Pub Date : 2018-01-25DOI: 10.4172/2376-0389.1000215
A. Podlecka-Piętowska, Joanna Przybek, Kamil Chorążka, M. Nojszewska, B. Zakrzewska-Pniewska, A. Kaminska
Objective: Uric acid is a potent endogenous antioxidant and scavenger of peroxynitrite (PN), which hypothesized to be involved in the pathogenesis of multiple sclerosis (MS). Some studies reported lower levels of UA in MS patients compared with controls, whereas other studies found no difference. The main purpose of this analysis was to verify the hypothesis on lower serum levels of UA in MS patients compared with controls.Materials and methods: We examined 80 patients with clinically defined MS, according to the McDonald’s criteria and 53 patients of controls group (non-inflammatory neurological diseases, excluding vascular disorders). Uric acid concentration was determined by using a commercially available enzymatic colorimetric assay according to the manufacturer’s instructions.Results: Serum UA levels of MS patients were significantly lower (4.2 ± 1.1 mg/dl) when compared with control group (4.9 ± 1.4 mg/dl, P=0.0092). Correlation between MS duration and serum UA concentration did not reach statistical significance, however the tendency showing that patients who are suffering from this disorder for a longer time have lower serum UA concentration was observed. Moreover, we found a statistically significant correlation between disease duration and UA concentration in a subgroup of patient who did not have a history of mitoxantrone intake (P<0.0321).Conclusion: Although we do not know exactly whether and how uric acid is involved in MS pathogenesis, data suggest that UA concentration is lower in MS patients than in control group. It seems that low uric acid levels indicate patients with a higher risk of disease progression. Whether or not UA concentration can be useful as a biomarker in MS requires further study.
{"title":"Assessment of Serum Uric Acid Levels in Multiple Sclerosis during Disease-Modifying Treatment","authors":"A. Podlecka-Piętowska, Joanna Przybek, Kamil Chorążka, M. Nojszewska, B. Zakrzewska-Pniewska, A. Kaminska","doi":"10.4172/2376-0389.1000215","DOIUrl":"https://doi.org/10.4172/2376-0389.1000215","url":null,"abstract":"Objective: Uric acid is a potent endogenous antioxidant and scavenger of peroxynitrite (PN), which hypothesized to be involved in the pathogenesis of multiple sclerosis (MS). Some studies reported lower levels of UA in MS patients compared with controls, whereas other studies found no difference. The main purpose of this analysis was to verify the hypothesis on lower serum levels of UA in MS patients compared with controls.Materials and methods: We examined 80 patients with clinically defined MS, according to the McDonald’s criteria and 53 patients of controls group (non-inflammatory neurological diseases, excluding vascular disorders). Uric acid concentration was determined by using a commercially available enzymatic colorimetric assay according to the manufacturer’s instructions.Results: Serum UA levels of MS patients were significantly lower (4.2 ± 1.1 mg/dl) when compared with control group (4.9 ± 1.4 mg/dl, P=0.0092). Correlation between MS duration and serum UA concentration did not reach statistical significance, however the tendency showing that patients who are suffering from this disorder for a longer time have lower serum UA concentration was observed. Moreover, we found a statistically significant correlation between disease duration and UA concentration in a subgroup of patient who did not have a history of mitoxantrone intake (P<0.0321).Conclusion: Although we do not know exactly whether and how uric acid is involved in MS pathogenesis, data suggest that UA concentration is lower in MS patients than in control group. It seems that low uric acid levels indicate patients with a higher risk of disease progression. Whether or not UA concentration can be useful as a biomarker in MS requires further study.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"1 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76665065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0389.1000220
S. M. Drakulić, A. Vujic, A. Arsić, Snjezana M Lazarevic, J. Jevdjić, D. Aleksić
Objectives: The first objective of our study was to determine differences between groups of patients receiving disease modifying therapy (DMTs) (INFβ-1a and INFβ-1b), patients without DMTs and a control group, in terms of neuropsychological tests and event-related brain potentials (ERP). The second objective was to determine factors that may serve to assess the risk of cognitive impairment in patients with relapsing remitting multiple sclerosis (RRMS). Methods: A total of 81 RRMS patients (mean age 41.09 ± 8.71 years old, 51 women, mean disease duration 133.05 ± 76.56 months) and 32 healthy controls participated in the study. Cognitive functions were evaluated using a standard PASAT-3, the symbol digit modality test (SDMT) and ERP. Results: There were statistically significant differences between the mean values for parietal (Pz) (p ≤ 0.05) and central (Cz) latency (p<0.05) between the four groups of study participants. RRMS increased the risk of cognitive impairment approximately 3.5 fold. Each year of age raised the risk of cognitive impairment by 6.0%. Each unit increase in level of education reduced the risk of cognitive impairment approximately 2.5 fold. Increase in reaction time (RT) Cz by 1 ms elevated the risk of cognitive impairment by 0.5%. Conclusions: There were statistically significant differences between the mean values of Pz and Cz latency between the four groups of study participants. Factors that may be used to assess the risk of developing cognitive impairment in patients with RRMS include age, education level, and RT Cz. However, ERP (latency and amplitude) did not independently assess the risk of cognitive impairment in RRMS patients.
