Interferon 3-la in the Treatment of Multiple Sclerosis
Multiple sclerosis (MS) is a progressive, debilitating illness that affects the nerve cells in the brain and spinal cord. It is presumed to be an autoimmune disorder of the central nervous system (CNS) that results in acute focal inflammatory demyelination and axonal loss with limited remyelination, culminating in chronic multifocal sclerotic plaques. This leads to a disruption of nerve signals within the CNS, causing symptoms that may affect vision, sensation, and body movements.
The disease affects twice as many women as men, with an estimated incidence of seven people per 100,000 annually. The prevalence is approximately 120 people per 100,000, and the lifetime risk is one person in 400. It is the most common nerve disorder in young people and affects more than one million young adults worldwide. The familial recurrence rate is approximately 15%. MS seems to be genuinely polygenic; however, the distribution of MS cannot be explained on the basis of population genetics alone.2 Although there appears to be a genetic predisposition, no single MS gene has been identified.
In about 25% of patients, MS does not affect activities of daily living; conversely, up to 15% of patients become severely disabled within a short time. The life expectancy varies according to the degree of disease progression and the individual. Overall life expectancy is usually at least 25 years from disease onset.
MS is difficult to diagnose and poses a challenge to many physicians. The symptoms of MS are similar to those of other autoimmune disorders and include blurred vision, slurred speech, trembling of the hands, muscle weakness, and unsteady gait, among others. In addition to the many different clinical symptoms experienced by patients, the course of MS can follow several different patterns throughout a patient’s life. The three most common patterns are as follows:
- Relapsing-remitting MS (RRMS). Relapses are followed by periods of recovery. For most patients with this form of MS, this phase evolves into the secondary, or progressive, stage of the disease.
- Primary-progressive MS (PPMS). Patients experience steady deterioration with no episodes of relapses or remissions. This form of MS affects approximately 10% of patients.
- Secondary-progressive MS (SPMS). Patients experience continuous neurological worsening, with or without superimposed relapses.
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Although there is no cure for MS, there are treatment options to alleviate symptoms, to prevent relapses, and to reduce the severity of relapses. Anti-depressants are used to improve the mental health of MS patients; diazepam (Valium®, Roche) and baclofen are commonly used to relieve muscle tightness and spasms. Corticosteroids and inter-ferons are used to treat relapses. Inter-ferons are the first-line drugs of choice for RRMS.
Interferon |3-1a (Rebif®, Serono) is a purified, 166-amino acid glycoprotein with a molecular weight of approximately 22,500 daltons. The interferon is produced by recombinant DNA technology via genetically engineered Chinese hamster ovary cells into which the human interferon beta gene has been introduced. The amino acid sequence of inter-feron |3-1a is identical to that of natural fibroblast-derived human interferon beta. Natural interferon beta and interferon |3-1a are glycosylated, with each one containing a single A-linked complex carbohydrate moiety.
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