视神经脊髓炎谱系疾病的发病机制及单克隆抗体治疗进展

Pathogenesis and advances in monoclonal antibody treatment of neuromyelitis optica spectrum disorder

视神经脊髓炎谱系疾病(NMOSD)是一种中枢神经系统免疫性疾病,具有高复发及高致残性,如何预防复发是该病治疗的关键。单克隆抗体(以下简称为单抗)是近年来针对NMOSD新兴且快速发展的临床治疗策略之一,越来越多的研究及临床试验也证实了单克隆抗体的有效性及安全性。B细胞表面抗原CD20单抗利妥昔单抗已被广泛用于NMOSD的治疗;B细胞表面抗原CD19单抗伊奈利珠单抗则是目前国内唯一获批用于临床治疗NMOSD的药物。此外,白细胞介素-6受体靶向抑制剂、补体C5靶向抑制剂等多种单抗也被用于NMOSD的治疗。随着对NMOSD发病机制研究的深入,疾病相关的免疫网络分子机制进一步明晰;多中心临床试验的广泛开展,促使更为精准的单抗治疗NMOSD策略将应用于临床,使更多的患者获益。

Neuromyelitis optica spectrum disorder(NMOSD)is a immune-mediated demyelinating disease of the central nervous system,characterized by high recurrence and disability rates.Preventing relapses is crucial in the treatment of this condition.Monoclonal antibodies have emerged as a novel and rapidly evolving clinical therapeutic strategy targeting NMOSD in recent years.An increasing number of studies and clinical trials have also confirmed the effectiveness and safety of monoclonal antibodies.Rituximab,a monoclonal antibody targeting the B-cell surface antigen CD20,has been widely used in the treatment of NMOSD.Currently,in China,the only approved monoclonal antibody for treating NMOSD is Inebilizumab,which targets the B-cell surface antigen CD19.Additionally,various monoclonal antibodies,such as interleukin-6 receptor inhibitors and complement C5 inhibitors,have been used in the treatment of NMOSD.With the deepening of the research on the pathogenesis of NMOSD,the molecular mechanism of disease-related immune network is further clarified,and multi-center clinical trials are widely carried out.More accurate monoclonal antibody treatment strategies for NMOSD will be applied to clinical practice,benefiting more patients.