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T L Demina

Publications and source records attributed to T L Demina.

At least 19 recordsLinked to original sources
PubMed2006

[The interferon beta therapy after the first clinical episode of demyelination in multiple sclerosis].

The currently available treatment of definite multiple sclerosis (MS) includes different preparations of interferon beta. Recently reported data of pathomorphological, MRI, MR-spectroscopy and immunohistochemical studies suggest that axonal damage secondary to inflammation appears at the very early stage of MS. Early pathological events can predict a future course of the disease. Inflammatory activity in relapsing MS does not confine to episodes of clinical impairment but often develops before the first episode and generally continues during remissions. Patients with clinically isolated syndrome (CIS) and an abnormal brain MRI scan are at high risk of developing clinically definite MS (CDMS). If the presence of lesions predisposes to MS, the number of lesions determines when disability will develop. The results of interferon beta trials in patients with CIS showed significant benefit of the treatment in decreasing risk of CDMS development.

Adjuvants, Immunologic↗
PubMed2006

[Risk factors of osteoporosis in women with multiple sclerosis].

Multiple sclerosis (MS) is a progressive disease that leads to early disability of young adults at a reproductive age. Motor disturbances caused by progressive pyramidal deficit and cerebellar dysfunction, accompanied by ataxia with frequent falls, and early decrease of physical activity are risk factors of osteoporosis in MS patients. A relapsing-remitting course of the disease with frequent attacks demands multiple courses of steroid therapy. Long-term steroid treatment causes bone loss and development of secondary osteoporosis. We have shown that reduced bone mineral density (BMD) in lumbar spine and femoral neck is associated with high level of EDSS score caused by the combination of moderate pyramidal and cerebellar dysfunction. An additional risk factor of osteoporosis in MS patients is low body weight. The glucocorticoid therapy does not exert a negative impact on BMD in lumbar spine and femoral neck in patients with MS.

Adult↗
PubMed2006

[The results of longitudinal use of copaxone and betaferon in Moscow Multiple Sclerosis Center: issues of efficacy and adherence to therapy].

In last decades, practical neurologists are able to use DMT in multiple sclerosis (MS) in every day practice. This paper presents data of 3-year study of DMT (copaxone and betaferon) treatment of 280 patients with definite diagnosis of multiple sclerosis (MS), 166 patients regularly receiving DMT (104--copaxone and 62--betaferon) for, at least, 3 years. Clinical symptoms of the patients, reasons of treatment withdrawal (48--copaxone and 31--betaferon) and the features of MS course after the withdrawal are analyzed. Patients who received betaferon previously had more severe MS course with frequent relapses, half of them had secondary progressive MS course (SPMS) with relapses. This made impossible a direct comparison of the data of two treatment groups. Treatment with copaxone reduced 5 times annual relapse rate, from 1.45 before DMT to 0.27 during these 3 years (p < 0.001), and this reduction remained stable. For 36 months, 40.4% of patients were relapse-free though all of them had, at least, one relapse per year before the treatment. No EDSS progression was observed in 80% of these patients. Treatment with betaferon caused the reduction of relapse rate from 1,84 to 0,69 per year (2.7 times), 8 patients (26%) with previously active RMS being relapse-free for 36 months. In 31 patients with SPMS, the reduction of relapse rate was also significant, from 1.89 to 0.49 (3.8 times, p < 0.001). Twenty-two patients (71%) with previous SPMS did not have EDSS progression for 36 months that indicate the positive effect of the therapy. Side-effects were moderate and were not the main cause of the treatment withdrawal. The latter was caused mainly by clinical un efficacy, most frequently by the increase of EDSS due to transformation of the MS course to SPMS without relapses and poor understanding by the patient of the goals and the possibilities of DMT. These facts stress the significance of improving compliance, motivation and adherence to DMT in everyday neurological practice.

Adjuvants, Immunologic↗
PubMed2003

[The role of the peripheral nervous system damage in clinical picture of multiple sclerosis].

Multiple sclerosis (MS) was believed to be an autoimmune disease of central nervous system (CNS). Recently, several studies showing early involvement of peripheral nervous system (PNS) in MS pathological process have been published. This review own analyzer and published clinical and paraclinical data on PNS pathology in MS patients and CNS damage in patients with chronic inflammatory demyelinating polyneuropathy. Different mechanisms of the damage of PNS may explain different clinical manifestation of PNS involvement in MS.

Adjuvants, Immunologic↗
PubMed2003

[Results of a multicenter study of Rebif-22 mcg administration in Russia].

The results of multicenter study of Rebif 22 micrograms in Russia have been reported. 167 multiple sclerosis patients have received Rebif 22 micrograms three times a week for 1 year. This study provides evidence for reduction of the relapse rate in patients with relapsing/remitting and secondary progressive multiple sclerosis. The tendency to the decrease of the severity of relapses, less need for steroid use and the decrease of EDSS score in patients with relapsing/remitting multiple sclerosis have been shown. In general Rebif 22 micrograms was tolerated well.

Adjuvants, Immunologic↗
PubMed2003

[Use of glatiramer acetate (Copaxone) in the treatment of patients with multiple sclerosis. Experience of the Moscow multiple sclerosis center].

146 patients with multiple sclerosis are treated by copaxone in the Moscow MS Centre. The relaps exacerbation rate decreased by 72%, the relapse rate reduced by 25.6% during the copaxone treatment. EDSS score did not increase both in group with and without relapses. The condition of 2/3 patients was stable. To achieve the best effect of treatment the program of patient support was successfully used in the Moscow MS Centre.

Adjuvants, Immunologic↗
PubMed2003

[Certain problems of therapy with beta-interferon preparations].

