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Results for “Multiple Sclerosis, Chronic Progressive”

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PubMed2001

[The role of MRI in the diagnosis and the natural course of multiple sclerosis].

Magnetic resonance imaging (MRI) is very sensitive in depicting multiple sclerosis (MS) lesions, but its specificity is poor. New sequences such as fast spin echo and FLAIR (fluid attenuated inversion recovery) improve the detection of lesions. The exploration of the whole central nervous system, brain, optic nerves and spinal cord improves sensitivity and specificity. The existence of lesions at different ages responds to temporal dissemination. MRI has also allowed to better understand the natural history of MS, showing 5 to 10 times more radiological than clinical activity. In case of isolated demyelinating syndrome, MRI is the best predictor of the occurrence of definite MS and of the severity of disability in the subsequent 10 years. However, the diagnosis of MS remains clinical, and systematic control MRI are not useful in clinical practice.

Brain↗
PubMed2002

[Multiple sclerosis. Therapeutic nihilism is the wrong approach here].

The standard treatment for acute multiple sclerosis relapses continues to be the intravenous administration of high-dose methylprednisolone. For prophylactic purposes, immunomodulatory therapy with interferon beta or glatiramer acetate, immunoglobulins or azathioprine. Studies have shown that interferon beta not only reduces the frequency of relapses by one-third, but also significantly delays the second relapse, provided it is administrated early, that is, immediately following the first relapse. The reduction in the patient's quality of life caused by the illness can be appreciably improved by a whole series of symptomatic treatments. The ideal situation is a cooperative effort by an interdisciplinary team.

Clinical Trials as Topic↗
PubMed2002

Multiple sclerosis.

Explore the source record for details and available documents.

Adrenocorticotropic Hormone↗
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↗
PubMed2005

[Multiple sclerosis: between wish and reality].

The guidelines for the therapy of multiple sclerosis (MS) are unchanged. An acute episode is treated intravenously with high-dosed glucocorticoid. This is usually followed by an immunomodulating basic therapy, although the currently approved preparations for this purpose are only partially effective. During the last ten years, a series of new therapeutic approaches have been developed. The monoclonal antibody natalizumab (Tysabri) was approved for use in the U.S.A. in 2004 and showed good success, but had to be removed from the market in February 2005 because of grave side effects. Up until now, the chemokine receptor antagonist CCR1 has been tested in a pilot study. A clinical phase III study is being planned with MS patients for the interleukin-2 receptor antagonist daclizumab.

Antibodies, Monoclonal↗
PubMed2006

Serum prolactin level in patients with multiple sclerosis: a case control study.

BACKGROUND: Multiple sclerosis (MS) is the most common demyelinating disorder of the central nervous system and is considered to be multifactorial with an autoimmune component. Prolactin (PRL) is a neuroendocrine peptide with potent immunomodulatory properties. Hyperprolactinemia enhances several autoimmune disorders and may play a role in the pathogenesis of MS. The aim of this study was to compare serum PRL levels in MS patients with those of healthy controls. MATERIAL/METHODS: There were 43 patients with definite MS and 43 sex- and age-matched healthy controls. Conditions leading to a rise in PRL, such as pregnancy, lactation, and specific underlying diseases and drugs, were excluded. PRL levels were measured in fasting blood samples. For the MS group, disease duration and subtype, clinical manifestations, and expanded disability status scores (EDSS) were also recorded. RESULTS: There were no significant differences in serum PRL levels between the case and control groups in both women and men (376.78+/-231.11 mIU/l in female patients with MS vs. 364.19+/-202.55 mIU/l in female controls, 266.00+/-200.83 mIU/l in male patients with MS vs. 197.25+/-65.25 mIU/l in male controls). We also found no significant relationship between PRL and disease activity, disease duration, and EDSS. CONCLUSIONS: Our findings do not support the hypothesis that MS patients are in a hyperprolactinemic state. However, further studies in more homogenous MS subgroups are needed.

Adult↗
PubMed1980

Liquor-cytological investigations in multiple sclerosis.

The report deals with values of cell number and total protein in intermittent and chronic-progressive multiple sclerosis taking into account age and sex. Moreover, the average values of monocytic, lymphocytic and lymphoid cells are correlated with age and sex. Finally, monocytic, lymphocytic and lymphoid cell forms are compared with agarelectrophoretic gamma 3- and gamma 4-globulin augmentation. For these investigations we summarized the parameters of 213 patients with multiple sclerosis according to the criteria of BAuer et al. (1973) and Poser et al. (1973). In intermittent multiple sclerosis there was a preponderance of lymphocytic and lymphoid cell forms, while in chronic-progressive syndromes and late polysclerosis monocytic cell reactions dominated. Although in chronic-progressive multiple sclerosis nearly the same changes in the gamma-globulin spectrum are demonstrable there seems to exist a disturbed condition of immunity which is expressed in a progressing demyelinization process.

Adult↗
PubMed1990

[Study of cellular immunity and the opioid peptide system in patients with multiple sclerosis].

Twenty-five patients with chronic progressing multiple sclerosis were examined for the content of beta-endorphin in blood serum, supernatants of activated lymphocytes and CSF by RIA. At the same time the parameters of cellular immunity were appraised. Different relations were discovered between cellular immunity and the content of beta-endorphin in biological fluids which may play a material part in the pathogenesis of multiple sclerosis.

