101
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Özen Ş, Karataş T, Polat Ü. Perceived social support, mental health, and marital satisfaction in multiple sclerosis patients. Perspect Psychiatr Care 2021; 57:1862-1875. [PMID: 33728706 DOI: 10.1111/ppc.12760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE This study aimed to examine the patients' perceived social support, mental health, and marital satisfaction. DESIGN AND METHODS Data were collected via Patient Information Form, Barthel Index of Activities of Daily Living, Marital Life Scale, Multidimensional Scale of Perceived Social Support, and General Health Questionnaire for 72 patients. FINDINGS Multiple sclerosis (MS) patients had a moderate level of marital satisfaction. The perceived social support showed positive correlation with marital satisfaction and negative correlation with mental health disorders in MS. PRACTICE IMPLICATIONS These results will facilitate the perception of mental problems, marital satisfaction, and social support in MS patients by the nurses.
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Affiliation(s)
- Şükrü Özen
- Department of Nursing, Faculty of Health Sciences, Bingöl University, Bingöl, Turkey
| | - Tuğba Karataş
- Department of Nursing, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Ülkü Polat
- Department of Nursing, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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102
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Rose DR, Amin M, Ontaneda D. Prediction in treatment outcomes in multiple sclerosis: challenges and recent advances. Expert Rev Clin Immunol 2021; 17:1187-1198. [PMID: 34570656 DOI: 10.1080/1744666x.2021.1986005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Multiple Sclerosis (MS) is a chronic autoimmune and neurodegenerative disease of the central nervous system with a course dependent on early treatment response. Increasing evidence also suggests that despite eliminating disease activity (relapses and lesions), many patients continue to accrue disability, highlighting the need for a more comprehensive definition of treatment success. Optimizing disability outcome measures, as well as continuously improving our understanding of neuroinflammatory and neurodegenerative biomarkers is required. AREAS COVERED This review describes the challenges inherent in classifying and monitoring disease phenotype in MS. The review also provides an assessment of clinical, radiological, and blood biomarker tools for current and future practice. EXPERT OPINION Emerging MRI techniques and standardized patient outcome assessments will increase the accuracy of initial diagnosis and understanding of disease progression.
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Affiliation(s)
- Deja R Rose
- Cleveland Clinic, Mellen Center for Multiple Sclerosis, Cleveland Ohio, United States
| | - Moein Amin
- Cleveland Clinic, Mellen Center for Multiple Sclerosis, Cleveland Ohio, United States.,Department of Neurology, Cleveland Clinic, Cleveland Ohio, United States
| | - Daniel Ontaneda
- Cleveland Clinic, Mellen Center for Multiple Sclerosis, Cleveland Ohio, United States.,Department of Neurology, Cleveland Clinic, Cleveland Ohio, United States
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103
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Muzio L, Viotti A, Martino G. Microglia in Neuroinflammation and Neurodegeneration: From Understanding to Therapy. Front Neurosci 2021; 15:742065. [PMID: 34630027 PMCID: PMC8497816 DOI: 10.3389/fnins.2021.742065] [Citation(s) in RCA: 174] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/25/2021] [Indexed: 12/19/2022] Open
Abstract
Microglia are the resident macrophages of the central nervous system (CNS) acting as the first line of defense in the brain by phagocytosing harmful pathogens and cellular debris. Microglia emerge from early erythromyeloid progenitors of the yolk sac and enter the developing brain before the establishment of a fully mature blood-brain barrier. In physiological conditions, during brain development, microglia contribute to CNS homeostasis by supporting cell proliferation of neural precursors. In post-natal life, such cells contribute to preserving the integrity of neuronal circuits by sculpting synapses. After a CNS injury, microglia change their morphology and down-regulate those genes supporting homeostatic functions. However, it is still unclear whether such changes are accompanied by molecular and functional modifications that might contribute to the pathological process. While comprehensive transcriptome analyses at the single-cell level have identified specific gene perturbations occurring in the "pathological" microglia, still the precise protective/detrimental role of microglia in neurological disorders is far from being fully elucidated. In this review, the results so far obtained regarding the role of microglia in neurodegenerative disorders will be discussed. There is solid and sound evidence suggesting that regulating microglia functions during disease pathology might represent a strategy to develop future therapies aimed at counteracting brain degeneration in multiple sclerosis, Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis.
