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Results for “SCLEROSIS, MULTIPLE”

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PubMed1991

[Epidemiology of multiple sclerosis].

Multiple sclerosis is unevenly distributed throughout the world. Its prevalence depends on latitude: it decreases in each hemisphere from pole to equator. France is situated in a high prevalence zone, with 40 cases for 100,000 inhabitants. The prevalence of multiple sclerosis is modulated by risk factors unrelated to latitude; genetic susceptibility factors (HLA, Gm), as well as environmental, occupational, nutritional and infectious (notably viral) factors have been identified, but no conclusion can be drawn concerning their role in the aetiology and pathogenesis of the disease. Among the hypotheses that could put an end to this deadlock, the heterogeneity of multiple sclerosis must seriously be considered, and it might serve as a basis for further epidemiological studies benefiting from recent technological developments such as molecular genetics and magnetic resonance imaging.

Environment↗

PubMed2003

Cannabinoids inhibit neurodegeneration in models of multiple sclerosis.

Multiple sclerosis is increasingly being recognized as a neurodegenerative disease that is triggered by inflammatory attack of the CNS. As yet there is no satisfactory treatment. Using experimental allergic encephalo myelitis (EAE), an animal model of multiple sclerosis, we demonstrate that the cannabinoid system is neuroprotective during EAE. Mice deficient in the cannabinoid receptor CB1 tolerate inflammatory and excitotoxic insults poorly and develop substantial neurodegeneration following immune attack in EAE. In addition, exogenous CB1 agonists can provide significant neuroprotection from the consequences of inflammatory CNS disease in an experimental allergic uveitis model. Therefore, in addition to symptom management, cannabis may also slow the neurodegenerative processes that ultimately lead to chronic disability in multiple sclerosis and probably other diseases.

Animals↗

PubMed1979

[Early symptoms and diagnosis of multiple sclerosis].

Multiple Sclerosis is one of the most common neurological diseases in North and Central Europe and USA, the prevalence is 0,03-0,06%. The precise aetiological and pathological processes underlying the disease are still unknown. As there is as yet no laboratory test that is specific for Multiple Sclerosis, the diagnosis is still a clinical one. It depends on the history--a majority of patients has a history of remissions--and on the demonstration of objective signs of lesions in the white matter of the central nervous system. There can be found some early symptoms--such as optic neuritis--and some typical combinations of symptoms that make the diagnosis Multiple Sclerosis probable or clinically definit. Among the laboratory tests the investigation of cerebrospinal fluid is most important.

Adult↗

PubMed2006

[Etiology of multiple sclerosis].

Multiple sclerosis is an inflammatory disease of the central nervous system responsible for demyelinating lesions within white matter in young adults. The activation of autoreactive CD4+ but also CD8+ T cells directed against myelin antigens of the central nervous system is a key phenomenon at the origin of multiple sclerosis lesions. Its etiology is unknown but implies the existence of genetic traits and a triggering by environmental factors such as viral infections. However, no virus or other environmental factor has been directly involved in the triggering of the disease. Functionnal abnormalities on regulation systems of immunity, such as regulatory T cells, could be partially involved in the triggering of the disease. However, it appears, on the basis of recent findings, that multiple sclerosis is not only a disease of the immune system but also implies specific neurobiological factors which must be determined in studies to come.

Environment↗

PubMed2000

[Videofluoroscopic study of deglutition in patients with multiple sclerosis].

Multiple sclerosis is a neurological disease that affects the I/II motor neurons of the CNS and its symptoms include oropharyngeal dysphagia. The onset and course of this dysphagia significantly conditions the progression of the disease. The present study evaluates the incidence on deglutition and type of alterations in a sampling of 10 multiple sclerosis patients of which 4 showed clinical signs of dysphagia. The results, obtained by combining quantitative (clinical severity) and qualitative (functional alterations) parameters showed that 9 of the 10 patients (90%) presented radiological abnormalities in the progression of the bolus. The conclusion drawn is that the high prevalence of dysphagia in multiple sclerosis, even if not always manifest clinically, justifies drawing up a standard protocol for radiological evaluation and clinical follow-up in order to screen those patients at greater risk of pulmonary complications and delay them as long as possible.

