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Diagnosis of multiple sclerosis: progress and challenges.

The diagnosis of multiple sclerosis is based on neurological symptoms and signs, alongside evidence of dissemination of CNS lesions in space and time. MRI is often sufficient to confirm the diagnosis when characteristic lesions accompany a typical clinical syndrome, but in some patients, further supportive information is obtained from cerebrospinal fluid examination and neurophysiological testing. Differentiation is important from other diseases in which demyelination is a feature (eg, neuromyelitis optica spectrum disorder and acute disseminated encephalomyelitis) and from non-demyelinating d…

JCV detection in multiple sclerosis patients treated with natalizumab.

Natalizumab therapy is associated with an increased risk of progressive multifocal leukoencephalopathy (PML). Because the prognosis of established PML is uniformly dismal, identification of highly susceptible patients to the disease may improve outcomes. We wanted to investigate whether serial plasma and cerebrospinal fluid (CSF) screening for polyomavirus would identify patients with laboratory evidence of viral infection prior to the development of clinical PML. Two hundred MS patients had pre-treatment CSF/plasma screening for JC virus (JCV) and BK virus (BKV) DNA, and thereafter every six

Vascular Comorbidities and an Increased Comorbidity Score Are Associated With Disability and Disability Progression in Secondary Progressive Multiple Sclerosis.

BACKGROUND: Vascular risk factors are associated with increased disease activity and disability progression in multiple sclerosis (MS). This has been studied mainly in cohorts with relapsing-remitting MS. However, the association between vascular comorbidities (VCM) and clinical disability in secondary progressive MS (SPMS) is less well studied. Our aim was to investigate the association between VCM, non-VCM, comorbidity burden and both physical and cognitive performance in SPMS. METHODS: Longitudinal analysis of 445 patients from the MS secondary progressive multi-arm trial (MS-SMART)-a mult…

Meningeal inflammation plays a role in the pathology of primary progressive multiple sclerosis.

The primary progressive form of multiple sclerosis is characterized by accrual of neurological dysfunction from disease onset without remission and it is still a matter of debate whether this disease course results from different pathogenetic mechanisms compared with secondary progressive multiple sclerosis. Inflammation in the leptomeninges has been identified as a key feature of secondary progressive multiple sclerosis and may contribute to the extensive cortical pathology that accompanies progressive disease. Our aim was to investigate the extent of perivascular and meningeal inflammation i…

Multiple sebaceous adenomas and extraocular sebaceous carcinoma in a patient with multiple sclerosis: case report and review of literature.

BACKGROUND: Sebaceous carcinomas are relatively rare cutaneous tumors; there are fewer than 600 cases reported. They most commonly arise within the meibomian gland of the eyelid; fewer than 150 of the reported cases were extraocular. These tumors have a high incidence of local recurrence and regional metastasis. The relationship of sebaceous tumors and visceral malignancy is well established in the literature. OBJECTIVE: We describe a 44-year-old white female with chronic progressive multiple sclerosis who developed multiple scalp sebaceous adenomas and a solitary sebaceous carcinoma. CONCLU…

Novel Therapeutic Approaches in Connective Tissue Disease-Associated Interstitial Lung Disease.

Connective tissue diseases (CTD) comprise a group of autoimmune diseases that can affect multiple organs in the body including the lungs. The most common form of pulmonary involvement is interstitial lung disease (ILD). CTD-associated ILD (CTD-ILD) can take one of several courses including nonprogressive, chronically progressive, or rapidly progressive. Chronically and rapidly progressive patterns are associated with increased mortality. Limited randomized controlled trial data are available for treatment of CTD-ILD, with most data coming from systemic sclerosis-related ILD. The current first-

Impact of treatment on cellular immunophenotype in MS: A cross-sectional study.

OBJECTIVE: To establish cytometry profiles associated with disease stages and immunotherapy in MS. METHODS: Demographic/clinical data and peripheral blood samples were collected from 227 patients with MS and 82 sex- and age-matched healthy controls (HCs) enrolled in a cross-sectional study at 4 European MS centers (Spain, Italy, Germany, and Norway). Flow cytometry of isolated peripheral blood mononuclear cells was performed in each center using specifically prepared antibody-cocktail Lyotubes; data analysis was centralized at the Genoa center. Differences in immune cell subsets were assessed

Therapeutic reactivation of hippocampal progenitors reverse cognition decline in mice with progressive brain demyelination.