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Affiliation(s)
- Luca Muzio
- Neuroimmunology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
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104
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Lechner-Scott J, Reeves P, Ribbons K, Saugbjerg B, Lea R. Do people with multiple sclerosis receive appropriate support from the National Disability Insurance Scheme matching their level of disability? A description of disease 'burden and societal cost in people with multiple sclerosis in Australia. AUST HEALTH REV 2021; 45:745-752. [PMID: 34543604 DOI: 10.1071/ah21056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/24/2021] [Indexed: 11/23/2022]
Abstract
ObjectiveThis study is the first to assess if the National Disability Insurance Scheme (NDIS) package allocated to people with multiple sclerosis (pwMS) is correlated with the disability level measured by standardised neurological assessment.MethodsWe aimed to recruit 10 pwMS per expanded disability status score (EDSS) step, including EDSS 0 (no disability) up to 9 (bedridden), and requested information about their NDIS application. Value of their packages was compared with mobility, cognition and psychological impact.ResultsOut of 186 pwMS, only 49% of all patients had an NDIS package approved. The mean values of the annual allowance were AU$30318 for patients with mild disability, AU$38361 for moderate disability and AU$115113 for severe disability. There was a striking variability in packages approved, but restricted mobility seems to be the driving factor. Rejection rates were <20% in patients with mild and moderate disability and none in those with severe disability. The package value correlated with EDSS steps, cognitive impairment and physical impact, but not psychological impact.ConclusionsThis is the first study to assess if NDIS packages correlate with internationally accepted disability scales. The NDIS support was correlated with disability measured by EDSS steps and cognition, but not psychological impact of the disease.What is known about the topic?There are over 25000 Australians living with multiple sclerosis, which is one of the most common neurological diseases leading to disability in early age. The National Disability Insurance Scheme has been introduced since 2013 to particularly assist young disabled Australians to participate in the community. Whether the approved package correlates with internationally accepted disability scores has not yet been assessed.What does this paper add?This study is the first to correlate disability, as assessed by the Expanded Disability Severity Scale (EDSS), with the approved package value.What are the implications for practitioners?Multiple sclerosis is a very variable disease affecting quality of life not only due to impairment of mobility, but also cognition and mental health. Although the NDIS package value was correlated with an EDSS and cognition, the psychological impact of the disease is often neglected.
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Affiliation(s)
- Jeannette Lechner-Scott
- John Hunter Hospital, Department of Neurology, New Lambton Heights, NSW 2305, Australia; and Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW 2305, Australia. ; ; ; ; and Corresponding author.
| | - Penny Reeves
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW 2305, Australia. ; ; ;
| | - Karen Ribbons
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW 2305, Australia. ; ; ;
| | - Bente Saugbjerg
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW 2305, Australia. ; ; ;
| | - Rodney Lea
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW 2305, Australia. ; ; ; ; and Queensland University of Technology, Brisbane, Qld 4000, Australia
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105
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Carnino L, Schwob JM, Neofytos D, Lazo-Porras M, Chappuis F, Eperon G. Screening for Parasitic Infection and Tuberculosis in Immunosuppressed and Pre-Immunosuppressed Patients: An Observational Study. Trop Med Infect Dis 2021; 6:tropicalmed6030170. [PMID: 34564554 PMCID: PMC8482080 DOI: 10.3390/tropicalmed6030170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/08/2021] [Accepted: 09/17/2021] [Indexed: 12/02/2022] Open
Abstract