Adult↗

PubMed2001

Bacterial peptidoglycan and immune reactivity in the central nervous system in multiple sclerosis.

Multiple sclerosis is believed to result from a CD4+ T-cell response against myelin antigens. Peptidoglycan, a major component of the Gram-positive bacterial cell wall, is a functional lipopolysaccharide analogue with potent proinflammatory properties and is conceivably a mediator of sterile inflammation. Here we demonstrate that peptidoglycan is present within antigen-presenting cells in the brain of multiple sclerosis patients. These cells have macrophage and dendritic cell characteristics, and are immunocompetent as evidenced by co-expression of inflammatory cytokines and co-stimulatory molecules. In addition, intrathecal plasma cells specific for peptidoglycan are present in multiple sclerosis brain tissue, and antibodies binding peptidoglycan are present in CSF during active disease. Peptidoglycan may thus contribute to T- and B-cell activity during brain inflammation without a requirement for local bacterial replication.

Adult↗

PubMed1989

Paramyxovirus SV5 and multiple sclerosis.

Multiple sclerosis is commonly associated with a local humoral immune response within the central nervous system. A hallmark of this intrathecal response is the presence of electrophoretically demonstrable oligoclonal bands of IgG in the cerebrospinal fluid (CSF) of up to 95% of patients. Observations indicating that a major part of the CSF IgG in some patients may represent antibodies to SV5, a simian virus closely related to human parainfluenza type 2 virus, were recently reported by Goswami et al. We have studied thirty patients with multiple sclerosis, but although we find intrathecal synthesis of IgG antibodies reacting with SV5 in seven of these, the antibodies were not associated with oligoclonal CSF IgG bands and could in each case be explained as potentially cross-reacting antibodies to other paramyxoviruses known to be human pathogens. We have therefore been unable to confirm that SV5 may be a major intrathecal immunogen in multiple sclerosis.

Adsorption↗

PubMed2002

Targeting leukocyte MMPs and transmigration: minocycline as a potential therapy for multiple sclerosis.

Multiple sclerosis is characterized by the infiltration of leukocytes into the CNS. As matrix metalloproteinases (MMPs) facilitate the passage of leukocytes across matrix barriers, we tested the hypothesis that targeting MMPs could attenuate neuro-inflammation. We report that minocycline, a widely used generic drug with a good safety record, inhibited MMP activity, reduced production of MMP-9 and decreased the transmigration of T lymphocytes across a fibronectin matrix barrier. In addition, minocycline was efficacious against both mild and severe experimental autoimmune encephalomyelitis (EAE) in mice, an animal model of multiple sclerosis. When severe EAE was produced, minocycline pre-treatment delayed the course of the disease: when maximal disease activity occurred in vehicle-treated EAE mice, minocycline animals were relatively normal and had minimal signs of inflammation and demyelination in the CNS. When tested in mice afflicted with mild EAE, minocycline attenuated the clinical severity of disease throughout the course of treatment. These results indicate that minocycline may constitute a safe and inexpensive therapy for multiple sclerosis.

Animals↗

PubMed1982

Neurourologic abnormalities in multiple sclerosis.

Multiple sclerosis is a demyelinating disease of the central nervous system, often producing abnormalities in sexual function and urinary control. Eighty-six patients with this disorder were referred to our neurourologic facilities for evaluation (45 women and 41 men). Symptomatic voiding dysfunction was present in 84 patients (97 per cent). Sexual dysfunction was present in 29 of the 41 men (71 per cent). Neurourologic evaluation was performed by rapid-fill carbon dioxide cystometry and perineal floor needle electromyography. Several neurourologic patterns were identified in multiple sclerosis patients: the most common cystometry pattern was detrusor hyperreflexia (76 per cent) and the most common electromyography finding was vesico-sphincter dyssynergia (50 per cent). Voiding symptoms alone were not found to correlate with neurourologic findings. The presence of bilateral extensor plantar reflexes was found to indicate the possibility of vesico-sphincter dyssynergia. The addition of sacral-evoked responses to the neurourologic evaluation was useful in the identification and localization of occult sacral cord pathology and was of special significance to men with sexual dysfunction undergoing evaluation for neurogenic impotence. The combination of abnormal perineal electromyography, abnormal sacral latency and detrusor hyperreflexia was suggestive of multilevel spinal cord dysfunction and, possibly, has diagnostic as well as therapeutic significance. Neurourologic patterns were found to change in 4 of 9 patients re-evaluated because of symptom changes or poor treatment responses. Neurourologic testing in multiple sclerosis patients may be used to identify pathologic lesions, characterize sexual and voiding dysfunctions, corroborate neurologic diagnosis in doubtful cases and form a basis for rational treatment planning.

