Inmunoterapia en enfermedades neurológicas, presente y futuro

Ricardo Constantino Ginestal-López

doi:10.7399/fh.11031

Inmunoterapia en enfermedades neurológicas, presente y futuro

Ricardo Constantino Ginestal-López

Resumen

Objetivo: El objetivo del presente trabajo es resumir el tratamiento inmunológico de las enfermedades neurológicas, describiendo la situación actual y los retos y oportunidades que se presentan en un futuro próximo.

Método: Se realiza un análisis bibliográfico para, tras clasificar topográficamente las patologías neurológicas autoinmunes, presentar las más relevantes según las opciones inmunoterapéuticas disponibles. Asimismo, se exponen otras enfermedades neurológicas que serán nuevas candidatas a terapia inmunológica en el futuro.

Resultados: Existen múltiples patologías neurológicas con base autoinmune, aunque su fisiopatología, a veces, solo sea parcialmente conocida. Sin embargo, pocos son los ensayos clínicos aleatorizados y controlados que soportan la evidencia de los tratamientos inmunológicos con los que las tratamos. Esta situación está cambiando rápidamente en enfermedades como la esclerosis múltiple, donde ensayos clínicos con un nivel de evidencia grado 1 son la norma. La enfermedad de Alzheimer y la migraña son algunas de las más prevalentes que se están incorporando al grupo de candidatas a inmunoterapia.

Conclusiones: Con un número rápidamente creciente de terapias inmunológicas y de enfermedades neurológicas potencialmente tratables por esta vía, será necesaria una adecuada evaluación del impacto sociosanitario que van a conllevar para llegar a compromisos y consensos por parte de todos los actores implicados en su manejo.

Palabras clave

Inmunoterapia; Patologías neurológicas; Enfermedades autoinmunes; Esclerosis múltiple; Neuromielitis óptica; Enfermedad de Alzheimer; Migraña; Trastornos del movimiento

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DOI: http://dx.doi.org/10.7399%2Ffh.11031