{"title":"Event Related Brain Potentials (ERP) Could Not Assess the Risk of Cognitive Impairment in Relapse-Remitting Multiple Sclerosis (RRMS)","authors":"S. M. Drakulić, A. Vujic, A. Arsić, Snjezana M Lazarevic, J. Jevdjić, D. Aleksić","doi":"10.4172/2376-0389.1000220","DOIUrl":"https://doi.org/10.4172/2376-0389.1000220","url":null,"abstract":"Objectives: The first objective of our study was to determine differences between groups of patients receiving disease modifying therapy (DMTs) (INFβ-1a and INFβ-1b), patients without DMTs and a control group, in terms of neuropsychological tests and event-related brain potentials (ERP). The second objective was to determine factors that may serve to assess the risk of cognitive impairment in patients with relapsing remitting multiple sclerosis (RRMS). Methods: A total of 81 RRMS patients (mean age 41.09 ± 8.71 years old, 51 women, mean disease duration 133.05 ± 76.56 months) and 32 healthy controls participated in the study. Cognitive functions were evaluated using a standard PASAT-3, the symbol digit modality test (SDMT) and ERP. Results: There were statistically significant differences between the mean values for parietal (Pz) (p ≤ 0.05) and central (Cz) latency (p<0.05) between the four groups of study participants. RRMS increased the risk of cognitive impairment approximately 3.5 fold. Each year of age raised the risk of cognitive impairment by 6.0%. Each unit increase in level of education reduced the risk of cognitive impairment approximately 2.5 fold. Increase in reaction time (RT) Cz by 1 ms elevated the risk of cognitive impairment by 0.5%. Conclusions: There were statistically significant differences between the mean values of Pz and Cz latency between the four groups of study participants. Factors that may be used to assess the risk of developing cognitive impairment in patients with RRMS include age, education level, and RT Cz. However, ERP (latency and amplitude) did not independently assess the risk of cognitive impairment in RRMS patients.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"181 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72646715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0389.1000217
Abdurasulova In, Matsulevich Av, Serdyuk Se, Gmiro Ve
The effect of N-decyltropine chloride (IEM-1556) and the reference drug glatiramer acetate (GA) on the severity of neurological disorders and the duration of the experimental allergic encephalomyelitis (EAE), modeling the processes of neural inflammation, demyelination and neurodegeneration characteristic for multiple sclerosis were studied. EAE in female Wistar rats was induced by a single subcutaneous (SC) inoculation of the homologous spinal cord homogenate in complete Freund’s adjuvant. The test preparations were administered from 2 to 16 days after induction of EAE. The severity of the disease was assessed in scores (from 0 to 6) by the presence in animals of persistent paresis and paralysis. The course systemic administration of IEM-1556 in a dose of 3 mg/kg reduced the severity and duration of EAE in rats, comparable to GA. Advantage of IEM-1556 before GA is the possibility of non-invasive application, as well as the presence of analgesic, antiparkinsonian and antidepressant action. It is assumed that the therapeutic effect of IEM-1556 is related to its ability to release endogenous adenosine, which causes neuroprotective, analgesic, antiparkinsonian and antidepressant effects of the drug.
