Multiple sclerosis (MS) is an autoimmune demyelinating disease in the central nervous system (CNS), and the currently approved disease-modifying therapy drugs (MTD) can inhibit the peripheral immune attack in MS, but still fail to prevent the disease process in patients with progressive MS or severe neurodegeneration. Microglia, as inherent immune cells in CNS, play a role in immune defense, regulate the proliferation and development of neurons and glial cells, and remove apoptotic cells, exerting the neural protective effect. In recent years, many existing clinical drugs for MS have been found to have regulatory effects on microglia, and various preclinical studies have confirmed that therapeutic strategies targeting microglia show great potential in the treatment of MS. In this paper, the role of microglia in the pathogenesis of MS and its potential therapeutic targets are reviewed.
Objective: To explore the effect of early rehabilitation intervention in children with autism spectrum disorder (ASD) .
Methods: Two samples were included in this study. Sample 1 included 76 children with ASD who received continuous rehabilitation for 6 months, and sample 2 included 108 children with ASD who received continuous rehabilitation for more than 2 years. According to the age at the beginning of rehabilitation intervention, they were divided into early rehabilitation intervention group (≤3 years of age) and non-early rehabilitation intervention group (more than 3 years and up to 5 years of age). All the children received comprehensive intervention mode with social function as the principal line combined with acupuncture therapy. The patients in sample 1 were assessed with Psychoeducational Profile-Third Edition (PEP-3) and Childhood Autism Rating Scale (CARS) before and 6 months after rehabilitation intervention, and the proportion of patients enrolled in general or special schools in sample 2 were assessed when they were 6 years old (normal enrollment) or 7 years old (delayed enrollment for one year).
Results: In sample 1 and sample 2, there was no significant difference in the baseline total score of CARS between the early rehabilitation intervention group and the non-early rehabilitation intervention group (P > 0.05). In sample 1, imitation in PEP-3 in early rehabilitation intervention group was significantly improved compared with that in the non-early rehabilitation intervention group (P = 0.022). There were no significant differences in other items including cognition, language expression, language understanding, small muscle, big muscle, emotional expression, social interaction, nonverbal behavior characteristics and language behavior characteristics (P > 0.05); the overall score of CARS in the early rehabilitation intervention group was significantly higher than that in the non-early rehabilitation intervention group (P < 0.05). In sample 2, the proportion of patients enrolled in general schools in the early rehabilitation intervention group was significantly higher than that in the non-early rehabilitation intervention group (41.67% vs 20.83%, P < 0.05).
Conclusion: Early rehabilitation intervention can significantly improve the outcomes of children with ASD, and reduce the disability rate, which is worthy of clinical application and policy support.