Reactivation of latent tuberculosis infection (LTBI) or latent parasitic infection (LPI) during drug-induced immunosuppression can have serious consequences. The Division of tropical and humanitarian medicine of the Geneva University Hospitals runs a specific consultation for parasitic screening of immunosuppressed or pre-immunosuppressed patients. We sought to determine the seroprevalence of LTBI and LPI in such patients and explore its relationship with country of origin or previous travel in a retrospective, single-centre observational study from 2016 to 2019. Demographic data, travel history, ongoing treatments and results of the parasitological (Strongyloides stercoralis, Trypanosoma cruzi, Echinococcus multilocularis, Entamoeba histolytica and Leishmania spp.) and TB screening were collected to calculate LPI or LTBI prevalence. Risk factors for LTBI and strongyloidiasis were analysed using Poisson regression with robust variance. Among 406 eligible patients, 24/353 (6.8%) had LTBI, 8/368 (2.2%) were positive for Strongyloides stercoralis infection, 1/32 (3.1%) was positive for Entamoeba histolytica and 1/299 (0.3%) was positive for Leishmaniasis. No cases of Trypanosoma cruzi (0/274) or Echinococcus multilocularis (0/56) infection were detected. Previous travel to or originating from high-prevalence countries was a risk factor for LTBI (PR = 3.4, CI 95%: 1.4–8.2 and 4.0, CI 95%: 1.8–8.9, respectively). The prevalence of serological Strongyloidiasis in immunosuppressed patients is lower in comparison to those without immunosuppression (PR = 0.1, CI 95%: 0.01–0.8). In conclusion, screening before immunosuppression needs to be individualized, and LTBI and LPI need to be ruled out in patients who originate from or have travelled to high-prevalence countries. The sensitivity of strongyloidiasis serology is reduced following immunosuppression, so an algorithm combining different tests or presumptive treatment should be considered.
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Affiliation(s)
- Luisa Carnino
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 6, 1205 Geneva, Switzerland; (J.-M.S.); (M.L.-P.); (F.C.); (G.E.)
- Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1205 Geneva, Switzerland
- Correspondence: ; Tel.: +41-(0)223729611; Fax: +41-(0)223729626
| | - Jean-Marc Schwob
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 6, 1205 Geneva, Switzerland; (J.-M.S.); (M.L.-P.); (F.C.); (G.E.)
| | - Dionysios Neofytos
- Division of Infectious Diseases, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 6, 1205 Geneva, Switzerland;
| | - Maria Lazo-Porras
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 6, 1205 Geneva, Switzerland; (J.-M.S.); (M.L.-P.); (F.C.); (G.E.)
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - François Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 6, 1205 Geneva, Switzerland; (J.-M.S.); (M.L.-P.); (F.C.); (G.E.)
- Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1205 Geneva, Switzerland
| | - Gilles Eperon
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 6, 1205 Geneva, Switzerland; (J.-M.S.); (M.L.-P.); (F.C.); (G.E.)
- Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1205 Geneva, Switzerland
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106
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Lace JW, Merz ZC, Galioto R. Nonmemory Composite Embedded Performance Validity Formulas in Patients with Multiple Sclerosis. Arch Clin Neuropsychol 2021; 37:309-321. [PMID: 34467368 DOI: 10.1093/arclin/acab066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Research regarding performance validity tests (PVTs) in patients with multiple sclerosis (MS) is scant, with recommended batteries for neuropsychological evaluations in this population lacking suggestions to include PVTs. Moreover, limited work has examined embedded PVTs in this population. As previous investigations indicated that nonmemory-based embedded PVTs provide clinical utility in other populations, this study sought to determine if a logistic regression-derived PVT formula can be identified from selected nonmemory variables in a sample of patients with MS. METHOD A total of 184 patients (M age = 48.45; 76.6% female) with MS were referred for neuropsychological assessment at a large, Midwestern academic medical center. Patients were placed into "credible" (n = 146) or "noncredible" (n = 38) groups according to performance on standalone PVT. Missing data were imputed with HOTDECK. RESULTS Classification statistics for a variety of embedded PVTs were examined, with none appearing psychometrically appropriate in isolation (areas under the curve [AUCs] = .48-.64). Four exponentiated equations were created via logistic regression. Six, five, and three predictor equations yielded acceptable discriminability (AUC = .71-.74) with modest sensitivity (.34-.39) while maintaining good specificity (≥.90). The two predictor equation appeared unacceptable (AUC = .67). CONCLUSIONS Results suggest that multivariate combinations of embedded PVTs may provide some clinical utility while minimizing test burden in determining performance validity in patients with MS. Nonetheless, the authors recommend routine inclusion of several PVTs and utilization of comprehensive clinical judgment to maximize signal detection of noncredible performance and avoid incorrect conclusions. Clinical implications, limitations, and avenues for future research are discussed.
