BRAIN and NERVE－神経研究の進歩73巻5号

2021年05月発行

増大特集 中枢神経の自己免疫性・炎症性疾患ハンドブック

第2章　疾患各論

一次性進行型多発性硬化症(PPMS)

著者： 久冨木原健二¹ 中原仁¹

所属機関： ¹慶應義塾大学医学部神経内科

ページ範囲：P.458 - P.465

文献概要

一次性進行型多発性硬化症（PPMS）は，発症時より寛解期を認めず持続的な進行を呈する中枢神経系脱髄疾患である。PPMSの主な病態として炎症，軸索変性，ミクログリア活性化や酸化副産物，ミトコンドリア障害，グルタミン酸興奮毒性がある。本邦でPPMSに保険適用のある疾患修飾薬はまだないが，海外では抗CD20抗体のocrelizumabが承認されている。また，複数の疾患修飾薬が臨床試験でPPMSに有効性を示しており，臨床応用がまたれる。

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