{"title":"Comparative Study of the Influence of Iem-1556 and Glatiramer Acetate (Copaxon) on the Severity of Neurologic Disorders and the Duration of Experimental Allergic Encephalomielitis in the Rats","authors":"Abdurasulova In, Matsulevich Av, Serdyuk Se, Gmiro Ve","doi":"10.4172/2376-0389.1000217","DOIUrl":"https://doi.org/10.4172/2376-0389.1000217","url":null,"abstract":"The effect of N-decyltropine chloride (IEM-1556) and the reference drug glatiramer acetate (GA) on the severity of neurological disorders and the duration of the experimental allergic encephalomyelitis (EAE), modeling the processes of neural inflammation, demyelination and neurodegeneration characteristic for multiple sclerosis were studied. EAE in female Wistar rats was induced by a single subcutaneous (SC) inoculation of the homologous spinal cord homogenate in complete Freund’s adjuvant. The test preparations were administered from 2 to 16 days after induction of EAE. The severity of the disease was assessed in scores (from 0 to 6) by the presence in animals of persistent paresis and paralysis. The course systemic administration of IEM-1556 in a dose of 3 mg/kg reduced the severity and duration of EAE in rats, comparable to GA. Advantage of IEM-1556 before GA is the possibility of non-invasive application, as well as the presence of analgesic, antiparkinsonian and antidepressant action. It is assumed that the therapeutic effect of IEM-1556 is related to its ability to release endogenous adenosine, which causes neuroprotective, analgesic, antiparkinsonian and antidepressant effects of the drug.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"80 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73598376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0389.1000222
M. Britz, N. Fourie, D. Giampaolo, Guldenpfennig Cg, Isaacs, Opperman Dc, Pearl Jc, Retief Cf, Shamley Dp, Terblanche Jm, Bhigjee Ai
Back ground: South Africa, which has a multi-ethnic population of over fifty million, is considered to have a medium (5-30/100 000) prevalence rate of Multiple Sclerosis. Teriflunomide is one of two oral disease modifying agents that have been registered in this country. We describe the real-world experience of this drug in South Africa with respect to efficacy, tolerability and side effects. Methods: A retrospective analysis was undertaken of the demographics, clinical presentation, number of preceding relapses, date of last relapse, degree of disability (Expanded Disability Status Scale–EDSS- score) and the magnetic resonance imaging (MRI) changes at initiation of therapy with teriflunomide (14 mg daily orally) and the subsequent course. Tolerability and side effects were recorded. Any preceding disease modifying therapy was recorded. The treating neurologists were asked about the effectiveness of teriflunomide in the patients under their care. Results: Data for 32 patients was analysed. The majority were women (75%) and of white race (78.1%). The mean age (±SD) was 41.1 (11.5) years at the time of initial assessment. Twenty six of the 32 (81%) patients were on prior disease modifying therapy (DMT) which consisted of an interferon-beta 1a or 1b and glatiramer acetate. One patient was on teriflunomide at initiation of the study. The duration on treatment with DMTs prior to teriflunomide ranged from 7.0 to 236.6 months with a mean (±SD) of 96.5 (71.2) months. The duration of therapy with teriflunomide varied from 3 to 24 months with a mean (±SD) of 12.3 (5.0) months. Fourteen patients experienced mild to moderate relapses while on teriflunomide treatment, with 56% remaining relapse free over the study period. The mean (±SD) EDSS score on teriflunomide was 2.5 (1.6), remaining relatively stable compared to the baseline score 2.6 (1.3). The drug was well tolerated in 24 patients, satisfactorily tolerated in 7 and not tolerated in 1. The treating neurologists’ assessment was that the drug was an effective treatment choice in 87.1% of patients, with 96.9% of patients remaining on therapy at the time of analysis. One patient experienced 2 relapses in the year of treatment and one experienced a relapse and progression of the gait disturbance. Conclusions: This small “real world” study confirms that teriflunomide is an effective DMT for patients with mild to moderate MS, prolonged disease duration and switching from other DMTs. It has a tolerable side effect profile. The oral administration compared to the interferons will appeal to many patients. The drug was also effective in patients who were on previous DMTs.
