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Safety and Efficacy of Rituximab: Experience of a Single Multiple Sclerosis Center.

OBJECTIVES: Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system. B cells play an important pathogenic role in MS. Rituximab (RTX), a B-cell depleting drug, has been used to treat MS and neuromyelitis optica (NMO). Patient characteristics, safety, and efficacy measures are reviewed to ascertain the therapeutic benefit and safety of RTX in a real-world setting with long-term follow-up. METHODS: This is a retrospective chart review of patients who received RTX at The Ohio State University's MS clinic from January 2005 to October 2016. RESULTS: Of the 64 patient c…

Quantitative susceptibility mapping identifies inflammation in a subset of chronic multiple sclerosis lesions.

Chronic active multiple sclerosis lesions, characterized by a hyperintense rim of iron-enriched, activated microglia and macrophages, have been linked to greater tissue damage. Post-mortem studies have determined that chronic active lesions are primarily related to the later stages of multiple sclerosis; however, the occurrence of these lesions, and their relationship to earlier disease stages may be greatly underestimated. Detection of chronic active lesions across the patient spectrum of multiple sclerosis requires a validated imaging tool to accurately identify lesions with persistent infla…

От адаптивного к неадаптационному гиппокампальному функциональному соединению в состоянии отдыха в течение нескольких склерозов для понимания нарушения памяти.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Остается неясным, каким образом изменения функциональных связей в состоянии покоя (RSF) в гиппокампе изменяют негативное воздействие повреждений белой материи (WM) на эффективность памяти в ходе множественных склерозов (MS). В ходе этого исследования изучается вопрос о том, влияют ли изменения гиппокампала resFC на каждой клинической стадии MS на эффективность памяти. Это перекрестное исследование охватывало 109 человек: 30 здоровых и 79 пациентов (20 с синдромом клинической или радиологической изоляции (CIS-RIS), 24 с релапсирующим MS (RRMS) и 35 с прогрессивным MS (PMS

Совпадение в аннотации оригинала
BACKGROUND: It remains unclear how resting-state functional connectivity (rsFC) changes in the hippocampus modulate the negative impact of white matter (WM) lesions on memory performance over the course of multiple sclerosis (MS). This study investigates whether hippocampal rsFC alterations at each MS clinical stage affect memory performance. METHODS: This …

Glial cell injury and atrophied lesion volume as measures of chronic multiple sclerosis inflammation.

BACKGROUND: Atrophied lesion volume (aLV), a proposed biomarker of disability progression in multiple sclerosis (MS) and transition into progressive MS (PMS), depicts chronic periventricular white matter (WM) pathology. Meningeal infiltrates, imaged as leptomeningeal contrast enhancement (LMCE), are linked with greater cortical pathology. OBJECTIVES: To determine the relationship between serum-derived proteomic data with the development of aLV and LMCE in a heterogeneous group of people with MS (pwMS). METHODS: Proteomic and MRI data for 202 pwMS (148 clinically isolated syndrome /relapsing-…

Multiple sclerosis and affective disorders.

Affective disorders occurring in association with multiple sclerosis have been attributed both to the psychosocial impact of a chronic disabling illness and to the structural lesions of cerebral demyelination. A review of research evidence suggests that while there is a correlation between chronic depressive symptoms and both progressive disability and lack of social support, acute major depressive and manic episodes may be psychiatric manifestations of demyelinating lesions and may be the initial presenting symptoms of multiple sclerosis. Anti-inflammatory agents may be required in the manage…

Evidence of skull bone translocator protein overexpression linked to multiple sclerosis progression.

The skull bone marrow contributes to brain immune homeostasis via recently discovered skull-meningeal channels, enabling the bidirectional trafficking of immune cells between skull bone and underlying dura mater. In multiple sclerosis, autoreactive T cells migrate to the bone marrow and shift its haematopoietic output towards myeloid differentiation, contributing to disease progression. However, the role of the skull bone marrow in multiple sclerosis pathophysiology, and its relationship to brain damage and clinical disability remain largely unexplored. We utilized simultaneous MR-PET with the…

Relating perivascular imaging measures to longitudinal lesion evolution and chronic inflammation in multiple sclerosis.

BACKGROUND: Perivascular space (PVS) alterations may be associated with acute and chronic inflammatory activity in people with multiple sclerosis (pwMS). PURPOSE: Investigate whether diffusion tensor image analysis along the PVS (DTI-ALPS) or PVS number/volume are associated with lesion evolution in pwMS over 5-years. METHODS: 182 patients (142 relapsing-remitting MS [pwRRMS] and 40 progressive MS [pwPMS]) underwent clinical and MRI examinations at baseline and 5-year follow-up. All pwMS were assessed for contrast enhancing lesions (CELs), T2 lesions, T1 lesions and cortical lesions (CLs). A…

Стул Glial Fibrilar Acidic Protein поднимается в прогрессивном многократном склерозе.