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Affiliation(s)
- John W Lace
- Section of Neuropsychology, P57, Cleveland Clinic, Cleveland, OH, USA
| | - Zachary C Merz
- LeBauer Department of Neurology, The Moses H. Cone Memorial Hospital, Greensboro, NC, USA
| | - Rachel Galioto
- Section of Neuropsychology, P57, Cleveland Clinic, Cleveland, OH, USA.,Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH, USA
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107
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Walczak-Nowicka ŁJ, Herbet M. Acetylcholinesterase Inhibitors in the Treatment of Neurodegenerative Diseases and the Role of Acetylcholinesterase in their Pathogenesis. Int J Mol Sci 2021; 22:9290. [PMID: 34502198 PMCID: PMC8430571 DOI: 10.3390/ijms22179290] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 12/21/2022] Open
Abstract
Acetylcholinesterase (AChE) plays an important role in the pathogenesis of neurodegenerative diseases by influencing the inflammatory response, apoptosis, oxidative stress and aggregation of pathological proteins. There is a search for new compounds that can prevent the occurrence of neurodegenerative diseases and slow down their course. The aim of this review is to present the role of AChE in the pathomechanism of neurodegenerative diseases. In addition, this review aims to reveal the benefits of using AChE inhibitors to treat these diseases. The selected new AChE inhibitors were also assessed in terms of their potential use in the described disease entities. Designing and searching for new drugs targeting AChE may in the future allow the discovery of therapies that will be effective in the treatment of neurodegenerative diseases.
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Affiliation(s)
| | - Mariola Herbet
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 8bStreet, 20-090 Lublin, Poland;
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108
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Gharaylou Z, Sahraian MA, Hadjighassem M, Kohanpour M, Doosti R, Nahardani S, Moghadasi AN. Widespread Disruptions of White Matter in Familial Multiple Sclerosis: DTI and NODDI Study. Front Neurol 2021; 12:678245. [PMID: 34484098 PMCID: PMC8415561 DOI: 10.3389/fneur.2021.678245] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/14/2021] [Indexed: 11/29/2022] Open
Abstract
Diffusion tensor imaging (DTI) is a noninvasive, quantitative MRI technique that measures white matter (WM) integrity. Many brain dimensions are heritable, including white matter integrity measured with DTI. Family studies are valuable to provide insights into the interactive effects of non-environmental factors on multiple sclerosis (MS). To examine the contribution of familial factors to the diffusion signals across WM microstructure, we performed DTI and calculated neurite orientation dispersion plus density imaging (NODDI) diffusion parameters in two patient groups comprising familial and sporadic forms of multiple sclerosis and their unaffected relatives. We divided 111 subjects (49 men and 62 women: age range 19-60) into three groups conforming to their MS history. The familial MS group included 30 participants (patients; n = 16, healthy relatives; n = 14). The sporadic group included 41 participants (patients; n = 10, healthy relatives; n = 31). Forty age-matched subjects with no history of MS in their families were defined as the control group. To study white matter integrity, two methods were employed: one for calculating the mean of DTI, FA, and MD parameters on 18 tracts using Tracts Constrained by Underlying Anatomy (TRACULA) and the other for whole brain voxel-based analysis using tract-based spatial statistics (TBSS) on NDI and ODI parameters derived from NODDI and DTI parameters. Voxel-based analysis showed considerable changes in FA, MD, NDI, and ODI in the familial group when compared with the control group, reflecting widespread impairment of white matter in this group. The analysis of 18 tracts with TRACULA revealed increased MD and FA reduction in more tracts (left and right ILF, UNC, and SLFT, forceps major and minor) in familial MS patients vs. the control group. There were no significant differences between the patient groups. We found no consequential changes in healthy relatives of both patient groups in voxel-based and tract analyses. Considering the multifactorial etiology of MS, familial studies are of great importance to clarify the effects of certain predisposing factors on demyelinating brain pathology.