{"title":"Real World Use of Teriflunomide in South Africa: A Medium Prevalence Multiple Sclerosis Area","authors":"M. Britz, N. Fourie, D. Giampaolo, Guldenpfennig Cg, Isaacs, Opperman Dc, Pearl Jc, Retief Cf, Shamley Dp, Terblanche Jm, Bhigjee Ai","doi":"10.4172/2376-0389.1000222","DOIUrl":"https://doi.org/10.4172/2376-0389.1000222","url":null,"abstract":"Back ground: South Africa, which has a multi-ethnic population of over fifty million, is considered to have a medium (5-30/100 000) prevalence rate of Multiple Sclerosis. Teriflunomide is one of two oral disease modifying agents that have been registered in this country. We describe the real-world experience of this drug in South Africa with respect to efficacy, tolerability and side effects. Methods: A retrospective analysis was undertaken of the demographics, clinical presentation, number of preceding relapses, date of last relapse, degree of disability (Expanded Disability Status Scale–EDSS- score) and the magnetic resonance imaging (MRI) changes at initiation of therapy with teriflunomide (14 mg daily orally) and the subsequent course. Tolerability and side effects were recorded. Any preceding disease modifying therapy was recorded. The treating neurologists were asked about the effectiveness of teriflunomide in the patients under their care. Results: Data for 32 patients was analysed. The majority were women (75%) and of white race (78.1%). The mean age (±SD) was 41.1 (11.5) years at the time of initial assessment. Twenty six of the 32 (81%) patients were on prior disease modifying therapy (DMT) which consisted of an interferon-beta 1a or 1b and glatiramer acetate. One patient was on teriflunomide at initiation of the study. The duration on treatment with DMTs prior to teriflunomide ranged from 7.0 to 236.6 months with a mean (±SD) of 96.5 (71.2) months. The duration of therapy with teriflunomide varied from 3 to 24 months with a mean (±SD) of 12.3 (5.0) months. Fourteen patients experienced mild to moderate relapses while on teriflunomide treatment, with 56% remaining relapse free over the study period. The mean (±SD) EDSS score on teriflunomide was 2.5 (1.6), remaining relatively stable compared to the baseline score 2.6 (1.3). The drug was well tolerated in 24 patients, satisfactorily tolerated in 7 and not tolerated in 1. The treating neurologists’ assessment was that the drug was an effective treatment choice in 87.1% of patients, with 96.9% of patients remaining on therapy at the time of analysis. One patient experienced 2 relapses in the year of treatment and one experienced a relapse and progression of the gait disturbance. Conclusions: This small “real world” study confirms that teriflunomide is an effective DMT for patients with mild to moderate MS, prolonged disease duration and switching from other DMTs. It has a tolerable side effect profile. The oral administration compared to the interferons will appeal to many patients. The drug was also effective in patients who were on previous DMTs.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"8 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87701513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0389.1000221
S. Abdullah, Tan Ct
Objective: To evaluate the efficacy of plasma exchange (PLEX) in steroid refractory inflammatory demyelination diseases (IDD) of Central nervous system (CNS). Methods: Retrospective review of patients presented with steroid refractory IDD from 2006 to 2016 that underwent PLEX. Clinical data on neurological assessment, time to treatment initiation, visual acuity (VA) and Expanded Disability Status Scale (EDSS) were gathered from the medical records. The primary outcome was improvement at 3 months after PLEX. Statistical analysis was done using the SPSS version 21. Results: Forty-three plasma exchanges were performed involving 27 patients (NMOSD= 22, RRMS= 4, ITM= 1). The mean age of patient was 43.60 ± 15.18, and the mean EDSS was 7.98 ± 1.07 at presentation. The anti-AQP4 antibody was detected in 81.5%. Treatment success was observed in 21/43 (48.8%) of patients with a significant improvement of 2.13 EDSS point post PLEX. A lower baseline EDSS score ≤ 6 showed a trend toward good outcome (p= 0.07). AQP4 status had no influence on treatment outcome. Male gender, preserved reflexes, use of DMT and shorter time to PLEX initiation, were not associated with treatment outcome. Conclusion: PLEX is an effective treatment for steroid refractory IDD, regardless of the AQP4 antibody status. A lower baseline EDSS might be associated with a better treatment outcome. PLEX should be considered irrespective of the symptom duration.