ЦЕЛИ: Кишечная микробиота и видоизмененная кишечная физиология были связаны с множественным склерозом (MS). Интестические глиальные клетки регулируют интестинальную нервную и иммунную функцию и экспресс-гильярный фибриллярный кислотный белок (GFAP) и S100β. Световая цепочка Serum GFAP и нейрофильтров может предсказывать ухудшение состояния заболеваний; однако никаких четких маркеров не отличает от рецидивов. МЕТОДЫ: Для изучения интеритальной глиальной функции в MS мы измерили стул GFAP (st-GFAP) с использованием анализа иммуносорбента, связанного с ферментом, в рамках 31 здорового контроля (H

Совпадение в аннотации оригинала
OBJECTIVES: The gut microbiota and altered intestinal physiology have been implicated in multiple sclerosis (MS). Enteric glial cells regulate enteric nervous and immune function and express glial fibrillary acidic protein (GFAP) and S100β. Serum GFAP and neurofilament light chain can predict disease worsening; however, no clear markers differentiate relapsi…

Comparative efficacy and safety of ocrelizumab in relapsing-remitting and primary progressive multiple sclerosis: A systematic review and meta-analysis.

OBJECTIVE: This meta-analysis synthesizes evidence from all available randomized trials and observational cohort studies evaluating the efficacy and safety of ocrelizumab compared to placebo or active comparator therapies. BACKGROUND: Ocrelizumab (OCR), a monoclonal antibody targeting CD20-positive B-cells, is a high-efficacy therapy for multiple sclerosis (MS). While pivotal trials demonstrate its efficacy in reducing relapses, its impact on disability progression and its safety profile in broader, real-world populations require further synthesis. METHODS: This systematic review and meta-an…

Multiple sclerosis in Belgian children: A multicentre retrospective study.

BACKGROUND: Although the diagnosis of multiple sclerosis (MS) in the paediatric population remains challenging, paediatric-onset MS is increasingly recognized worldwide. METHODS: We report on the clinical and biochemical features of a Belgian multicentre cohort of paediatric MS patients in a national retrospective descriptive study. RESULTS: Twenty one paediatric MS patients from four Belgian University Hospitals were included. In nine patients, onset of MS was before the age of ten years which makes the study cohort of special interest. We report a higher incidence of acute disseminated enc…

Актуальность объемов хороидного слекуса в множестве склерозов.

РЫНК: Хороидный спекус (ChP) играет ключевую роль в провокационных процессах, происходящих при множестве склерозов (MS). Расширение ЧП при повторном излучающем многократном склерозе (RRMS) рассматривается как свидетельство активности заболеваний и связано с нарушением перивентральной ремиелинации. Цель этого перекрестного исследования состояла в том, чтобы определить взаимосвязь между повреждением ПЗ и перивентральной ткани, которое происходит в MS, и разъяснить роль нейроинфламмации в первичном прогрессивном множественном склерозе (ППМС). МЕТОДЫ: Объем ЧВ был оценен с помощью нового метода гл

Совпадение в аннотации оригинала
BACKGROUND: The choroid plexus (ChP) plays a pivotal role in inflammatory processes that occur in multiple sclerosis (MS). The enlargement of the ChP in relapsing-remitting multiple sclerosis (RRMS) is considered to be an indication of disease activity and has been associated with periventricular remyelination failure. This cross-sectional study aimed to ide…

A comprehensive systematic review of Ibudilast as a neuroprotective therapy for progressive multiple sclerosis.

BACKGROUND: Ibudilast, a phosphodiesterase inhibitor, has shown promise potential in Multiple sclerosis (MS) therapy. OBJECTIVES: This systematic review synthesizes evidence from clinical trials to assess the neuroprotective effects of ibudilast in progressive MS, focusing on brain atrophy, disability progression, and safety outcomes. METHODS: Following PRISMA 2020 guidelines, a systematic search of PubMed, Embase, Web of Science, and Scopus (1995-2025) for randomized controlled trials and prospective studies was conducted. Thirteen studies met inclusion criteria, including the phase 2 SPRIN…

Isolated intestinal myopathy resembling progressive systemic sclerosis in a child.