The latest data on clinical effects of beta-interferon-1b (betaferon) in different clinical types of multile sclerosis (MS) are discussed in this review. All local and systemic side effects of this treatment are discussed as well as possible influence of neutralizing antibodies (NAB) on clinical efficacy of this treatment. Moderate and easily treated side effects as well as the absence of significant evidence for modulation of positive clinical effects of beta-interferons by NAT allow one to consider this medicine as one of the basic methods of MS treatment.

Adjuvants, Immunologic↗
PubMed2002

[Results of open post-registration clinical trials of copaxone in patients with multiple sclerosis].

Results of the 2-year open postregistration study of Copaxone (glatiramer acetate), conducted in 3 Moscow leading medical centres are given. 32 MS patients with remitting-relapsing MS were investigated in accordance with international requirements (neurological scales, MRI of the brain, multimodal evoked potential). Significant reduction of annual relapse rate for 70.3%, stabilization of neurological status and benign safety profile were demonstrated during Copaxone treatment. Practical recommendations for Copaxone use are given.

Adjuvants, Immunologic↗
PubMed2000

[Comparative clinico-immuno-chemical analysis of remittent and secondary-progressive course of multiple sclerosis].

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.

Adolescent↗
PubMed2000

[The possibility of the use of several clinical, genetic and MRI characteristics for the prognosis of effects of beta-interferon-1beta treatment in multiple sclerosis].

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.

Adjuvants, Immunologic↗
PubMed1999

[Risk factors of multiple sclerosis in Moscow population. I. Exogenous risk factors].

Descriptive epidemiologic investigations revealed the necessity of the exogenous influence for the development of multiple sclerosis (MS). By means of "case-control" method the relations of MS with exogenous factors were studied. On the first stage there were analysed questionnaire data on 250 "patient-control" pairs matched by age, sex, nationality and birth in Moscow or out of it. The questionnaire was elaborated on the basis of the epidemiologic one recommended for the epidemiologic studies in the countries of South-East Europe. Significant correlations were found between MS and exogenous factors, namely: "tonsillitis at the age under 15 years" and "predominance of meat in the diet at the age under 15 years". These associations were confirmed by the data of both stratificative, discriminative analysis and logic regression. More detailed questionnaire was used on the second stage in 110 "patient-control" pairs. The second study confirmed such associations and found the most significant connection between MS and both tonsillitis at the age of 7-15 years and consumption of smoked meat. The influence of both exogenous factors were probably conditioned by permanent antigenic stimulation of the immune system in predisposed individuals.

Adult↗
PubMed1999

[The risk factors for the development of multiple sclerosis in the Moscow population. II. The combination of exogenous and hereditary factors].

Simultaneous study of both external and hereditary risk factors of the development of multiple sclerosis (MS) was carried out in Moscow population. As a result of the genotyping of HLA-DR locus on the chromosome 6, there were found markers of the predisposition to MS: by HLA-DR: DR2(15) way, especially, in homozygous heredity and in the absence of such specificity--alleles of DR3 group. The data were confirmed concerning both the elevation of frequency of the alleles of tumor necrosis factor (TNF)a1 and alpha 2 and the decrease of frequency of TNF-alpha 7 allele in MS. There was also confirmed association of the disease with the external factors, such as "predominance of the meat nutrition at the age under 15 years" and "tonsillitis at the age under 15 years". There were two combinations of the external and hereditary factors, when the power of the association increased significantly: "predominance of meat nutrition at the age under 15 years" and DR2(15) and "tonsillitis at the age under 15 years" and DR3. When genetic factors were excluded, the relation of MS with the external factors was considerably reduced; when the external factors were excluded, the association of MS with genetic markers became statistically insignificant. A combination of these external factors, which were the sources for the additional antigenic immunostimulation, with certain genetic factors in DR region suggested the presence of the genetically determined peculiarities of the composition of antigen presentation HLA-DR in the individuals with DR2(15) and DR3. There was no statistically confirmed presence of a combination of the external factors with TNF-alpha alleles which increased additionally MS risk. The presence of immunostimulating antigen-containing external factors may be significant for the influence of TNF-alpha in less degree than for the realization of predisposition in form of the certain composition of HLA molecules.

Adolescent↗
PubMed1999

[Clinical and immunochemical characteristics of remittent multiple sclerosis].

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.

Adolescent↗
PubMed1997

[Genetic predisposition factors for multiple sclerosis (based on the data from genotyping patients of the Russian ethnic group)].

Patients' genotyping of Russian ethnic group with multiple sclerosis (MS) was performed for the first time in two loci of the main complex of histocompatibility: in DR HLA class II (gene DRB1) and in the locus of tumor necrosis factors (TNF). There was no difference in the incidence of alleles groups which correlated with some specificity of DR. Meanwhile TNF-a1 and TNF-a9 alleles were encountered significantly more frequently in patients and TNF-a7 in control group. When all the patients and controls examined were divided into groups in dependence on combination of DR and TNF it was found that relations observed between MS and TNF-a7 and TNF-a9 alleles were displayed much more in individuals which carried alleles of gene DRB1, corresponding to DR15 specificity. These are alleles which are known as the main risk factor of MS in Caucasians. The patients with "protective" TNF-a7 allele were characterized by more favorable course of the disease. Thus highly significant genetic markers were revealed for the first time in region of TNF genes which were associated with increased or decreased risk of MS development at least in Russian ethnic group. There was also possibility of their interaction with group of DR15 alleles of DRB1 gene. One of the markers revealed (TNF-a7) occurred to be bound both with decreased risk of MS and with favorable clinical course, which was observed for genetic markers of MS for the first time. Manifestation of one or another property of TNF-a7 marker depends on the presence of alleles of DRB1 gene which corresponds to DR15 specificity.

Adult↗