{"title":"Therapeutic Effect of Plasma Exchange in Steroid Refractory Inflammatory Demyelination of Central Nervous System: Outcome from a Tertiary Centre in Malaysia","authors":"S. Abdullah, Tan Ct","doi":"10.4172/2376-0389.1000221","DOIUrl":"https://doi.org/10.4172/2376-0389.1000221","url":null,"abstract":"Objective: To evaluate the efficacy of plasma exchange (PLEX) in steroid refractory inflammatory demyelination diseases (IDD) of Central nervous system (CNS). Methods: Retrospective review of patients presented with steroid refractory IDD from 2006 to 2016 that underwent PLEX. Clinical data on neurological assessment, time to treatment initiation, visual acuity (VA) and Expanded Disability Status Scale (EDSS) were gathered from the medical records. The primary outcome was improvement at 3 months after PLEX. Statistical analysis was done using the SPSS version 21. Results: Forty-three plasma exchanges were performed involving 27 patients (NMOSD= 22, RRMS= 4, ITM= 1). The mean age of patient was 43.60 ± 15.18, and the mean EDSS was 7.98 ± 1.07 at presentation. The anti-AQP4 antibody was detected in 81.5%. Treatment success was observed in 21/43 (48.8%) of patients with a significant improvement of 2.13 EDSS point post PLEX. A lower baseline EDSS score ≤ 6 showed a trend toward good outcome (p= 0.07). AQP4 status had no influence on treatment outcome. Male gender, preserved reflexes, use of DMT and shorter time to PLEX initiation, were not associated with treatment outcome. Conclusion: PLEX is an effective treatment for steroid refractory IDD, regardless of the AQP4 antibody status. A lower baseline EDSS might be associated with a better treatment outcome. PLEX should be considered irrespective of the symptom duration.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90760092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0389.1000219
Chmelařová Dana, P. Marek, D. Martin, B. Petra, Beran Jiří
Objectives: The purpose of the current study was to evaluate whether a 12-week neuropsychological rehabilitation program has a positive effect on the improvement of cognitive functions and what methods can be used to measure this effect. Furthermore, this study intended to verify the effect of the chosen training plan on the resulting state of cognitive functions, in particular with regard to the frequency and duration of the plan. Methodology: Fifty-eight patients diagnosed with MS were randomized into an experimental condition or the control group, 15 patients were excluded from the study. The experimental condition included 26 patients (22 women and 4 men), whole the control group consisted of 17 patients (12 women and 5 men). All of these patients had a cognitive defect that was assessed at the beginning of the study and monitored using the neuropsychological tests after the participation in the training program. Participants in the experimental group received their rehabilitation of cognitive functions using a PC training program, which they completed in their home environments (30 mins/4 times per week, for 8 consecutive weeks). Overall, there were 32 training sessions on predetermined days with a specific detailed training plan. The control group received no training. The neuropsychological tests used at the beginning and the conclusion of the study showed a positive effect of the training program, while the greatest improvement was seen in the areas of immediate memory and attention. Results: The results showed a positive effect related to neuropsychological rehabilitation in MS patients that received regular training four times per week for eight consecutive weeks.
{"title":"The Possibilities and Limits of the Rehabilitation of Cognitive Functions in Patients with Multiple Sclerosis Using a Computer Program","authors":"Chmelařová Dana, P. Marek, D. Martin, B. Petra, Beran Jiří","doi":"10.4172/2376-0389.1000219","DOIUrl":"https://doi.org/10.4172/2376-0389.1000219","url":null,"abstract":"Objectives: The purpose of the current study was to evaluate whether a 12-week neuropsychological rehabilitation program has a positive effect on the improvement of cognitive functions and what methods can be used to measure this effect. Furthermore, this study intended to verify the effect of the chosen training plan on the resulting state of cognitive functions, in particular with regard to the frequency and duration of the plan. Methodology: Fifty-eight patients diagnosed with MS were randomized into an experimental condition or the control group, 15 patients were excluded from the study. The experimental condition included 26 patients (22 women and 4 men), whole the control group consisted of 17 patients (12 women and 5 men). All of these patients had a cognitive defect that was assessed at the beginning of the study and monitored using the neuropsychological tests after the participation in the training program. Participants in the experimental group received their rehabilitation of cognitive functions using a PC training program, which they completed in their home environments (30 mins/4 times per week, for 8 consecutive weeks). Overall, there were 32 training sessions on predetermined days with a specific detailed training plan. The control group received no training. The neuropsychological tests used at the beginning and the conclusion of the study showed a positive effect of the training program, while the greatest improvement was seen in the areas of immediate memory and attention. Results: The results showed a positive effect related to neuropsychological rehabilitation in MS patients that received regular training four times per week for eight consecutive weeks.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"107 2 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91003695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0389.1000223
Sapko K, Jamroz-Wisniewska A, Kulczynski M, Marciniec M, Szczepanska-Szerej A, Rejdak K
Multiple sclerosis is an inflammatory, demyelinating disease of the central nervous system. Most patients have a relapsing-remitting disease type, for which medicines are mostly dedicated. Clinical course of some patients will transition to secondary progressive multiple sclerosis and small portion of patients is classified as primary progressive multiple sclerosis from the beginning. The treatment of progressive multiple sclerosis has been limited for a long time, however, for a few years attention has been paid to the need for new disease modifying drugs that would focus on the treatment of progressive multiple sclerosis. The breakthrough was ocrelizumab, which is the first medicine registered in the treatment of primary progressive multiple sclerosis, while siponimod is planned to be approved soon in the treatment of secondary progressive multiple sclerosis. Numerous studies are currently underway on new substances with anti-inflammatory, neuroprotective or remyelinating effects such as high-dose biotin, ibudilast, simvastatin, alpha lipoic acid or clemastine. The first research results are very promising nevertheless, more accurate drug research is needed.
