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[Search for the pathogenesis of multiple sclerosis from the bedside].

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system (CNS), whereas neuromyelitis optica (NMO) is an inflammatory disease of the CNS selectively affecting the optic nerves and the spinal cord. The pathological hallmark of MS is sharply demarcated demyelinating plaque with axons relatively preserved, while in NMO both axons and myelin are involved, resulting in necrotic cavitation. The nosological position of NMO has long been a matter of debate. MS has aspects of an antigen-driven disease as well as those of a process-driven disease that is unrelated to any …

Peripapillary retinal nerve fiber layer thickness measured by optical coherence tomography in different clinical subtypes of multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory demyelinating autoimmune disease of the central nervous system (CNS) with axonal degeneration as major determinant of neurological disability. Assessment of unmyelinated retinal nerve fibers using optical coherence tomography (OCT) may be useful for diagnosing the onset and rate of progression of neurodegeneration. OBJECTIVE: To assess the incidence and severity of damage of the peripapillary retinal nerve fiber layer (RNFL) in two different MS subtypes: non-progressive [Prog(-)MS] and progressive [Prog(+)MS]. METHODS: 48 patients…

Societal Versus Healthcare Perspectives on the Cost Effectiveness of Ocrelizumab for Treatment of Primary Progressive Multiple Sclerosis in Aotearoa New Zealand.

OBJECTIVES: Multiple sclerosis (MS) is a progressive, degenerative, autoimmune neuronal disease. This study compares the impact of a societal versus a healthcare perspective on the cost effectiveness of treatment of primary progressive MS (PPMS) with ocrelizumab (OCR) versus best supportive care (BSC) in New Zealand. METHODS: The analysis utilises a lifetime cohort Markov model based on ten Expanded Disability Status Scale (EDSS) states, plus death. It has two structurally identical arms, with forward transition probabilities in the treatment arm obtained by multiplying forward transition pro…

Wedge-shaped medullary lesions in multiple sclerosis.

Multiple sclerosis (MS) is a heterogeneous disease with variable clinical features and magnetic resonance imaging (MRI) findings. We report four MS cases with unusual wedge-shaped lesions in the paramedian ventral medulla oblongata demonstrated on MRI. The clinical features and MRI characteristics of the medullary lesions suggest an impairment of venous drainage. We propose that the formation of these wedge-shaped lesions may be related to the pattern of venous drainage in the ventral medulla and raised venous pressure due to chronic cerebrospinal venous insufficiency which has recently been d…

Mitoxantrone therapy in multiple sclerosis and acute leukaemia: a case report out of 644 treated patients.

As a rare complication of mitoxantrone (MITOX) therapy in multiple sclerosis (MS), a therapy-related acute leukaemia (TRAL) may develop. The incidence is difficult to estimate, as frequently single cases are reported, up to now a total of eight MS patients. Here we report a new case out of 644 patients. This is a 45-year-old female patient with secondary progressive MS who developed TRAL after a total dose of 48 mg/m2 MITOX. The TRAL was classified as acute myeloblastic leukaemia (AML) M4eo and showed an inversion of chromosome 16 and a partial trisomy 11. Her TRAL was treated with chemotherap…

Chitinase effects on immune cell response in neuromyelitis optica and multiple sclerosis.

BACKGROUND: Recent studies conducted in arthritis, asthma, and inflammatory bowel disease suggest that chitinases are important in inflammatory processes and tissue remodeling. OBJECTIVE: To investigate the role of chitinases in multiple sclerosis (MS) and neuromyelitis optica (NMO). METHODS: Levels of chitotriosidase, acid mammalian chitinase (AMCase), and chitinase 3-like-1 (CHI3L1) were measured using ELISA, in cerebrospinal fluid (CSF) and in serum from 24 patients with relapsing remitting (RR) MS, 24 patients with secondary progressive (SP) MS, 12 patients with NMO, 24 patients with oth…

Multimarker risk stratification approach at multiple sclerosis onset.

