Pharmacological and non-pharmacological possibilities of multiple sclerosis therapy

Multipla skleroza je kronična autoimuna bolest središnjeg živčanog sustava koja je u konstantnom porastu, a najčešće se javlja u mladoj odrasloj dobi. Ćešće obolijevaju osobe ženskog spola, a bolest je prisutnija u razvijenim dijelovima svijeta Europe i Sjeverne Amerike. Multipla skleroza je nepoznatog uzroka i tijeka, a smatra se da je povezana s faktorima okoliša i genetikom. Ovu bolest možemo podijeliti u četiri klinička tipa: relapsno-remitirajući (RRMS), sekundarno progresivni (SPMS), primarno progresivni (PPMS) i benigni oblik. Raspon simptoma ove bolesti je širok, zbog čega ju je nerijetko teško prepoznati te ju se naziva bolešću s tisuću lica. Sjmptomi najčešće obuhvaćaju oštećenje motorike (poremećaj kretanja ili slabost motoričke snage ekstremiteta), smanjivanje vidne oštrine, poremećenu ravnotežu i vrtoglavicu, smetnje kontrole mokrenja i stolice, depresivne epizode, spoznajne disfunkcije i dr. Simptomi s kojima se susreću oboljeli od multiple skleroze nepovoljno utječu na kvalitetu njihova života. Osim otežane pokretljivosti, ova bolest s vremenom može uzrokovati i potpunu nepokretnost. Postojeće terapijske opcije uključuju lijekove koji modificiraju tijek bolesti, lijekove za akutnu fazu te različite nefarmakološke pristupe kojima se uglavnom smanjuju ili odgađaju popratni simptomi. Farmakološke mogućnosti uključuju različite lijekove koji se daju ovisno o tipu bolesti, individualnim karakteristikama pacijenta i profilu nuspojava. Usmjerene su na odgađanje progresije bolesti i smirivanje akutne faze. Simptomatska terapija izuzetno je bitna u kasnijim fazama bolesti kada su prisutni brojni simptomi. Od najveće su važnosti takve vrste terapije odgovarajuća fizička aktivnost, psihološka terapija, pravilna prehrana te konzumacija ljekovitog bilja i dodataka prehrani. Iako ova vrsta terapije još uvijek nije dovoljno istražena te ne postoji velik broj kvalitetnih studija, smatra se da donosi određene koristi.Multiple sclerosis is a chronic autoimmune disease of the central nervous system that is on the rise and most commonly occurs in young adulthood. Women are more likely to suffer from this disease. It is more prevalent in developed parts of the world in Europe and North America. The cause of multiple sclerosis is unknown and it is possible that it is related to environmental factors and genetics. This disease can be divided into four clinical types: relapsing-remitting (RRMS), secondary progressive (SPMS), primary progressive (PPMS), and benign type. The range of symptoms of this disease is wide, which is why it is often difficult to recognize it and it is called a disease with a thousand faces. Symptoms most often include impaired motor skills (movement disorders or weakness of motor strength of the extremities), impaired sensation, decreased visual acuity, impaired balance and dizziness, impaired urination and stool control, depressive disorders, cognitive dysfunction, etc. Symptoms encountered by patients with multiple sclerosis adversely affect their quality of life. In addition to impaired mobility, this disease can cause complete immobility over time. Existing therapeutic options include course-modifying drugs, acute- phase drugs, and various nonpharmacological approaches that generally reduce or delay the accompanying symptoms. Pharmacological options include different drugs that are given depending on the type of disease, the individual characteristics of the patient and the profile of side effects. They are aimed at delaying disease progression and calming the acute phase. Symptomatic therapy is extremely important in the later stages of the disease when numerous symptoms are present. Appropriate physical activity, psychological therapy, proper nutrition and consumption of medicinal herbs and dietary supplements have the greatest importance. Although this type of therapy has not yet been sufficiently researched and there is not a large number of quality studies, it is considered to bring certain benefits