发进行型多发性硬化	[10]
TEMV诱导的模型	将TMEV注射到 SJL/J 小鼠脑内	原发性进展型多发性硬化	[6]
Cuprizone 诱导的模型	用 0.2% Cuprizone喂养 C57BL/6 小鼠 6 周	脱髓鞘和髓鞘再生过程	[11]
溶血卵磷脂诱导的模型	直接注射1 μL 1%的LPC至C57BL/6小鼠的脑内	脱髓鞘和髓鞘再生过程	[12]

药物名称	给药途径	可治疗的多发性硬化类型	可治疗的其他自身免疫病	参考文献
特立氟胺	口服	RRMS	活动性类风湿性关节炎银屑病关节炎系统性红斑狼疮系统性血管炎	[37, 57]
富马酸二甲酯	口服	RRMS	中重度银屑病	[41, 57]
芬戈莫德	口服	RRMS	克罗恩病溃疡性结肠炎银屑病对哮喘有积极影响	[54, 57-58]
奥扎莫德	口服	RRMS	克罗恩病溃疡性结肠炎银屑病	[54, 57]
西尼莫德	口服	SPMS	克罗恩病溃疡性结肠炎银屑病	[54, 57]
庞西莫德	口服	RRMS和SPMS	克罗恩病溃疡性结肠炎银屑病	[54, 57]
克拉屈滨	口服	RRMS	活动性类风湿性关节炎银屑病关节炎系统性红斑狼疮	[48, 57]
干扰素 β	皮下注射	RRMS和SPMS	葡萄膜炎	[54, 57]
醋酸格拉替雷	皮下注射	RRMS	尚不确定	[49, 57]
奥法木单抗	皮下注射	PPMS	MS合并类风湿性关节炎系统性红斑狼疮	[56-57]
奥瑞珠单抗	静脉注射	PPMS	MS合并类风湿性关节炎系统性红斑狼疮	[55, 57]
那他珠单抗	静脉注射	RRMS	克罗恩病	[57]
阿仑单抗	静脉注射	RRMS和/或对其他治疗选择无反应的多发性硬化患者	对难治性肉芽肿性多血管炎、系统性血管炎、活动性和难治性类风湿关节炎、散发性包涵体肌炎有积极影响	[52, 57]

药物名称	给药途径	可治疗的多发性硬化类型	可治疗的其他自身免疫病	参考文献
特立氟胺	口服	RRMS	活动性类风湿性关节炎银屑病关节炎系统性红斑狼疮系统性血管炎	[37, 57]
富马酸二甲酯	口服	RRMS	中重度银屑病	[41, 57]
芬戈莫德	口服	RRMS	克罗恩病溃疡性结肠炎银屑病对哮喘有积极影响	[54, 57-58]
奥扎莫德	口服	RRMS	克罗恩病溃疡性结肠炎银屑病	[54, 57]
西尼莫德	口服	SPMS	克罗恩病溃疡性结肠炎银屑病	[54, 57]
庞西莫德	口服	RRMS和SPMS	克罗恩病溃疡性结肠炎银屑病	[54, 57]
克拉屈滨	口服	RRMS	活动性类风湿性关节炎银屑病关节炎系统性红斑狼疮	[48, 57]
干扰素 β	皮下注射	RRMS和SPMS	葡萄膜炎	[54, 57]
醋酸格拉替雷	皮下注射	RRMS	尚不确定	[49, 57]
奥法木单抗	皮下注射	PPMS	MS合并类风湿性关节炎系统性红斑狼疮	[56-57]
奥瑞珠单抗	静脉注射	PPMS	MS合并类风湿性关节炎系统性红斑狼疮	[55, 57]
那他珠单抗	静脉注射	RRMS	克罗恩病	[57]
阿仑单抗	静脉注射	RRMS和/或对其他治疗选择无反应的多发性硬化患者	对难治性肉芽肿性多血管炎、系统性血管炎、活动性和难治性类风湿关节炎、散发性包涵体肌炎有积极影响	[52, 57]

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