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Multiple sclerosis treatments

Tobias Sejbaek, Mads Nybo, Thor Petersen, Zsolt Illes
BACKGROUND: Dimethyl fumarate (DMF) has been registered for the treatment of relapsing-remitting multiple sclerosis (RRMS). Differences in tolerability between multiple sclerosis clinics in patients treated with DMF has not been examined. AIM: We examined real-world tolerability to DMF, and also compared adherence data between two MS clinics. METHODS: Adverse events (AE), discontinuation rates, and causes of discontinuation were investigated...
June 2, 2018: Multiple Sclerosis and related Disorders
A Khamidulla, G Kabdrakhmanova, A Utepkaliyeva, D Darin, Zh Urasheva
Multiple sclerosis is a chronic dysimmune neurodegenerative disease of the central nervous system, that affects people of working age and inevitably leads to disability. Treatment of the disease is one of the urgent problems of modern clinical neurology, which is explained by the variety of clinical variants of the flow, the lack of an effective method of treatment. This article is devoted to a review of modern approaches to the issues of etiology, pathogenesis and treatment of multiple sclerosis. Also, the classification of multiple sclerosis depending on the course of the disease, data on modern approaches to the treatment of multiple sclerosis, the criteria for the appointment of differentiated therapy depending on the course of the disease with the use of Disease-Modifying Drugs (DMDs) are given...
May 2018: Georgian Medical News
Georgina Flórez-Grau, Irati Zubizarreta, Raquel Cabezón, Pablo Villoslada, Daniel Benitez-Ribas
The identification of activated T-lymphocytes restricted to myelin-derived immunogenic peptides in multiple sclerosis (MS) and aquaporin-4 water channel in neuromyelitis optica (NMO) in the blood of patients opened the possibility for developing highly selective and disease-specific therapeutic approaches. Antigen presenting cells and in particular dendritic cells (DCs) represent a strategy to inhibit pro-inflammatory T helper cells. DCs are located in peripheral and lymphoid tissues and are essential for homeostasis of T cell-dependent immune responses...
2018: Frontiers in Immunology
Anna T Wilmes, Sabrina Reinehr, Sandra Kühn, Xiomara Pedreiturria, Laura Petrikowski, Simon Faissner, Ilya Ayzenberg, Gesa Stute, Ralf Gold, H Burkhard Dick, Ingo Kleiter, Stephanie C Joachim
BACKGROUND: The oral immunomodulatory agent laquinimod is currently evaluated for multiple sclerosis (MS) treatment. Phase II and III studies demonstrated a reduction of degenerative processes. In addition to anti-inflammatory effects, laquinimod might have neuroprotective properties, but its impact on the visual system, which is often affected by MS, is unknown. The aim of our study was to investigate potential protective effects of laquinimod on the optic nerve and retina in an experimental autoimmune encephalomyelitis (EAE) model...
June 14, 2018: Journal of Neuroinflammation
Catherine J Andersen
Cellular cholesterol metabolism, lipid raft formation, and lipoprotein interactions contribute to the regulation of immune-mediated inflammation and response to pathogens. Lipid pathways have been implicated in the pathogenesis of bacterial and viral infections, whereas altered lipid metabolism may contribute to immune dysfunction in autoimmune diseases, such as systemic lupus erythematosus, multiple sclerosis, and rheumatoid arthritis. Interestingly, dietary cholesterol may exert protective or detrimental effects on risk, progression, and treatment of different infectious and autoimmune diseases, although current findings suggest that these effects are variable across populations and different diseases...
June 13, 2018: Nutrients
M León Ruiz, M Sospedra, S Arce Arce, J Tejeiro-Martínez, J Benito-León
INTRODUCTION: A growing number of studies have evaluated the effects of transcranial magnetic stimulation (TMS) for the symptomatic treatment of multiple sclerosis (MS). METHODS: We performed a PubMed search for articles, recent books, and recommendations from the most relevant clinical practice guidelines and scientific societies regarding the use of TMS as symptomatic treatment in MS. CONCLUSIONS: Excitatory electromagnetic pulses applied to the affected cerebral hemisphere allow us to optimise functional brain activity, including the transmission of nerve impulses through the demyelinated corticospinal pathway...
June 10, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
A Juanatey, L Blanco-Garcia, N Tellez
INTRODUCTION: Ocrelizumab is a humanised monoclonal antibody that targets the CD20 antigen on B cells. It has recently been approved by the US (Food and Drug Administration) and European health agencies (European Medicines Agency) for the treatment of multiple sclerosis (MS) and is the first drug marketed for both relapsing-remitting MS (RRMS) and primary progressive MS (PPMS). The clinical trials conducted for both the relapsing forms (OPERA I/II) and the progressive forms of the disease (ORATORIO) have demonstrated its efficacy...