Adult↗

PubMed2004

Audiovestibular evolution in a patient with multiple sclerosis.

Multiple sclerosis is characterized by the presence of multiple plaques within the central nervous system, manifesting as remission and exacerbation of neurologic dysfunction over variable time courses. We present the case of a 20-year-old woman. Before treatment, her auditory brain stem response (ABR) test revealed bilateral prolongation. A caloric test showed canal paresis of the right ear and a normal response on the left. A vestibular evoked myogenic potential (VEMP) test displayed an absent response in the right ear and a delayed response in the left. A magnetic resonance imaging (MRI) scan demonstrated multiple diffuse high signal lesions in the hemispheres, brain stem, and cerebellum. Six months after treatment, the demyelinating plaques were shown to have resolved spontaneously on MRI. Recovery of caloric responses was anticipated. Bilateral prolongation of ABRs remained, but the VEMP test disclosed a normal response in the right ear and a delayed response in the left. Accordingly, in addition to MRI, caloric tests and ABR and VEMP tests are useful in monitoring the evolution of audiovestibular function in patients with multiple sclerosis.

Adult↗

PubMed2006

Drug Insight: interferon treatment in multiple sclerosis.

Multiple sclerosis (MS) is a chronic demyelinating disease of the CNS. Between 1987 and 1997, clinical trials of three preparations of recombinant interferon-beta were conducted in patients with MS, ushering in a new therapeutic era. These medications have demonstrable benefits and seem to be safe; they represent an important advance in MS treatment. All three formulations of interferon-beta had modest effects on relapses and short-term progression of disability, but the effects on MRI lesion parameters were more substantial. The benefits were greater in clinically isolated syndromes and relapsing-remitting MS than in secondary progressive MS. Although these drugs have been shown to be effective, however, their long-term impact on clinically relevant disability progression is uncertain, and there are many areas of controversy in the MS field regarding the use of these products. There is still a need for more effective treatments, which might include new agents or combination therapies.

Antibodies↗

PubMedDate not supplied

A pilot, open label, clinical trial using hydroxyzine in multiple sclerosis.

Multiple sclerosis (MS) is an autoimmune disorder of myelin destruction. Blood-brain-barrier (BBB) disruption precedes pathological or clinical findings and could involve mediators from perivascular brain mast cells, such as histamine and vascular endothelial growth factor (VEGF). Mast cells could be activated by many triggers, including acute stress that has been correlated with MS exacerbations. We considered that the histamine-1 (H1) receptor antagonist hydroxyzine, which also partially inhibits brain mast cells and has anxiolytic properties, may reduce MS symptoms. This open label, pilot, clinical trial investigated the effect on MS of an oral solution of hydroxyzine (100 mg per day), together with caffeine (200 mg per day) to reduce sedation. Twenty patients (8 males; 12 females) with relapsing-remitting or relapsing-progressive MS completed the study (12 +/- 1 months) and were evaluated using disability scales. Most patients on hydroxyzine (75%) remained stable or improved neurologically and all but one showed improved mood. Hydroxyzine could be used as an adjuvant in MS, but the small number of patients enrolled and the short duration of the study precludes any definitive conclusions. A double-blind, placebo-controlled study is warranted.

Adolescent↗

PubMed2003

Complementarity-determining region 3 spectratyping analysis of the TCR repertoire in multiple sclerosis.

