摘要
视神经脊髓炎谱系疾病(NMOSD)是一类主要累及视神经和脊髓的中枢神经系统炎性脱髓鞘疾病,由于其严重的致盲性和致残性,如何有效预防复发成为眼科医师考虑的重点。随着对NMOSD发病机制的深入了解和科技手段的进步,越来越多的单克隆抗体(mAb)不断进入临床试验研究,其中B细胞表面抗原CD20阻断剂利妥昔单抗已成为治疗NMOSD的一线药物,CD19阻断剂inebilizumab可降低NMOSD患者复发,减轻疾病致残;免疫治疗的基础上附加白细胞介素6受体阻断剂satralizumab、补体C5抑制剂eculizumab可降低复发;而纳他珠单抗、阿仑单抗等部分mAb可能对NMOSD的治疗无效。有关mAb治疗适应证的拓展及新药的上市仍需开展大规模、国际间的合作与更多的临床试验,同时其潜在的不良事件及费用问题不容忽视。
Neuromyelitis optica spectrum disorder(NMOSD)is a kind of demyelinating disease of central nervous system which mainly affect optic nerve and spinal cord.Because of its serious blindness and disability,how to effectively prevent relapse has become the focus of ophthalmologists.With the deep understanding of the pathogenesis and the progress of scientific and technological means,more and more monoclonal antibodies(mAb)continue to enter clinical trials.B cell surface antigen CD20 blocker,rituximab,has become a first-line drug for the treatment of NMOSD.CD19 blocker,inebilizumab,can reduce the recurrence and disability of NMOSD patients.The addition of interleukin 6 receptor blocker,satralizumab,and complement C5 inhibitor,eculizumab,reduce the recurrence.Some mAbs such as natalizumab and alemtuzumab may not be effective for the treatment of NMOSD.The expansion of mAb treatment indications and the launch of new drugs still require more clinical trials which are large-scale and international cooperation.At the same time,its potential adverse events and cost issues cannot be ignored.
作者
付俊霞
魏世辉
Fu Junxia;Wei Shihui(Department of Ophthalmology,PLA General Hospital,Beijing 100853,China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2021年第3期240-244,共5页
Chinese Journal of Ocular Fundus Diseases
基金
国家自然科学基金(81870662)。
关键词
视神经脊髓炎
抗体
单克隆
综述
Neuromyelitis optica
Antibodies,monoclonal
Review