{"title":"New Highlights in the Treatment of Progressive Multiple Sclerosis","authors":"Sapko K, Jamroz-Wisniewska A, Kulczynski M, Marciniec M, Szczepanska-Szerej A, Rejdak K","doi":"10.4172/2376-0389.1000223","DOIUrl":"https://doi.org/10.4172/2376-0389.1000223","url":null,"abstract":"Multiple sclerosis is an inflammatory, demyelinating disease of the central nervous system. Most patients have a relapsing-remitting disease type, for which medicines are mostly dedicated. Clinical course of some patients will transition to secondary progressive multiple sclerosis and small portion of patients is classified as primary progressive multiple sclerosis from the beginning. The treatment of progressive multiple sclerosis has been limited for a long time, however, for a few years attention has been paid to the need for new disease modifying drugs that would focus on the treatment of progressive multiple sclerosis. The breakthrough was ocrelizumab, which is the first medicine registered in the treatment of primary progressive multiple sclerosis, while siponimod is planned to be approved soon in the treatment of secondary progressive multiple sclerosis. Numerous studies are currently underway on new substances with anti-inflammatory, neuroprotective or remyelinating effects such as high-dose biotin, ibudilast, simvastatin, alpha lipoic acid or clemastine. The first research results are very promising nevertheless, more accurate drug research is needed.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"1 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90563401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-28DOI: 10.4172/2376-0389.1000210
B. Nexø, E. Horváth-Puhó, J. Sundbøll
Background: We studied the cancer comorbidity of 18,212 Danish Multiple Sclerosis (MS) patients. Methods: Using data from the Danish National Patient Registry we identified all persons with a first-time MS diagnosis during 1980-2013. Cancer outcomes of the study cohort were ascertained using diagnoses from the Danish Cancer Registry. Patients with cancer prior to MS were excluded. We computed standardized incidence ratios with 95% confidence intervals calculated as the number of observed cancers relative to the expected based on national incidence rates by sex, age and calendar year. Results: All sites of cancers in the CNS were significantly increased, namely cancers of 1) membrane of the brain and spinal meninges, 2) brain, as well as 3) spinal cord, cranial nerves and central nervous system. MS is a disease of the CNS, and the 3 CNS cancer groups were individually significant. Several other cancers were also increased, namely 1) overall cancer, 2) urinary bladder cancer, 3) metastases and non-specified cancer in lymph nodes and 4) basal cell carcinoma. Conclusion: Multiple sclerosis is associated with increased registration of a range of cancers, in particular in the period following debut of MS. The results may be due to detection bias and misregistration. Finally, the results could be due to confounding.