Delay in the diagnosis of multiple sclerosis (MS) stems from the lack of specific clinical and analytical markers to assist in the early diagnosis and prediction of progressive course. We propose a decision-tree model that better defines early at onset MS patients and those with the progressive form by analysing a 12-biomarkers panel in serum and CSF samples of patients with MS, other neurological diseases (OND) and healthy contols. Thus, patients at onset of neurological disease were first classified by serum IL-7 levels <141pg/ml (OR=6.51, p<0.001). Combination of IL-7 and CXCL10 indicated r…

The concept of type-1 and type-2 helper T cells and their cytokines in humans.

In both mice and humans, functionally distinct helper T (Th)-cell subsets, known as Th1 and Th2 cells, are characterized by the patterns of … to understand that a number of diseases are mediated by Th1 cells, the two clearest examples being multiple sclerosis and thyroid autoimmunity. In other disorders, Th1/Th2 polarization is less prominent, or rather Th2 responses tend to predominate, such as in systemic lupus erythematosus, progressive systemic sclerosis or allergic diseases. It is of note that in ex …

[Olfactory ensheathing cells transplantation for central nervous system diseases in 1,255 patients].

OBJECTIVE: To analyze the therapeutic effect of olfactory ensheathing cells (OECs) transplantation for central nervous system diseases. METHODS: Between November 2001 and January 2008, 1,255 participants with central nervous system diseases were enrolled in this clinical study for fetal OECs transplantation. There were 928 males and 327 females aged 1.2-87 (mean 40) years. The course of disease was (4.52 +/- 4.67) years. Among them, 656 participants suffered from chronic spinal cord injury (SCI), 457 amyotrophic lateral sclerosis (ALS), 68 cerebral palsy (CP), 20 multiple sclerosis (MS), 11 t…

Novel Molecular Leads for the Prevention of Damage and the Promotion of Repair in Neuroimmunological Disease.

Neuroinflammation is a prominent pathological feature of all neuroimmunological diseases, including, but not limited to, multiple sclerosis (MS), myasthenia gravis, neuromyelitis optica, and Guillain-Barré syndrome. All currently-approved therapies for the treatment of these diseases focus on controlling or modulating the immune (innate and adaptive) responses to limit demyelination and neuronal damage. The primary purpose of this review is to detail the pre-clinical data and proposed mechanism of action of novel drugs currently in clinical trial, with a focus on novel compounds that promote r…

Pharmacological treatment for memory disorder in multiple sclerosis.

BACKGROUND: This is an update of the Cochrane review "Pharmacologic treatment for memory disorder in multiple sclerosis" (first published in The Cochrane Library 2011, Issue 10).Multiple sclerosis (MS) is a chronic immune-mediated, inflammatory, demyelinating, neurodegenerative disorder of the central nervous system (CNS) and can cause both neurological and neuropsychological disability. Both demyelination and axonal and neuronal loss are believed to contribute to MS-related cognitive impairment. Memory disorder is one of the most frequent cognitive dysfunctions and presents a considerable bur…

Late-onset versus adult-onset multiple sclerosis: A comparative analysis of clinical, radiological, and confirmed disability progression.

BACKGROUND: Multiple sclerosis (MS) is a chronic, immune-mediated disorder of the central nervous system (CNS). In Egypt, its occurrence is approximately 13.7 per 100,000 inhabitants. The average age of onset for relapsing-remitting MS (RRMS) is between the second and fourth decades of life. OBJECTIVES: To determine the differences in clinical characteristics, disease course, and progression between adult-onset MS (AOMS) and late-onset MS (LOMS). SUBJECTS AND METHODS: This observational comparative study was conducted on patients diagnosed with MS according to the revised McDonald criteria a…

Increased EBNA1-specific antibody response in primary-progressive multiple sclerosis.

BACKGROUND AND OBJECTIVES: The impact of viral infections on disease susceptibility and progression has predominantly been studied in patients with relapse-onset MS (RMS). Here, we determined immune responses to ubiquitous viruses in patients with primary progressive MS (PPMS). METHODS: Antibody responses to Epstein-Barr virus (EBV), specifically to the latent EBV nuclear antigen 1 and the lytic viral capsid antigen VCA, human herpesvirus 6 (HHV-6), human cytomegalovirus (HCMV), and measles virus were determined in a cohort of 68 PPMS patients with a mean follow-up of 8 years and compared wit

Accumulation of irreversible disability in multiple sclerosis: from epidemiology to treatment.

