ABSTRACT
The paper demonstrates that resilience consists in both tangible and intangible institutions. Specifically, the paper equates objective resilience with administrative capacity, and argues that certain vulnerabilities of Romania's public health system are related to other vulnerabilities of the state, such as an underdeveloped fiscal capacity. Subjective resilience implies not only the resolve of population to lend credence to public institutions during an emergency situation, but also the vertical trust that public institutions create through specific policies. Therefore, the level of administrative and political development in normal times could be a predictor of a given state's subjective resilience in times of crises. Methodologically, the paper rests on in-depth case study.
ABSTRACT
Beta interferons (IFN-ß) are pleiotropic cytokines with antiviral properties. They play important roles in the pathogenesis of multiple sclerosis (MS), an incurable immune-mediated disorder of the central nervous system. The clinical expression of MS is heterogeneous, with relapses of neuroinflammation and with disability accrual in considerable part unrelated to the attacks. The injectable recombinant IFN-ß preparations are the first approved disease-modifying treatments for MS. They have moderate efficacy in reducing the frequency of relapses, but good long-term cost-efficacy and safety profiles, so are still widely used. They have some tolerability and adherence issues, partly mitigated in recent years by the introduction of a PEGylated formulation and use of 'smart' autoinjector devices. Their general impact on long-term disability is modest but could be further improved by developing accurate tools for identifying the patient profile of best responders to IFN-ß. Here, we present the IFN-ß-based immunomodulatory therapeutic approaches in MS, highlighting their place in the current coronavirus disease (COVID-19) pandemic. The potential role of IFN-ß in the treatment of COVID-19 is also briefly discussed.