{"title":"Registration of Increased Risk of Brain Cancer after the Diagnosis of Multiple Sclerosis","authors":"B. Nexø, E. Horváth-Puhó, J. Sundbøll","doi":"10.4172/2376-0389.1000210","DOIUrl":"https://doi.org/10.4172/2376-0389.1000210","url":null,"abstract":"Background: We studied the cancer comorbidity of 18,212 Danish Multiple Sclerosis (MS) patients. \u0000Methods: Using data from the Danish National Patient Registry we identified all persons with a first-time MS diagnosis during 1980-2013. Cancer outcomes of the study cohort were ascertained using diagnoses from the Danish Cancer Registry. Patients with cancer prior to MS were excluded. We computed standardized incidence ratios with 95% confidence intervals calculated as the number of observed cancers relative to the expected based on national incidence rates by sex, age and calendar year. \u0000Results: All sites of cancers in the CNS were significantly increased, namely cancers of 1) membrane of the brain and spinal meninges, 2) brain, as well as 3) spinal cord, cranial nerves and central nervous system. MS is a disease of the CNS, and the 3 CNS cancer groups were individually significant. Several other cancers were also increased, namely 1) overall cancer, 2) urinary bladder cancer, 3) metastases and non-specified cancer in lymph nodes and 4) basal cell carcinoma. \u0000Conclusion: Multiple sclerosis is associated with increased registration of a range of cancers, in particular in the period following debut of MS. The results may be due to detection bias and misregistration. Finally, the results could be due to confounding.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"81 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82203650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-25DOI: 10.4172/2376-0389.1000209
Toktam Deylami, M. Sanati, G. Ahangari
Background: Multiple sclerosis (MS) is a chronic, inflammatory and autoimmune disease of central nervous system. MS affects nearly 2.5 million people in the world and is twice more common in women than men. Autoimmune T-cells target the myelin sheath in central nervous system, causing inflammation, demyelination and eventual destruction of neurons. We examined changing expression of serotonin receptor (5-HT3RA) as well as monoamine oxidase (MAO-A) genes in peripheral blood mononuclear cells in MS patients. Materials and methods: In this study, peripheral blood mononuclear cells (PBMC) were first isolated from 30 healthy controls and 30 volunteers with MS using Ficoll-hypaque. Total RNA was extracted and cDNA was synthesized. In this process, mRNA concentration of 5-HT3RA and MAO-A as target genes as well as β-actin as reference gene was compared in PBMC of healthy subjects and patients using Real-time PCR. Results: After statistical analysis of resulting data, a significant increase was observed in the expression of 5-HT3RA receptor gene as well as MAO-A gene in PBMC of patients with multiple sclerosis (P=0.001). Conclusion: According to previous studies on the association between serotonin level with MS importance of 5-HT3RA serotonin receptor in the function of this neurotransmitter as well as T-cell activation along with significant increase in the expression of 5-HT3RA receptor in MS patients, it can be concluded that overexpression of this receptor has a significant correlation with MS progress. On the other hand, considering the fact that monoamine oxidase is a key enzyme responsible for oxidation of serotonin in the nervous system, perhaps the body is not capable of maintaining normal level of this enzyme in MS patients. Therefore, considerable increase in MAO level may be responsible for reduced level of serotonin in MS patients, which is a likely reason for depression in these patients.
{"title":"New Discernment of Pathophysiological Aspects of Multiple Sclerosis Based On Mono Amino Oxidase (MAO) and Ion Channel Receptor 5HT3RA as Activator of T-Cells","authors":"Toktam Deylami, M. Sanati, G. Ahangari","doi":"10.4172/2376-0389.1000209","DOIUrl":"https://doi.org/10.4172/2376-0389.1000209","url":null,"abstract":"Background: Multiple sclerosis (MS) is a chronic, inflammatory and autoimmune disease of central nervous system. MS affects nearly 2.5 million people in the world and is twice more common in women than men. Autoimmune T-cells target the myelin sheath in central nervous system, causing inflammation, demyelination and eventual destruction of neurons. We examined changing expression of serotonin receptor (5-HT3RA) as well as monoamine oxidase (MAO-A) genes in peripheral blood mononuclear cells in MS patients. \u0000Materials and methods: In this study, peripheral blood mononuclear cells (PBMC) were first isolated from 30 healthy controls and 30 volunteers with MS using Ficoll-hypaque. Total RNA was extracted and cDNA was synthesized. In this process, mRNA concentration of 5-HT3RA and MAO-A as target genes as well as β-actin as reference gene was compared in PBMC of healthy subjects and patients using Real-time PCR. \u0000Results: After statistical analysis of resulting data, a significant increase was observed in the expression of 5-HT3RA receptor gene as well as MAO-A gene in PBMC of patients with multiple sclerosis (P=0.001). \u0000Conclusion: According to previous studies on the association between serotonin level with MS importance of 5-HT3RA serotonin receptor in the function of this neurotransmitter as well as T-cell activation along with significant increase in the expression of 5-HT3RA receptor in MS patients, it can be concluded that overexpression of this receptor has a significant correlation with MS progress. On the other hand, considering the fact that monoamine oxidase is a key enzyme responsible for oxidation of serotonin in the nervous system, perhaps the body is not capable of maintaining normal level of this enzyme in MS patients. Therefore, considerable increase in MAO level may be responsible for reduced level of serotonin in MS patients, which is a likely reason for depression in these patients.