Dianas farmacológicas en la esclerosis múltiple / Pharmacological targets in multiple sclerosis

Resumen. La esclerosis múltiple es la enfermedad inflamatoria, desmielinizante y neurodegenerativa crónica más frecuente en jóvenes adultos, pero carece de un tratamiento farmacológico definitivo. Es una enfermedad heterogénea, desde el punto de vista inmunológico, neuropatológico y clínico, al igual que lo es su respuesta a las distintas terapias. Durante las últimas dos décadas, la farmacología ha centrado sus esfuerzos en el desarrollo de fármacos modificadores del curso de esta enfermedad, con el objetivo de reducir la frecuencia de los brotes y la velocidad de progresión de la discapacidad que produce la enfermedad. Sin embargo, hoy día no disponemos de un fármaco capaz de presentar un efecto curativo que estabilice por completo la enfermedad, y las estrategias neuroprotectoras y neurorreparadoras están en sus inicios. En este trabajo realizamos una revisión crítica de las diferentes vías patogénicas que participan en la esclerosis múltiple y discutimos las diferentes aproximaciones farmacológicas realizadas, basándonos en los ensayos clínicos que están actualmente en desarrollo. Es previsible que en un futuro próximo consigamos, primero, estabilizar por completo la enfermedad y, más adelante, recuperar parte de las funciones alteradas que ocasiona esta enfermedad. La investigación tiene lugar a tal ritmo que sólo se puede ser optimista y pensar que seremos capaces de mejorar pronto la situación de las personas que padecen la enfermedad (AU)

Summary. Multiple sclerosis is the most frequent chronic inflammatory, demyelinating and neurodegenerative disease in young adults, but has no definitive pharmacological treatment. It is a heterogeneous disease from the immunological, neuropathological and clinical point of view, as well as in terms of its response to different therapies. Over the last two decades, pharmacology has focused on developing drugs that are capable of modifying the course of this disease, with the aim of reducing the frequency of the outbreaks and the speed at which the disability produced by the disease progresses. Nevertheless, today, there are no drugs that are capable of offering a curative effect that can fully stabilise the disease, and neuroprotective and neuroreparative strategies are still in their early stages. In this work we carry out a critical review of the different pathogenic paths involved in multiple sclerosis and we discuss the different pharmacologicalapproaches that have been followed, based on the clinical trials that are currently being conducted. In the near future it is to be expected that, first, we will manage to stabilise the disease completely and, later, recover some of the functions altered by this disease. Research is being conducted at such a rate that we have to be optimistic and think that soon we will be able to improve the situation of those who suffer from the disease (AU)

[Pharmacological targets in multiple sclerosis]. / Dianas farmacologicas en la esclerosis multiple.

Multiple sclerosis is the most frequent chronic inflammatory, demyelinating and neurodegenerative disease in young adults, but has no definitive pharmacological treatment. It is a heterogeneous disease from the immunological, neuropathological and clinical point of view, as well as in terms of its response to different therapies. Over the last two decades, pharmacology has focused on developing drugs that are capable of modifying the course of this disease, with the aim of reducing the frequency of the outbreaks and the speed at which the disability produced by the disease progresses. Nevertheless, today, there are no drugs that are capable of offering a curative effect that can fully stabilise the disease, and neuroprotective and neuroreparative strategies are still in their early stages. In this work we carry out a critical review of the different pathogenic paths involved in multiple sclerosis and we discuss the different pharmacological approaches that have been followed, based on the clinical trials that are currently being conducted. In the near future it is to be expected that, first, we will manage to stabilise the disease completely and, later, recover some of the functions altered by this disease. Research is being conducted at such a rate that we have to be optimistic and think that soon we will be able to improve the situation of those who suffer from the disease.