Chronic brain demyelination and neurodegeneration are hallmarks of progressive multiple sclerosis (MS) that underlie cognitive impairments. Neural precursor cells (NPCs) in the hippocampus support cognition through neurogenesis. With MS chronicity, neurogenesis declines leading to memory impairments. The mechanisms that drive NPC quiescence in MS are largely unknown. Here, we link downregulation of neuregulin-1 (NRG-1) to diminished self-renewal, activity and neurogenesis of NPCs, and hippocampal neurodegeneration and memory decline in mice with chronic demyelination. NRG-1 is a key signaling …

Развитие и проблемы в области множественного склероза: понимание болезни от этологии до лечения.

Множественный склероз (MS) — хроническое нервно-дегенеративное расстройство центральной нервной системы (ЦСН), которое затрагивает более 2,8 миллиона человек во всем мире. Она признается в качестве одной из главных причин нетравматической неврологической инвалидности среди молодых людей. Это воспалительное заболевание обезвоживания с аксоновым повреждением и постепенной неврологической инвалидностью, что влечет за собой высокие личные, социальные и экономические издержки. Развитие нейроимации, иммунобиологии и молекулярной биологии значительно повысило точность диагностики, мониторинга заболев

Совпадение в аннотации оригинала
Multiple Sclerosis (MS) is a chronic immune-mediated neurodegenerative disorder of the Central Nervous System (CNS) that affects more than 2.8 million people worldwide. It is recognized as one of the leading causes of non-traumatic neurological disability among young adults. It is an inflammatory demyelination disease with axonal damage and progressive neuro…

CD200R1 agonist attenuates mechanisms of chronic disease in a murine model of multiple sclerosis.

To assess the effects and mechanisms of a CD200R1 agonist administered during the progressive stage of a multiple sclerosis model, we administered CD200R1 agonist (CD200Fc) or control IgG2a during the chronic phase of disease (days 10-30) in mice with experimental autoimmune encephalomyelitis (EAE), induced using myelin oligodendrocyte glycoprotein peptide 35-55 (MOG35-55) peptide. We found that administration of CD200Fc during the chronic stages of EAE reduced disease severity, demyelination, and axonal damage, through the modulation of several key disease mechanisms. CD200Fc treatment suppre…

[Proliferative retinal vasculitis and multiple sclerosis: a case report].

INTRODUCTION: Retinal periphlebitis can precede the neurological effects of multiple sclerosis and reveal the disease. Although these occurrences of vasculitis are noted in 10% - 35% of multiple sclerosis patients, proliferative retinopathy is, on the contrary, an exceptional complication. CASE REPORT: We report the case of a 28-year-old woman who presented bilateral, proliferative, retinal vasculitis complicated with recurrent vitreous hemorrhages occurring with multiple sclerosis. Initially, there was a unilateral, central venous thrombosis in a particularly ischemic and proliferative form.…

Chronic steadily progressive central and peripheral predominantly motor demyelination, involving the cranial nerves, responsive to immunoglobulins.

The association of central and peripheral demyelination was reported previously. Most of the cases refer to central chronic relapsing demyelination with clinical criteria for multiple sclerosis associated with later signs of peripheral nerve involvement. Other authors, described central lesions in patients with chronic inflammatory demyelinating polyneuropathy and in Guillain-Barré syndrome, as a seldom occurrence. We report a patient in which a chronic steadily progressive central and peripheral predominantly motor nervous system demyelination, involving the cranial nerves, was identified. Th…

B cell rich meningeal inflammation associates with increased spinal cord pathology in multiple sclerosis.

Increased inflammation in the cerebral meninges is associated with extensive subpial cortical grey matter pathology in the forebrain and a more severe disease course in a substantial proportion of secondary progressive multiple sclerosis (SPMS) cases. It is not known whether this relationship extends to spinal cord pathology. We assessed the contribution of meningeal and parenchymal immune infiltrates to spinal cord pathology in SPMS cases characterized in the presence (F+) or absence (F-) of lymphoid-like structures in the forebrain meninges. Transverse cryosections of cervical, thoracic and …

Misdiagnosis of Graves' hyperthyroidism due to therapeutic biotin intervention.