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73457488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-21DOI: 10.4172/2376-0389.1000211
A. A. Dabilgou, C. Napon, Benilde Teinture, Kambou, J. Kyelem, A. Dravé, J. Kaboré
Introduction: Multiple sclerosis (MS) is the main demyelinating inflammatory disease of the central nervous system. It usually affects young female adults between 20 and 40 years old, during professional activity period. Diagnosis is based on combination of the clinical presentation, the white-matter abnormalities on MRI, the CSF and the evoked potentials, making differential diagnosis of MS. Treatment of MS intend to prevent relapses and to delay progressive aggravation of the disease. Through this case report, the authors show that multiple sclerosis is a disease present in sub-Saharan Africa. Case presentation: This is a case report of a 25-year-old Burkinabe, hospitalized in the department of neurology on 13th September 2014 for motor deficit of the four limbs developing progressively without fever over three weeks. The medical history found diffuse paraesthesias described as tingling of the four limbs to the flexion of the neck, a decline in visual acuity of the left eye, a slowing of walk speed, dysarthria and sphincter disorders like urinary urgency. Neurological examination revealed a predominantly proximal spastic tetraparesis with bilateral Babinski sign; cerebellar dysfunction with dysarthria, enlargement of the polygon and kinetic ataxia of upper limbs, swallowing disorders and lingual atrophy. The lumbar puncture showed a clear cerebrospinal fluid, at normal pressure, increased cell count with 8 cells /ml and a normal glycorrhachia. On cerebral and spinal MRI, there were diffuse hyper-intensities which met the criteria of Bancroft and of MacDonald supporting multiple sclerosis diagnosis. The clinical course was favorable under corticosteroid therapy after 30 days of hospitalization. Conclusion: Multiple sclerosis is a rare neurological disease in the black African. The discovery of a case in Burkina Faso shows the importance of carrying out radiological assessment in every case of acute myelitis occurring in the young people.
{"title":"Multiple Sclerosis in West Africa, about a Case Confirmed at Ouagadougou, Burkina Faso","authors":"A. A. Dabilgou, C. Napon, Benilde Teinture, Kambou, J. Kyelem, A. Dravé, J. Kaboré","doi":"10.4172/2376-0389.1000211","DOIUrl":"https://doi.org/10.4172/2376-0389.1000211","url":null,"abstract":"Introduction: Multiple sclerosis (MS) is the main demyelinating inflammatory disease of the central nervous system. It usually affects young female adults between 20 and 40 years old, during professional activity period. Diagnosis is based on combination of the clinical presentation, the white-matter abnormalities on MRI, the CSF and the evoked potentials, making differential diagnosis of MS. Treatment of MS intend to prevent relapses and to delay progressive aggravation of the disease. Through this case report, the authors show that multiple sclerosis is a disease present in sub-Saharan Africa. \u0000Case presentation: This is a case report of a 25-year-old Burkinabe, hospitalized in the department of neurology on 13th September 2014 for motor deficit of the four limbs developing progressively without fever over three weeks. The medical history found diffuse paraesthesias described as tingling of the four limbs to the flexion of the neck, a decline in visual acuity of the left eye, a slowing of walk speed, dysarthria and sphincter disorders like urinary urgency. Neurological examination revealed a predominantly proximal spastic tetraparesis with bilateral Babinski sign; cerebellar dysfunction with dysarthria, enlargement of the polygon and kinetic ataxia of upper limbs, swallowing disorders and lingual atrophy. The lumbar puncture showed a clear cerebrospinal fluid, at normal pressure, increased cell count with 8 cells /ml and a normal glycorrhachia. On cerebral and spinal MRI, there were diffuse hyper-intensities which met the criteria of Bancroft and of MacDonald supporting multiple sclerosis diagnosis. The clinical course was favorable under corticosteroid therapy after 30 days of hospitalization. \u0000Conclusion: Multiple sclerosis is a rare neurological disease in the black African. The discovery of a case in Burkina Faso shows the importance of carrying out radiological assessment in every case of acute myelitis occurring in the young people.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"111 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80253610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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