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Affiliation(s)
- Zeinab Gharaylou
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoudreza Hadjighassem
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Kohanpour
- Neuroimaging and Analysis Group (NIAG), Research Center for Molecular and Cellular Imaging, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Rozita Doosti
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Nahardani
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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109
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Shoeibi A, Khodatars M, Jafari M, Moridian P, Rezaei M, Alizadehsani R, Khozeimeh F, Gorriz JM, Heras J, Panahiazar M, Nahavandi S, Acharya UR. Applications of deep learning techniques for automated multiple sclerosis detection using magnetic resonance imaging: A review. Comput Biol Med 2021; 136:104697. [PMID: 34358994 DOI: 10.1016/j.compbiomed.2021.104697] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/22/2021] [Accepted: 07/25/2021] [Indexed: 11/18/2022]
Abstract
Multiple Sclerosis (MS) is a type of brain disease which causes visual, sensory, and motor problems for people with a detrimental effect on the functioning of the nervous system. In order to diagnose MS, multiple screening methods have been proposed so far; among them, magnetic resonance imaging (MRI) has received considerable attention among physicians. MRI modalities provide physicians with fundamental information about the structure and function of the brain, which is crucial for the rapid diagnosis of MS lesions. Diagnosing MS using MRI is time-consuming, tedious, and prone to manual errors. Research on the implementation of computer aided diagnosis system (CADS) based on artificial intelligence (AI) to diagnose MS involves conventional machine learning and deep learning (DL) methods. In conventional machine learning, feature extraction, feature selection, and classification steps are carried out by using trial and error; on the contrary, these steps in DL are based on deep layers whose values are automatically learn. In this paper, a complete review of automated MS diagnosis methods performed using DL techniques with MRI neuroimaging modalities is provided. Initially, the steps involved in various CADS proposed using MRI modalities and DL techniques for MS diagnosis are investigated. The important preprocessing techniques employed in various works are analyzed. Most of the published papers on MS diagnosis using MRI modalities and DL are presented. The most significant challenges facing and future direction of automated diagnosis of MS using MRI modalities and DL techniques are also provided.
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Affiliation(s)
- Afshin Shoeibi
- Faculty of Electrical Engineering, Biomedical Data Acquisition Lab (BDAL), K. N. Toosi University of Technology, Tehran, Iran.
| | - Marjane Khodatars
- Faculty of Engineering, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Mahboobeh Jafari
- Electrical and Computer Engineering Faculty, Semnan University, Semnan, Iran
| | - Parisa Moridian
- Faculty of Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mitra Rezaei
- Electrical and Computer Engineering Dept., Tarbiat Modares University, Tehran, Iran
| | - Roohallah Alizadehsani
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, Australia
| | - Fahime Khozeimeh
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, Australia
| | - Juan Manuel Gorriz
- Department of Signal Theory, Networking and Communications, Universidad de Granada, Spain; Department of Psychiatry. University of Cambridge, UK
| | - Jónathan Heras
- Department of Mathematics and Computer Science, University of La Rioja, La Rioja, Spain
| | | | - Saeid Nahavandi
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, Australia
| | - U Rajendra Acharya
- Department of Biomedical Engineering, School of Science and Technology, Singapore University of Social Sciences, Singapore; Dept. of Electronics and Computer Engineering, Ngee Ann Polytechnic, 599489, Singapore; Department of Bioinformatics and Medical Engineering, Asia University, Taiwan
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110
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Kashyap K, Siddiqi MI. Recent trends in artificial intelligence-driven identification and development of anti-neurodegenerative therapeutic agents. Mol Divers 2021; 25:1517-1539. [PMID: 34282519 DOI: 10.1007/s11030-021-10274-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/05/2021] [Indexed: 12/12/2022]
Abstract
Neurological disorders affect various aspects of life. Finding drugs for the central nervous system is a very challenging and complex task due to the involvement of the blood-brain barrier, P-glycoprotein, and the drug's high attrition rates. The availability of big data present in online databases and resources has enabled the emergence of artificial intelligence techniques including machine learning to analyze, process the data, and predict the unknown data with high efficiency. The use of these modern techniques has revolutionized the whole drug development paradigm, with an unprecedented acceleration in the central nervous system drug discovery programs. Also, the new deep learning architectures proposed in many recent works have given a better understanding of how artificial intelligence can tackle big complex problems that arose due to central nervous system disorders. Therefore, the present review provides comprehensive and up-to-date information on machine learning/artificial intelligence-triggered effort in the brain care domain. In addition, a brief overview is presented on machine learning algorithms and their uses in structure-based drug design, ligand-based drug design, ADMET prediction, de novo drug design, and drug repurposing. Lastly, we conclude by discussing the major challenges and limitations posed and how they can be tackled in the future by using these modern machine learning/artificial intelligence approaches.
