[Diagnostic and prognostic potential of MRI in multiple sclerosis].
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Biomedical subjects
Publications and source records attributed to I A Beliaeva.
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Immunochemical monitoring of remittent and secondary-progressive course of multiple sclerosis (MS) was performed. Examination of 61 patients was performed during 3 years. Inflammatory cytokines: (IL-1, IL-2, IL-6, TNF-alpha), were measured in supernatants of the peripheral blood mononuclear cells while some neurospecific proteins (GFAP and alpha 2-GP), vesicular-cellular molecules of the adhesion (sVCAM-1) were estimated in blood serum. 50 healthy donors entered the control group. The results demonstrated a remaining functional tension of cell immunity and a decrease of the resistance of hematoencephalic barrier (HEB) at all MS stages. However, in secondary-progressive MS concentration of the sVCAM-1 in blood serum was elevated as compared with the control group, patients with remittent course and in clinical improvement. It is suggested that some functional alteration of HEB endothelium, manifest in constant pathologic expression of sVCAM-1 molecule, is one of the pathochemical mechanisms promoting progression of MS process.
Recently, beta-interferons have become the first line medicine of pathogenic treatment of multiple sclerosis (MS). 75 MS patients from Moscow received the treatment with beta-interferon-1b (betaferon). Clinical, genetic and MRI data on 48 of them were included in detailed statistical analyses. High basic frequency of relapses, absence of atrophy of the brain at the first MRI scans and the presence of HLA-DRB1*15 (less significant DRB1*0301 and DRB1*04) were associated with better clinical effects of one year Betaferon course--decrease of relapses frequency and delay in EDSS progression.
Immunochemical monitoring was used to examine 37 patients with remittent multiple sclerosis (MS) for 3 years. There were changes in the blood concentrations of the supernatants IL-1 beta, IL-2, IL-6, alpha-TNF, in the serum levels of the adhesion molecule sVCAM, the neurospecific proteins GFAP and alpha 2GP. Only does active MS show a simultaneous increase in the serum concentrations of SVCAM and GFAP and alpha 2GP, which may be used as a test for the objectification of MS aggravation, the efficiency of therapy. The revealed higher secretion of antiinflammatory of cytokines at all disease stages, no recovery of blood-brain barrier responsiveness and at remission provide evidence for the likelihood of a permanent immunopathological process in MS with prevailing inflammatory and destructive changes during a clinical exacerbation and of the induction of active astrogliosis at its remission.
The dynamic state of hematoencephalic barrier (HEB) was estimated in Russian tick-borne encephalitic (RTBE) and in meningeal syndrome (Lyme's disease, LD). The enzyme immunoassays of neurospecific proteins in blood serum such as alpha 1-BG and enolase (NSE) were performed in the course of disease. The break of HEB at blood-brain direction was proved in patients with RTBE and LD for the proteins mentioned above. The blood serum NSE levels as well as their dynamics confirmed the functional alteration of brain neurons' permeability in LD and pronounced destruction of such neurons in RTBE. The acute increase of blood NSE concentration was observed within some days before the development of clinical signs of paresis. The authors suppose that the enzyme immunoassays of neurospecific proteins which are of rather high value for HEB permeability and neuronal destruction control may be successfully applied in monitoring of both therapy's efficacy and individualization of pharmacotherapy.
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