scholarly journals New Insights into Multiple Sclerosis Mechanisms: Lipids on the Track to Control Inflammation and Neurodegeneration

2021 ◽  
Vol 22 (14) ◽  
pp. 7319
Author(s):  
Maria Podbielska ◽  
Joan O’Keeffe ◽  
Anna Pokryszko-Dragan
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Options ◽  
Specific Treatment ◽  
Central Nervous System Disease ◽  
Therapeutic Agents ◽  
Review Of The Literature ◽  
System Disease ◽  
Progressive Degeneration ◽  
Immune Mediated ◽  
Progressive Stage

Multiple sclerosis (MS) is a central nervous system disease with complex pathogenesis, including two main processes: immune-mediated inflammatory demyelination and progressive degeneration with axonal loss. Despite recent progress in our understanding and management of MS, availability of sensitive and specific biomarkers for these both processes, as well as neuroprotective therapeutic options targeted at progressive phase of disease, are still being sought. Given their abundance in the myelin sheath, lipids are believed to play a central role in underlying immunopathogenesis in MS and seem to be a promising subject of investigation in this field. On the basis of our previous research and a review of the literature, we discuss the current understanding of lipid-related mechanisms involved in active relapse, remission, and progression of MS. These insights highlight potential usefulness of lipid markers in prediction or monitoring the course of MS, particularly in its progressive stage, still insufficiently addressed. Furthermore, they raise hope for new, effective, and stage-specific treatment options, involving lipids as targets or carriers of therapeutic agents.

scholarly journals Supplementation and therapeutic use of vitamin D in patients with multiple sclerosis: Consensus of the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology

2014 ◽  
Vol 72 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Doralina Guimarães Brum ◽  
Elizabeth Regina Comini-Frota ◽  
Claúdia Cristina F. Vasconcelos ◽  
Elza Dias-Tosta
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Trial ◽  
Vitamin D ◽  
Environmental Factors ◽  
Scientific Evidence ◽  
Hypovitaminosis D ◽  
Central Nervous System Disease ◽  
Keywords Multiple Sclerosis ◽  
System Disease ◽  
Genetic And Environmental Factors

Multiple sclerosis (MS) is an inflammatory, autoimmune, demyelinating, and degenerative central nervous system disease. Even though the etiology of MS has not yet been fully elucidated, there is evidence that genetic and environmental factors interact to cause the disease. Among the main environmental factors studied, those more likely associated with MS include certain viruses, smoking, and hypovitaminosis D. This review aimed to determine whether there is evidence to recommend the use of vitamin D as monotherapy or as adjunct therapy in patients with MS. We searched PUBMED, EMBASE, COCHRANNE, and LILACS databases for studies published until September 9 th , 2013, using the keywords “multiple sclerosis”, “vitamin D”, and “clinical trial”. There is no scientific evidence up to the production of this consensus for the use of vitamin D as monotherapy for MS in clinical practice.

Retinopathy Associated with Adjuvant Interferon in a Patient with Malignant Melanoma: A Case Report and Review of the Literature

2019 ◽  
pp. 1-7
Author(s):  
Mahmut Dogan
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Side Effects ◽  
Vision Loss ◽  
Interferon Treatment ◽  
Ocular Toxicity ◽  
Review Of The Literature ◽  
Immune Mediated ◽  
Adjuvant Interferon

Interferons are kinds of proteins with immuneregulatory, antiviral and anti-proliferative functions. Interferons are widely used worldwide for the treatment of many diseases including cancer, hepatit C and immune mediated disease such as multiple sclerosis. Long-term use of interferons have some side effects. However, interferons have ophthalmologic side effects. Ocular toxicity may occur at any time during treatment. There is no association between the dose or duration of interferon treatment and ocular toxicity. Although visual acuity returns to normal in most patients when interferon is discontinued, vision loss may be permanent.

scholarly journals What Can We Learn from Sex Differences in MS?

2021 ◽  
Vol 11 (10) ◽  
pp. 1006
Author(s):  
Patricia K. Coyle
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Young Adults ◽  
Sex Differences ◽  
Central Nervous System Disease ◽  
Nervous System Disease ◽  
System Disease ◽  
The Impact

Multiple sclerosis (MS) is the major acquired central nervous system disease of young adults. It is a female predominant disease. Multiple aspects of MS are influenced by sex-based differences. This has become an important area of research and study. It teaches us how the impact of sex on a disease can lead to new insights, guidelines, management, and treatments.

scholarly journals How Important Is the Etiology in the Treatment of Epiphora?

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mahmut Oğuz Ulusoy ◽  
Sertaç Argun Kıvanç ◽  
Mehmet Atakan ◽  
Berna Akova-Budak
Keyword(s):  
Negative Impact ◽  
Treatment Options ◽  
Specific Treatment ◽  
Treatment Modalities ◽  
Common Cause ◽  
Lacrimal System ◽  
System Disease ◽  
Chronic Dacryocystitis ◽  
Wide Range ◽  
Ophthalmologic Examination

Purpose.There are several etiological factors that cause epiphora, and treatment differs according to the cause. We aimed to evaluate the etiology of epiphora and the treatment modalities of the affected patients.Materials and Methods.Data of patients who were referred to ophthalmology clinics for epiphora were retrospectively analyzed. All patients were evaluated for epiphora etiology, treatment modalities, and duration of complaints, after complete ophthalmologic examination.Results.This study consisted of 163 patients with a mean age of 64.61 ± 16.52 years (range 1–92 years). Lacrimal system disease (48.4% [79/163]) was the most common cause, followed by ocular surface disease (dry eye/blepharitis) (38.7% [63/163]). Among the patients included in this study, 69% (113/163) did not receive any treatment, whereas only 1.8% (3/163) were treated surgically. About 4.3% of the patients (7/163) had a complaint for more than 5 years (p=0.012) and six of these had chronic dacryocystitis and one had ectropion.Conclusion.Epiphora not only has a negative impact on patients’ comfort, but also puts them at risk for probable intraocular operations in the future. Therefore, the wide range of its etiology must be taken into consideration and adequate etiology-specific treatment options must be applied.