There is convincing evidence that neurological relapses in multiple sclerosis (MS) are the clinical counterpart of acute focal inflammation of the central nervous system (CNS) whereas neurological progression is that of chronic diffuse neurodegeneration. The classical view is to consider that MS is an organ-specific autoimmune disease, i.e. that inflammation is the cause of the neurodegeneration. The succession of relapses eventually leads to accumulation of disability and clinical progression results from subclinical relapses. A series of recent observations tends to challenge this classical …

The Impact of Multiple Sclerosis on Work Productivity: A Preliminary Look at the North American Registry for Care and Research in Multiple Sclerosis.

OBJECTIVE: We aimed to quantify multiple sclerosis (MS)-related work productivity and to illustrate the longitudinal trends for relapses, disease progression, and utilization of health care resources in a nationally representative cohort of working North Americans living with MS. BACKGROUND: The North American Registry for Care and Research in Multiple Sclerosis (NARCRMS) is a multicentered physician-reported registry which prospectively collects clinical information including imaging data over a long period of time from people with MS from sites across the U.S. and Canada. The Health Economi…

Design and validation of a multi-task, multi-context protocol for real-world gait simulation.

BACKGROUND: Measuring mobility in daily life entails dealing with confounding factors arising from multiple sources, including pathological … thy adults (HA) and participants with potentially altered mobility due to Parkinson's disease (PD), multiple sclerosis (MS), proximal femoral fracture (PFF), chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF). A novelty introduced in the protocol was the tiered approach to increase difficulty both within the same task (e.g., by allowing u …

Beyond relapse control: motor and cognitive subclinical progression in RRMS -a real-world longitudinal study of ocrelizumab and interferon beta.

INTRODUCTION: Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system, with therapeutic goals focused on preventing disability progression and cognitive decline. This prospective, two-year study aimed to analyse the clinical and neuroradiological efficacy, disability progression, cognitive function, and safety profile in people with relapsing-remitting MS (RRMS) treated with ocrelizumab and IFN-beta 1a and 1b. METHODS: The study included 140 people with RRMS, evenly distributed into two treatment groups and followed over 24 months. Clinica…

Management of Multiple Sclerosis: Incorporating Recent Advances in Pathophysiology and Diagnosis to Guide Treatment Strategies.

Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disorder of the central nervous system for which more than 20 disease-modifying therapies (DMTs) are currently available. Recent advances in diagnostic criteria, biomarker development, and understanding of disease biology have challenged traditional phenotype-based treatment paradigms and created new opportunities for individualized therapeutic strategies. The 2024 McDonald diagnostic criteria expand the biological definition of MS through incorporation of advanced MRI biomarkers, thereby supporting earlier diagnosis and p…

Myelin Repair as a Neuroprotective Strategy for Multiple Sclerosis: From Bench to Bedside.

Multiple sclerosis (MS) is a neuro-inflammatory disease characterized by demyelination in the central nervous system (CNS). Although a substantial endogenous capacity for remyelination has been demonstrated, this process is frequently incomplete and exhibits marked intra- and inter-individual heterogeneity. Several factors influence the extent of spontaneous myelin regeneration, including age, sex, disease course, and lesion localization. Oligodendrocytes (OL), derived from oligodendrocyte progenitor cells (OPCs), are the principal myelinating cells of the CNS. The regenerative cascade involve…

Железо во множестве склероза - от патофизиологии до развития болезней - обзор описательной литературы.

Множественный склероз (MS) — хроническое аутоиммунное заболевание, характеризующееся демиелинацией и нейродегенерацией, которое вызывает физические расстройства и серьезные изменения в неврологической системе, включая глиоз и потерю нейронов. Болезнь поражает в первую очередь миелионированные части центральной нервной системы (КНС), такие как зрительные нервы, мозжечок, мозговой ствол и спинной мозг. Т клетки играют важную роль в патогенезе MS, вызывая обезвоживание, и факторы риска включают генетическую предрасположенность, воздействие на окружающую среду и решения, касающиеся образа жизни. Р

Совпадение в аннотации оригинала
Multiple sclerosis (MS) is a chronic autoimmune illness characterized by demyelination and neurodegeneration, which causes physical disability and severe alterations in the neurological system, including gliosis and neuron loss. The disease primarily affects myelinated parts of the central nervous system (CNS), such as the optic nerves, cerebellum, brain ste…