Multiple sclerosis (MS) is considered to be an autoimmune disease mediated by T cells reactive with Ags in the CNS. Therefore, it has been postulated that neuroantigen-reactive T cells bearing particular types of TCRs are expanded clonally during the course of the disease. However, there is a controversy with regard to the TCR usage by T cells associated with the development of MS. By the use of complementarity-determining region 3 spectratyping analysis that is shown to be a useful tool for identification of pathogenic TCR in autoimmune disease models, we tried to demonstrate that spectratype was T cells bearing particular types of TCR are activated in MS patients. Consequently, it was found that Vbeta5.2 were often oligoclonally expanded in peripheral blood of MS patients, but not of healthy subjects. Sequence analysis of the complementarity-determining region 3 region of spectratype-derived TCR clones revealed that the predominant TCR clone was different from patient to patient, but that similar results were obtained in a patient examined at different time points. More importantly, examination of cerebrospinal fluid T cells and longitudinal studies of PBLs from selected patients revealed that Vbeta5.2 expansion was detectable in the majority of patients examined. These findings suggest that Vbeta5.2 spectratype expansion is associated with the development of MS and that TCR-based immunotherapy can be applicable to MS patients if the TCR activation pattern of each patient is determined at different stages of the disease.

Adolescent↗

PubMed2001

[Borderline forms of multiple sclerosis].

Multiple sclerosis (MS) has been described for more than a century, but its cause remains unknown and no simple diagnostic marker is available. Therefore, it is not surprising that numerous articles were written on closely related diseases, borderline forms of multiple sclerosis. Different forms have been distinguished: a clinical form of MS (Devic's neuromyelitis optica), pathological forms (Balo, Schilder, Maburg), forms associated with MS (peripheral neuropathy, autoantibodies) and closely related disorders (acute disseminated encephalomyelitis).

Diagnosis, Differential↗

PubMed1995

Intravenous methylprednisolone for exacerbations in multiple sclerosis.

Multiple sclerosis remains one of the most difficult neurological diseases to treat. It is important for medical-surgical nurses to understand the pathophysiology of multiple sclerosis, as well as recent evidence suggesting that intravenous methylprednisolone treatment may be effective for treating exacerbations of the disease. Indications and criteria for treatment, side effects, and patient teaching issues are discussed.

Humans↗

PubMed1998

Insights into the aetiology and pathogenesis of multiple sclerosis.

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system, and the most common neurological disease affecting young adults. Multiple sclerosis is a clinically heterogeneous disorder. It is believed to be an autoimmune disease, with cell-mediated and humoral responses directed against myelin proteins. This hypothesis largely comes from pathological parallels with an animal model, experimental autoimmune encephalomyelitis (EAE). Autoimmunity to myelin proteins in humans may be inadvertently triggered by microbes which have structural homologies with myelin antigens (molecular mimicry). As with other autoimmune diseases, susceptibility to MS is associated with certain MHC genes/haplotypes. Full genomic screening of mutiplex families has underscored the role for MHC genes as exerting moderate but the most significant effects in susceptibility. The primary target autoantigen in MS has yet to be definitively identified, but as well as the major myelin proteins, it is now clear that minor myelin components, such as myelin oligodendrocyte glycoprotein (MOG) may play a primary role in disease initiation. This review examines the current knowledge about the aetiology and pathogenesis of MS, and the important similarities with EAE. A better understanding of the molecular mechanisms of autoimmune pathology will provide the basis for more rational immunotherapies to treat MS.

Adult↗

PubMed1983

Possible relationship of Chlamydia to multiple sclerosis.

Multiple sclerosis is an acquired disease of the central nervous system, probably due to a transmissible factor, and characterized by pathological changes in the white matter of the brain and cord. These changes consist of loss of the myelin covering of the axons in the form of demyelinative plaques. Based on a review of the following studies, Chlamydia may indeed be one of the agents involved in the pathophysiology of multiple sclerosis.

Chlamydia Infections↗

PubMed1984

Retinal venous sheathing in multiple sclerosis.

Multiple sclerosis is among those disease entities in which sheathing of the retinal veins has been documented. A case with marked unilateral retinal vein sheathing in a patient with a diagnosis of multiple sclerosis is reported. Discussion with reference to epidemiology, etiology, histopathology, differential diagnosis, and management is presented.

Adult↗