June 16, 2018: Revista de Neurologia
Vanesa Cunill, Margarita Massot, Antonio Clemente, Carmen Calles, Valero Andreu, Vanessa Núñez, Antonio López-Gómez, Rosa María Díaz, María de Los Reyes Jiménez, Jaime Pons, Cristòfol Vives-Bauzà, Joana Maria Ferrer
Multiple sclerosis (MS) is considered a T cell-mediated autoimmune disease, although several evidences also demonstrate a B cell involvement in its etiology. Follicular T helper (Tfh) cells, a CXCR5-expressing CD4+ T cell subpopulation, are essential in the regulation of B cell differentiation and maintenance of humoral immunity. Alterations in circulating (c)Tfh distribution and/or function have been associated with autoimmune diseases including MS. Dimethyl fumarate (DMF) is a recently approved first-line treatment for relapsing-remitting MS (RRMS) patients whose mechanism of action is not completely understood...
2018: Frontiers in Immunology
Salene M W Jones, Rana Salem, Dagmar Amtmann
Background: People with multiple sclerosis (MS) are at increased risk for depression and anxiety. The symptoms of MS are often similar to the somatic or physical symptoms of depression and anxiety (fatigue, trouble concentrating). This study examined whether MS symptoms and effects biased the assessment of somatic symptoms of anxiety and depression. Methods: People with MS (n = 513) completed a survey about MS symptoms, treatments, and distress. The Patient Health Questionnaire-9 assessed depression, and the patient-report version of the Primary Care Evaluation of Mental Disorders assessed anxiety...
May 2018: International Journal of MS Care
Brienne A McKenzie, Manmeet K Mamik, Leina B Saito, Roobina Boghozian, Maria Chiara Monaco, Eugene O Major, Jian-Qiang Lu, William G Branton, Christopher Power
Multiple sclerosis (MS) is a progressive inflammatory demyelinating disease of the CNS of unknown cause that remains incurable. Inflammasome-associated caspases mediate the maturation and release of the proinflammatory cytokines IL-1β and IL-18 and activate the pore-forming protein gasdermin D (GSDMD). Inflammatory programmed cell death, pyroptosis, was recently shown to be mediated by GSDMD. Here, we report molecular evidence for GSDMD-mediated inflammasome activation and pyroptosis in both myeloid cells (macrophages/microglia) and, unexpectedly, in myelin-forming oligodendrocytes (ODCs) in the CNS of patients with MS and in the MS animal model, experimental autoimmune encephalomyelitis (EAE)...
June 12, 2018: Proceedings of the National Academy of Sciences of the United States of America
F Castillo-Álvarez, P Pérez-Matute, J A Oteo, M E Marzo-Sola
INTRODUCTION: The association between gut microbiota and animal models of multiple sclerosis has been well established; however, studies in humans are scarce. METHODS: We performed a descriptive, cross-sectional study comparing the relative composition of gut microbiota in 30 patients with multiple sclerosis (15 treated with interferon β-1b, 15 not receiving this treatment) and 14 healthy controls using next generation sequencing. RESULTS: Patients with multiple sclerosis and controls showed differences in the proportion of Euryarchaeota, Firmicutes, Proteobacteria, Actinobacteria, and Lentisphaerae phyla and in 17 bacterial species...
June 9, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Dinesh Khanna, Donald P Tashkin, Christopher P Denton, Martin W Lubell, Cristina Vazquez-Mateo, Stephen Wax
SSc is a rare CTD that affects multiple organ systems, resulting in substantial morbidity and mortality. Evidence of interstitial lung disease (ILD) is seen in ∼80% of patients with SSc. Currently there is no approved disease-modifying treatment for ILD and few effective treatment options are available. CYC is included in treatment guidelines, but it has limited efficacy and is associated with toxicity. MMF is becoming the most commonly used medication in clinical practice in North America and the UK, but its use is not universal...
June 8, 2018: Rheumatology
Mark S Freedman, Daniel Selchen, Alexandre Prat, Paul S Giacomini
Recent therapeutic advances in the management of multiple sclerosis (MS) have raised questions about the selection of appropriate patient candidates for various treatments and, if the plan is to move from one treatment to another, the appropriate sequencing of these therapies. The selected approach should provide optimal disease management without limiting future therapeutic options based on safety concerns, and recognize potential future treatments and the possibility of combination therapies. Additional challenges include incorporation of patient needs and preferences into the overall therapeutic approach, in order to ensure optimal outcomes in the short and long term...
