Fingolimodterápia sclerosis multiplexben: A hatásmechanizmus kérdése

Translated title of the contribution: Fingolimod therapy in multiple sclerosis - The issue of the pathomechanism

Lilla Tar, László Vécsei

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Multiple sclerosis is an autoimmune inflammatory disease of the central nervous system with neurodegenerative chararacteristics. The newly discovered per os administrable drug fingolimod (FTY720) has a different mechanism of action than the current disease-modifying therapies. In vivo the drug binds to four out of the five sphingosine-1-phosphate receptors after phosphorylation. Fingolimod-phosphate (FTY720-P) causes internalization and degradation of the sphingosine-1-phosphate receptors in the membrane of lymphocytes thus in contrast to sphingosine-1-phosphate it acts like a functional antagonist. In experimental autoimmune encephalomyelitis - an animal model of multiple sclerosis - fingolimod blocks the sphingosine-1-phosphate gradient controlled lymphocyte egress from the lymph nodes and therefore reduces the peripheral lymphocyte count especially the encephalitogenic Th17 subset is reduced. Modulation of the sinus lining and blood-brain-barrier constructing endothelial cells also contributes to the complex mechanism of action. Additionally due to its liphohilic nature fingolimod is able to penetrate the blood brain barrier thus, beside its peripheral effects the drug can probably modulate the cells of the central nervous system directly. Presumably it can reduce neurodegeneration caused by astrogliosis through modification of astrocyte and oligodendrocyte activity. The results of current clinical studies are holding out with bright prospective in the aspect of either the favourable effects or the well tolerated side effects.

Translated title of the contributionFingolimod therapy in multiple sclerosis - The issue of the pathomechanism
Original languageHungarian
Pages (from-to)83-100
Number of pages18
JournalIdeggyogyaszati szemle
Volume65
Issue number3-4
Publication statusPublished - Mar 30 2012

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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