Purpose of Review

The purpose of this review is to discuss the interaction between aging, progressive disease course, disability worsening, and treatment strategies in multiple sclerosis (MS).

Recent Findings

The transition from the relapsing-remitting phase to the progressive phase in MS often happens in the fifth decade. In MS, structural central nervous system reserve decreases with aging and MS-associated mechanisms. While clinical and subclinical disease activity decreases with aging, the post-relapse recovery potential decreases with aging as well. Moreover, the efficacy of disease-modifying treatments declines with older age.

Summary

Aging emerges as the ultimate target for prevention of progressive disease course, which is the most important determinant of disability worsening in MS. While none of our current treatment strategies targets the association between aging and progressive disease in MS, future treatment targets will likely consider the neuron-astrocyte complex, microglia, and oligodendrocyte functions impacted by the aging process.

中文翻译：

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年龄对多发性硬化症活动和进展的影响。

审查目的

本综述的目的是讨论衰老、疾病进展、残疾恶化和多发性硬化症 (MS) 治疗策略之间的相互作用。

最近的发现

多发性硬化症从复发-缓解期向进展期的转变通常发生在第五个十年。在 MS 中，结构性中枢神经系统储备随着衰老和 MS 相关机制而减少。虽然临床和亚临床疾病活动随着年龄的增长而降低，但复发后恢复的潜力也随着年龄的增长而降低。此外，疾病缓解治疗的功效会随着年龄的增长而下降。

概括

老龄化成为预防进行性疾病进程的最终目标，这是 MS 残疾恶化的最重要决定因素。虽然我们目前的治疗策略都没有针对 MS 中衰老和进行性疾病之间的关联，但未来的治疗目标可能会考虑受衰老过程影响的神经元-星形胶质细胞复合体、小胶质细胞和少突胶质细胞功能。