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Multiple Sklerose: potenzielle Therapieansätze und Update laufender Studien

Multiple sclerosis: potential therapeutic options and update of ongoing clinical trials

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Zusammenfassung

Die Therapiemöglichkeiten der Multiplen Sklerose (MS) haben sich in den letzten Jahren deutlich verbessert. Trotz dieser Fortschritte bleibt die Erkrankung bis heute unheilbar, und das Ziel einer nebenwirkungsarmen und hocheffizienten Therapie ist nicht erreicht. Die Erkenntnisse im zellulären und molekularen Verständnis wichtiger Schritte in der MS-Pathogenese weisen auf verschiedenartige und neue Zielstrukturen bzw. Ansatzpunkte zukünftiger Entwicklungen hin, bei denen neben der selektiven Modulation entzündlicher Komponenten nunmehr vor allem Strategien zur aktiven Neuroprotektion, Remyelinisierung und Förderung der Regeneration in das zentrale Interesse rücken. Auf Grundlage gegenwärtiger pathogenetischer Konzepte skizziert der vorliegende Artikel denkbare Therapiekonzepte und -strategien. Agentien und Ansätze, die sich gegenwärtig in der klinischen Prüfung befinden, werden aktuell zusammengestellt, wobei unterteilt wird zwischen (immun)pathogenetisch orientierten Ansätzen, neueren immunmodulatorischen und immunsuppressiven Agentien sowie antiinfektiösen Therapien.

Summary

The therapeutic options for the treatment of multiple sclerosis (MS) have experienced enormous progress over recent years. Despite these encouraging developments, available therapies are only partially effective, and the ultimate goal of curing MS is still far from being attained. The improved understanding of the cellular and molecular mechanisms of MS (immune) pathogenesis together with recent shifts in paradigms led to a variety of new therapeutic targets and approaches. In addition to modulation of the inflammatory process, therapeutic approaches focussing on active neuroprotection, remyelinization, and regeneration have become increasingly important. Based on current concepts of the MS pathogenesis, this article summarizes new therapeutic approaches. Substances and strategies currently tested in clinical trials are reviewed.

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Danksagung

Das Institut für klinische Neuroimmunologie wird von der Hermann-und-Lilly-Schilling-Stiftung unterstützt. H. Wiendl, R. Hohlfeld, H-P. Hartung und B.C. Kieseier haben teilgenommen oder nehmen an Studien genannter Präparate teil. Ebenso haben sie Honorare seitens der Pharmaindustrie für Konsultationen und/oder Referententätigkeiten erhalten.

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  1. Abteilung für Allgemeine Neurologie und Hertie-Institut für Klinische Hirnforschung, Neurologische Klinik der Eberhard-Karls-Universität Tübingen

    H. Wiendl

  2. Neurologische Klinik der Heinrich-Heine-Universität Düsseldorf

    H. C. Lehmann, H.-P. Hartung & B. C. Kieseier

  3. Institut für Klinische Neuroimmunologie, Klinikum Großhadern der Ludwig-Maximilians-Universität München

    R. Hohlfeld

  4. Abteilung für Allgemeine Neurologie und Hertie-Institut für Klinische Hirnforschung, Universität Tübingen, Hoppe-Seyler-Straße 3, 72076 , Tübingen

    H. Wiendl

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  1. H. Wiendl
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  2. H. C. Lehmann
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  3. R. Hohlfeld
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  4. H.-P. Hartung
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  5. B. C. Kieseier
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Correspondence to H. Wiendl.

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Wiendl, H., Lehmann, H.C., Hohlfeld, R. et al. Multiple Sklerose: potenzielle Therapieansätze und Update laufender Studien. Nervenarzt 75, 536–552 (2004). https://doi.org/10.1007/s00115-003-1665-4

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