June 12, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Olga M Koper, Joanna Kamińska, Karol Sawicki, Halina Kemona
The aim of this review is to present data from the available literature concerning CXCL9, CXCL10 and CXCL11, as well as their receptor 3 (CXCR3) in selected diseases of the central nervous system (CNS), such as tickborne encephalitis (TBE), neuroborreliosis (NB), Alzheimer's disease (AD), and multiple sclerosis (MS). CXCL9, CXCL10, and CXCL11 lack glutamic acid-leucine-arginine (ELR), and are unique, because they are more closely related to each other than to any other chemokine. The aforementioned chemokines are especially involved in Th1-type response and in various diseases, as their expression correlates with the tissue infiltration of T cells...
June 8, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Vera B Morhenn
Significance: Better understanding of wound healing could lead to improved treatment(s) of multiple sclerosis (MS) and psoriasis (Pso). Recent Advances: New concepts in the events of wound healing, such as the roles of the innate and adaptive immune systems, have generated targets for treating these debilitating diseases. Innovation: That in MS and Pso defective wound healing is responsible for the diseases' progression has not been hypothesized to date. Conclusion: Impaired initiation of wound repair by oligodendrocyte precursor cells or oligodendrocytes may play a role in MS, and a lack of inhibition of the proliferative phase in wound healing may explain the pathophysiology involved in Pso...
June 1, 2018: Advances in Wound Care
J L López-Estebaranz, P de la Cueva-Dobao, C de la Torre Fraga, M Galán Gutiérrez, E González Guerra, J Mollet Sánchez, I Belinchón Romero
BACKGROUND: There is currently little information available on the management of patients with psoriasis in the daily clinical practice of dermatologists in Spain. OBJECTIVE: The aim of this study was to survey a group of Spanish dermatologists with particular expertise in the management of psoriasis to determine their opinions on the protocols used in routine clinical practice. MATERIAL AND METHODS: A cross-sectional study based on an online survey about the management of psoriasis sent to 75 dermatologists...
June 8, 2018: Actas Dermo-sifiliográficas
Anne M Skalicky, Anne M Rentz, Zhimei Liu, Qayyim Said, Jo Anne Nakagawa, Michael D Frost, James W Wheless, David W Dunn
AIMS: Tuberous sclerosis complex (TSC) is a multi-organ autosomal-dominant, genetic disorder with incomplete penetrance. The multiple manifestations of TSC and impacts to numerous organ systems represent significant disease, health care and treatment burden. The economic and employment burden of the disease on individuals and their families is poorly understood. This study assessed the cost of illness and work and school productivity burden associated with TSC in a cross-sectional web-survey sample...
June 11, 2018: Journal of Medical Economics
P Sarat Chandra, Pankaj Singh, Rajender K, Deepak Agarwal, Vivek Tandon, S S Kale, Chitra Sarkar
BACKGROUND: Vertebral body (VH) hemangiomas with myelopathy are difficult to manage. OBJECTIVE: To evaluate the role of intra-operative ethanol embolization, surgical decompression and instrumented short segment fusion in VH with myelopathy and long-term outcome (>24 months). METHODS: Prospective study: Symptomatic VH with cord compression with myelopathy. Excluded: pathological fractures, and/or deformity or multi-level pathologies. Surgery consisted of intra-operative bilateral pedicular absolute alcohol (<1% hydrated ethyl alcohol) injection, laminectomy and cord decompression at the level of pathology followed by a short segment instrumented fusion using pedicle screws...
June 8, 2018: Spine Journal: Official Journal of the North American Spine Society
Zsigmond Kincses, Eszter Tóth, Zsanett Fricska-Nagy, Judit Füvesi, Cecília Rajda, Krisztina Bencsik, Erika Vörös, Angéla Csomor, András Palkó, László Vécsei
The paraclinical examinations, principally the MRI have an increasing significance in the diagnosis of multiple sclerosis. However, MRI markers also have a prominent role in monitoring of the disease-course and activity, and also in the planning of possible therapeutic changes. In accordance with previously published international guidelines, in this article we propose a protocol for the monitoring the treatment efficacy in multiple sclerosis. This could be the basis of a consensus based guideline to be implemented in Hungary...
March 30, 2018: Ideggyógyászati Szemle
Eszter Tóth, Krisztina Bencsik, Erika Vörös, Zsanett Fricska-Nagy, Judit Füvesi, Cecília Rajda, Angéla Csomor, András Palkó, László Vécsei, Zsigmond Tamás Kincses
MRI has a significant role in the diagnosis of multiple sclerosis. The newer and newer treatment options of the disease make it necessary to monitor the effectiveness of the therapy. Besides the clinical signs (clinical relapses and progression), the different MRI parameters can also reflect the disease activity. In our current article we summarize those MRI markers, which best predict the long-term disability, based on the international standards.
March 30, 2018: Ideggyógyászati Szemle
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