视神经脊髓炎相关性视神经炎的治疗策略

Treatment strategies for neuromyelitis optica related optic neuritis

视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorders,NMOSD)是一组主要累及视神经和脊髓以免疫介导的脱髓鞘和轴突损伤为特征的中枢神经系统炎症性疾病,其中视神经脊髓炎相关性视神经炎(neuromyelitis optica related neuritis,NMO-ON)是引起患者视力严重下降的常见神经眼科疾病。水通道蛋白4抗体的发现,证实视神经脊髓炎是一种不同于多发性硬化的独立疾病实体。NMO-ON治疗的2个主要目标是控制急性炎症和预防复发。随着对NMOSD发病机制的深入研究,针对疾病发生过程中不同靶点的新的治疗方法不断出现。该文就NMO-ON的治疗现状和免疫治疗策略进行了综述。

Neuromyelitis optica spectrum disorders （NMOSD） are a group of inflammatory disorders of the central nervous system characterized by episodes of immune-mediated demyelination and axonal damage mainly involving optic nerves and spinal cord. Neuromyelitis optica related optic neuritis （NMO-ON） is a common neuro-ophthalmic disease which often results in permanent blindness. The discovery of aquaporin 4 antibodies confirms that neuromyelitis optica is a distinct disease entity different from multiple sclerosis. In patients with NMO-ON, the correct therapeutic approach has to recognize two distinct clinical situations： treatment of the acute attacks and prevention of the relapses. With the in-depth study of the pathogenesis of NMOSD, new treatments are emerging in different targets of the disease. This review gives an update of latest treatment of NMO-ON, emphasizing both current situation and future immunotherapy strategies.