A 15-yr-old girl had a life-threatening episode of toxic megacolon at age 6 yr and a life-long history of constipation and abdominal distention. A diagnosis of chronic intestinal pseudoobstruction was made. Her clinical course was that of repeated bouts of pseudoobstruction, multiple episodes of intestinal volvulus at different sites, and progressive cachexia. Histologic examination of specimens of jejunum, ileum, appendix, and colon revealed progressive fibrotic changes in intestinal smooth muscle. The abnormalities observed are most consistent with those described in progressive systemic scl

Sodium channel blockers for neuroprotection in multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is an autoimmune, inflammatory, demyelinating disease of the central nervous system (CNS), which can occur in many parts of the CNS and result in a wide range of symptoms including sensory impairment, fatigue, walking or balance problems, visual impairment, vertigo and cognitive disabilities. At present, the most commonly used MS treatments are immunomodulating agents, but they have little effect on the disability. Experimental studies show that sodium (Na(+)) accumulation leads to intracellular calcium (Ca(2+)) release, and the increased calcium levels can …

Progressive Multifocal Leukoencephalopathy in a Patient With Progressive Multiple Sclerosis Treated With Ocrelizumab Monotherapy.

IMPORTANCE: Progressive multifocal leukoencephalopathy (PML) is an opportunistic infection caused by the JC virus that has no proven effective treatment. Although rare cases of PML have occurred with other anti-CD20 therapies, there had been no prior cases associated with ocrelizumab. OBJECTIVE: To report the first ever case of PML occurring with ocrelizumab monotherapy in a patient with progressive multiple sclerosis without prior immunomodulation. DESIGN, SETTING, AND PARTICIPANT: This case was reported from an academic medical center. The patient had multiple sclerosis while receiving ocr…

Decreased frequency of regulatory T cells and level of helios gene expression in secondary progressive multiple sclerosis patients: Evidence about the development of multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is an aggressive disease characterized by central nervous system (CNS) inflammatory and demyelinating lesions. Tolerance failure is implicated in the development of several autoimmune disorders, including MS. Due to their involvement in maintaining environmental tolerance, regulatory T cells (Tregs) are regarded as efficient immune cells. We examined the frequency of Tregs in this study using CD4/CD25/forkhead box protein P3 (FOXP3)/Helios markers. METHODS: Fifty participants, including 25 patients with secondary progressive MS (SPMS) and 25 healthy control…

Serum Neurofilament Light Chain and Glial Fibrillary Acidic Protein as Biomarkers in Primary Progressive Multiple Sclerosis and Hereditary Spastic Paraplegia Type 4.

In patients with slowly progressive spastic paraparesis, the differential diagnosis of primary progressive multiple sclerosis (PPMS) and hereditary spastic paraplegia (HSP) can be challenging. Serum neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) are promising fluid biomarkers to support the diagnostic workup. Serum NfL is a marker of neuroaxonal decay sensitive to temporal changes, while elevated sGFAP levels may reflect astrocytal involvement in PPMS. We assessed sNfL and sGFAP levels in 25 patients with PPMS, 25 patients with SPG4 (the most common type of HSP) a…

Laminar analysis of the cortical T1/T2-weighted ratio at 7T.

OBJECTIVE: In this observational study, we explored cortical structure as function of cortical depth through a laminar analysis of the T1/T2-weighted (T1w/T2w) ratio, which has been related to dendrite density in ex vivo brain tissue specimens of patients with MS. METHODS: In 39 patients (22 relapsing-remitting, 13 female, age 41.1 ± 10.6 years; 17 progressive, 11 female, age 54.1 ± 9.9 years) and 21 healthy controls (8 female, , age 41.6 ± 10.6 years), we performed a voxel-wise analysis of T1w/T2w ratio maps from high-resolution 7T images from the subpial surface to the gray matter/white mat

The prevalence of multiple sclerosis in the District of Santarém, Portugal.

The prevalence of multiple sclerosis (MS) in Portugal is still unknown. Recent studies conducted in southern European countries showed higher than expected rates of MS prevalence. In an attempt to evaluate the MS prevalence in Santarém--a district with 62621 inhabitants (1991 census) located in the centre of Portugal--we have conducted a population survey in this district for five years. The crude prevalence rate found was 46.3/100,000. This figure is not different from findings recently reported in studies conducted at similar latitudes in neighbour southern European countries. This was the f…

B-cell abundance in perivascular cuffs associates with local lesion activity in multiple sclerosis.

Perivascular aggregations of leukocytes, referred to as perivascular cuffs, are a pathological phenomenon in progressive multiple sclerosis (MS). Perivascular cuffing is an exaggerated form of compartmentalized inflammation present in progressive disease. By studying traits of perivascular cuffs, this study aims to elucidate processes within the perivascular niche of the MS brain. We characterized n = 255 MS donors from the Netherlands Brain Bank for the presence of perivascular cuffs and investigated their association with clinical and pathological donor characteristics. Furthermore, we exami…