BACKGROUND: Lately, high dose of biotin is often given orally to patients with a primary progressive multiple sclerosis (PPMS). However, the molecule biotin is also a principle compound in various analytic immunoassays. CLINICAL CASE: An asymptomatic 60-year-old woman with PPMS on high dose of biotin therapy (3 × 100 mg/d) displayed abnormal thyroid function tests (TSH 0.02 mU/l, fT4 > 103 pmol/l, and fT3 > 46 pmol/l). TSH was determined by a homogeneous sandwich chemiluminescent immunoassay and fT4 and fT3 were both determined by a homogeneous, sequential, chemiluminescent immunoassay. TSH r…

Primary progressive multiple sclerosis and generalized myasthenia gravis: an uncommon association.

The co-occurrence of myasthenia gravis (MG) and multiple sclerosis (MS) is rare, and in all the described cases MS had a relapsing-remitting course and the diseases had a benign clinical evolution. We describe herewith a patient with primary progressive MS (PPMS) and generalized MG with severe clinical course. This is the first report on a case of PPMS associated to MG. Studies on the histology and pathogenesis show that neurodegeneration is predominant over inflammation in PPMS, even if cellular and humoral immune-mediated mechanisms are thought to maintain a crucial importance in the develop…

The recurrence of disease activity after ocrelizumab discontinuation in multiple sclerosis.

INTRODUCTION: Ocrelizumab (OCR) is a highly effective treatment of multiple sclerosis (MS), and B cell repopulation profiles suggest that it might be used as an immune reconstitution therapy. However, data on disease recurrence after stopping treatment with OCR are scarce. Our objective was to evaluate the recurrence of disease activity after OCR discontinuation. METHODS: In this multicenter retrospective cohort study, we included MS patients who discontinued OCR, without switching to another treatment, for twelve months or more, after having received at least one full dosage of 600 mg. We de…

Escalating immunotherapy of multiple sclerosis--new aspects and practical application.

Recent clinical studies in multiple sclerosis (MS) provide new data on the treatment of clinically isolated syndromes, on secondary progression, on direct comparison of immunomodulatory treatments and on dosing issues. All these studies have important implications for the optimized care of MS patients. The multiple sclerosis therapy consensus group (MSTCG) critically evaluated the available data and provides recommendations for the application of immunoprophylactic therapies. Initiation of treatment after the first relapse may be indicated if there is clear evidence on MRI for subclinical diss…

Переход от педиатрической помощи к альтернативной склерозовой терапии для взрослых: проблемы, стратегии и терапия.

Множественный склероз (MS) — хроническое аутоиммунное состояние, вызывающее повреждение защитного покрытия нервов в центральной нервной системе. Педиатрический множественный склероз является редкой формой болезни, которая затрагивает 3-5% лиц с множественным склерозом. Множественный склероз (POMS) у педиатрии Onset (Podiatric Onset Multical Sclerosis) имеет весьма иной клинический профиль по сравнению с более распространенным множественным склерозом у взрослых. Помимо классических симптомов множественного склероза, дети, как правило, испытывают различные нетипичные симптомы, которые могут влия

Совпадение в аннотации оригинала
Multiple sclerosis (MS) is a chronic autoimmune condition causing damage to the protective covering of nerves in the central nervous system. Pediatric multiple sclerosis is a rare form of the disease that affects 3-5% of individuals with multiple sclerosis. Pediatric Onset Multiple Sclerosis (POMS) has a rather different clinical profile from the more preval…

Choroid Plexus Volume Change-A Candidate for a New Radiological Marker of MS Progression.

(1) Background: Multiple sclerosis (MS) is an auto-immune, chronic, neuroinflammatory, demyelinating disease that affects mainly young patients. This progressive inflammatory process causes the chronic loss of brain tissue and results in a deterioration in quality of life. To monitor neuroinflammatory process activity and predict the further development of disease, it is necessary to find a suitable biomarker that could easily be used. In this research, we verify the usability of choroid plexus (CP) volume, a new MS biomarker, in the monitoring of the progression of multiple sclerosis disease.…