scholarly journals Progressive Multifocal Leukoencephalopathy in a Multiple Sclerosis Patient Diagnosed after Switching from Natalizumab to Fingolimod

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Tim Sinnecker ◽  
Jalal Othman ◽  
Marc Kühl ◽  
Imke Metz ◽  
Thoralf Niendorf ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Milky Way ◽  
Jc Virus ◽  
Brain Biopsy ◽  
Central Nervous System Disease ◽  
Mri Findings ◽  
Diagnostic Biomarkers ◽  
System Disease ◽  
Inflammatory Syndrome

Background. Natalizumab- (NTZ-) associated progressive multifocal leukoencephalopathy (PML) is a severe and often disabling infectious central nervous system disease that can become evident in multiple sclerosis (MS) patients after NTZ discontinuation. Recently, novel diagnostic biomarkers for the assessment of PML risk in NTZ treated MS patients such as the anti-JC virus antibody index have been reported, and the clinical relevance of milky-way lesions detectable by MRI has been discussed. Case Presentation and Conclusion. We report a MS patient in whom PML was highly suspected solely based on MRI findings after switching from NTZ to fingolimod despite repeatedly negative (ultrasensitive) polymerase chain reaction (PCR) testing for JC virus DNA in cerebrospinal fluid. The PML diagnosis was histopathologically confirmed by brain biopsy. The occurrence of an immune reconstitution inflammatory syndrome (IRIS) during fingolimod therapy, elevated measures of JCV antibody indices, and the relevance of milky-way-like lesions detectable by (7 T) MRI are discussed.

Multiple Sclerosis and Schizophrenia: A Case Report

1972 ◽  
Vol 3 (3) ◽  
pp. 251-257 ◽  
Author(s):  
Marc H. Hollender ◽  
Philip P. Steckler
Keyword(s):  
Multiple Sclerosis ◽  
Psychiatric Disorder ◽  
Central Nervous System Disease ◽  
Dramatic Improvement ◽  
Healthy Children ◽  
System Disease ◽  
Essential Questions ◽  
Sodium Amobarbital ◽  
Relationship Of ◽  
The Relationship

In the borderland between psychiatry and neurology the clinician occasionally encounters patients with diseases which challenge diagnostic skills and treatment methods. A case is presented in which the coexistence of multiple sclerosis and schizophrenia raises essential questions about the relationship of mind and brain. A young woman with multiple sclerosis developed a clinical picture of schizophrenia in the initial stages of her disease. During sodium amobarbital interviews the patient's mental functioning cleared temporarily, although tranquilizers failed to control disruptive behavior. Electroconvulsive therapy was administered with dramatic improvement of her psychiatric disorder and no worsening of her neurological disease. In the seven years since recovery she has married and raised two healthy children without recurrence of either neurological or psychiatric disorder. While no cause-and-effect relationship can be defined, such cases emphasize the need for further studies of the relationship of central nervous system disease to psychiatric disorder.

Interferon Beta for Multiple Sclerosis

1994 ◽  
Vol 28 (5) ◽  
pp. 610-616 ◽  
Author(s):  
Julie F. Connelly
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Clinical Trials ◽  
Nervous System ◽  
Adverse Effects ◽  
Clinical Efficacy ◽  
Interferon Beta ◽  
Central Nervous System Disease ◽  
Nervous System Disease ◽  
System Disease

OBJECTIVE: To introducereaders to the use of a new agent, interferon beta-1b (IFNser), in the treatment of relapsing-remitting multiple sclerosis(RRMS). Therapeuticand economic issues surrounding IFNβser are discussed, as are its pharmacology, clinical efficacy, adverse effects, and dosage guidelines. DATA SOURCES: A MEDLINE search was used to identify pertinent literature, including clinical trials and reviews. STUDY SELECTIONS: All available trials were reviewed. DATA EXTRACTION: Since trials evaluating subcutaneously administered interferon beta are sparse, clinical trials evaluating intrathecal IFNβser were included, as was toxicology information from the oncology population. DATA SYNTHESIS: IFNβser has recently been approved by the Food and Drug Administration for the treatmentof RRMS. Its exact mechanism of action is unknown, but it may downregulate interferon gamma (IFNγ) production and the IFNγ-stimulated major histocompatibility complex antigen expression, and/or augment T-suppressor cell function. Primary adverse effects include flu-like symptoms, fever, chills, myalgia, sweating, and injection-site reactions. Clinical efficacy has been investigated in 372 ambulatory patients with RRMS. IFNβser treatment resulted in a reduction in the annual exacerbationrate and a greater proportionof exacerbation-free patients. Burden of central nervous system disease was also significantly reduced in treated patients. However, no reductions were detected on the Scripps Neurologic Rating Scale or with confirmed endpoint scoreson the Kurtzke Expanded Disability Status Scale. Although many questions remain concerning IFNβser's long-term efficacy, its benefits in patients with other types of multiple sclerosis (MS), and its effect on progressionof disease and ultimate disability, IFNβser is the first treatment modality that has substantially altered the natural course of MS in a controlled clinical trial. CONCLUSIONS: IFNβser is not a cure for MS, but it is well tolerated and patients with RRMS have shown significant improvements in exacerbation rates and burden of central nervous system disease. IFNβser should be considered a definite improvementin RRMS treatment, although many therapeutic issues remain unanswered. Additional clinical trials are needed.

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