Adult↗
PubMed1994

Total lymphoid irradiation in multiple sclerosis.

Following a report of the efficacy of total lymphoid irradiation (TLI) in the treatment of chronic progressive multiple sclerosis a further randomised double-blind placebo-controlled study was undertaken with the intention of entering 56 patients. In the event it was possible to recruit only 27 patients in a 2.5 year period. Three patients received active treatment openly and 24 were randomised to either active (14) or sham (10) treatment. Treatment was 1980 cGy to the lymphoid system and spleen or sham treatment after full simulation. The primary outcome measure was a comparison of the mean rates of change between treatment groups on the expanded Kurtzke disability scale (EDSS) over the two year follow up period. Patients were also assessed on other clinical outcome measures, psychometry, and serial MRI of the brain. Active treatment resulted in a profound and prolonged fall in T lymphocytes especially those with the CD4 marker and a reversal in CD4:CD8 ratio. No significant benefit was demonstrated on the rate of clinical disease progression (EDSS). A small but significant benefit was found on a score of bladder function. No significant benefit was demonstrated on other clinical or psychometric indices or on subjective visual analogue scales. There was a small but significant difference in the rate of accumulation of lesions on brain MRI favouring the treatment group. The treated group had a higher incidence of clinically relevant side effects, notably amenorrhoea and infections: three deaths (one in the TLI group, two in the sham treated group) occurred. A post hoc calculation indicates that the study had a possible 35% risk of a false negative result using the principal outcome measure. The study fails to confirm the previously reported clinical benefit of TLI although there may be a minor benefit on disease progression as indicated by MRI lesion counts. It is concluded that TLI cannot be recommended for the routine treatment of chronic progressive multiple sclerosis but the beneficial effect on MRI lesions, though modest, suggests that further research into immune modulation of this condition may be worthwhile.

Adult↗
PubMed1991

Importance of intrathecal synthesis of IgD in multiple sclerosis. A combined clinical, immunologic, and magnetic resonance imaging study.

There is increasing evidence that soluble IgD has a certain role in the humoral immune response within the central nervous system. We report herein the results of a combined clinical, magnetic resonance imaging, and immunopathologic study to determine the clinical importance of intrathecal IgD synthesis. Intrathecal synthesis of IgD (detected through the calculation of index values) was studied in 64 patients with multiple sclerosis and in 50 neurologic control patients and normal subjects. Locally secreted IgD was detected in 30% of patients with clinically active multiple sclerosis, including two in whom magnetic resonance images of brain and spinal cord were normal and who had no evidence of intrathecal IgG synthesis. No intrathecal IgD production was detected in patients with clinically stable multiple sclerosis or those suffering from chronic progressive multiple sclerosis, while it significantly correlated with the interval from the last relapse and with the total duration of the disease process in patients with relapsing, remitting multiple sclerosis. Intrathecal IgD synthesis also correlated with the degree of cerebrospinal fluid pleocytosis and with the presence of free kappa and lambda light chain bands in cerebrospinal fluid. Present results supplement and expand earlier data and suggest that intrathecally secreted IgD is a putatively important part of the immune response in clinically active relapsing, remitting multiple sclerosis.

Adult↗
PubMed1993

Failure to detect genomic material of HTLV-I or HTLV-II in mononuclear cells of Italian patients with multiple sclerosis and chronic progressive myelopathy.

To contribute to the undecided question if a retrovirus of the human T-cell lymphotropic virus (HTLV) family may be involved in the development of multiple sclerosis (MS), we investigated by the polymerase chain reaction (PCR) the presence of HTLV-I and HTLV-II sequences in the peripheral blood mononuclear cell DNAs from 30 patients affected by MS and 15 by chronic progressive myelopathy. Moreover a control group of 14 blood donors was examined. All these patients were devoid of anti-HTLV-I antibody in the serum and cerebrospinal fluid at ELISA. For the PCR, primers and probes specific for the tax region common to HTLV-I and HTLV-II, for the pol region of HTLV-I, and for the pol region of HTLV-II were used. In spite of the high sensitivity of the technique used, the three groups of subjects were negative for HTLV-I and HTLV-II genomic sequences.

Adult↗
PubMed1994

Defective CD3 mediated proliferation and LPS responsiveness in multiple sclerosis.

Multiple sclerosis [MS] is a chronic inflammatory disease of the central nervous system which has been postulated to be a T cell mediated disease. We examined proliferation of mononuclear cells to OKT3 mAb, Con A, ionomycin plus PMA and human myelin basic protein in subjects with relapsing-remitting and chronic progressive multiple sclerosis. Age and sex matched controls demonstrated a good proliferation to anti-CD3 mAb whereas subjects with relapsing-remitting multiple sclerosis showed a significantly decreased anti-CD3 mAb response. There was no difference in mitogen, ionomycin plus PMA or human MBP proliferation between controls and MS subjects. There was also a trend for decreasing anti-CD3 mAb proliferation in patients with chronic progressive multiple sclerosis compared to controls. LPS significantly decreased anti-CD3 mAb proliferation in controls but not in the MS subjects. An abnormality of signal transduction via the CD3 T-cell receptor complex in T cells and responsiveness to the immunomodulatory effect of IFN inducers may exist in multiple sclerosis.

CD3 Complex↗