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Affiliation(s)
- Kushagra Kashyap
- Academy of Scientific and Innovative Research (AcSIR), CSIR-Central Drug Research Institute (CSIR-CDRI) Campus, Lucknow, India.,Molecular and Structural Biology Division, CSIR-Central Drug Research Institute (CSIR-CDRI), Sector 10, Jankipuram Extension, Sitapur Road, Lucknow, 226031, India
| | - Mohammad Imran Siddiqi
- Academy of Scientific and Innovative Research (AcSIR), CSIR-Central Drug Research Institute (CSIR-CDRI) Campus, Lucknow, India. .,Molecular and Structural Biology Division, CSIR-Central Drug Research Institute (CSIR-CDRI), Sector 10, Jankipuram Extension, Sitapur Road, Lucknow, 226031, India.
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111
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Afifi ZE, Shehata RI, El Sayed AF, Hammad ESM, Salem MR. Nutritional status of multiple sclerosis (MS) patients attending Kasr Alainy MS unit: an exploratory cross-sectional study. J Egypt Public Health Assoc 2021; 96:20. [PMID: 34255211 PMCID: PMC8276896 DOI: 10.1186/s42506-021-00080-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 06/01/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Nutrition was claimed to be a factor in MS causation, course, complications, and management. Several studies were conducted to assess the nutritional status of MS patients; however, few studies were conducted to assess this problem in Egypt. Therefore, the purpose of the current study was to assess the nutritional status of a sample of MS patients. METHODS The researchers conducted an exploratory cross-sectional study among 76 relapsing-remitting MS (RRMS) patients attending Kasr Alainy Multiple Sclerosis Unit (KAMSU) from October 2018 to January 2019 to assess the nutritional status of a sample of MS patients. Data were collected using a structured interview questionnaire including an inquiry about the socioeconomic status, and nutritional status using anthropometric measurements, patient-generated subjective global assessment (PG-SGA), semi-quantitative food frequency questionnaires (SQFFQ), and hemoglobin level measurement. Assessment of fatigue was done using the Modified Fatigue Impact Scale 5-items version. RESULTS The mean age of the study participants was 30 ± 6 years. The disease duration ranged from 2 to 264 months. Malnutrition was prevalent among 67.1% (27.6 % overweight, 36.8% obese, and 2.6% underweight). Half of the investigated patients were anemic. According to the PG-SGA, more than half of the studied patients (53.9%) were classified as moderately or suspected malnourished. The unhealthy dietary habits such as taking only a few meals, junk food intake and skipping breakfast were observed in considerable proportions of the group. The SQFFQ revealed overconsumption of energy and fat, and less than acceptable consumption of dietary fibers by most of the studied patients. CONCLUSIONS Overweight, obesity, anemia, and unhealthy dietary habits were prevalent among the RRMS patients attending the KAMSU. Nutrition care service is extremely needed for this group of patients.
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Affiliation(s)
- Zeinab E Afifi
- Public Health and Community Medicine Department, Faculty of Medicine, Cairo University, PO Box 109 El Malek El Saleh, Cairo, 11559, Egypt
| | - Rania I Shehata
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Asmaa F El Sayed
- Public Health and Community Medicine Department, Faculty of Medicine, Cairo University, PO Box 109 El Malek El Saleh, Cairo, 11559, Egypt
| | - El Sayed M Hammad
- Clinical Nutrition Department, National Nutrition Institute, Cairo, Egypt
| | - Marwa R Salem
- Public Health and Community Medicine Department, Faculty of Medicine, Cairo University, PO Box 109 El Malek El Saleh, Cairo, 11559, Egypt.
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Facci L, Barbierato M, Fusco M, Giusti P, Zusso M. Co-Ultramicronized Palmitoylethanolamide/Luteolin-Induced Oligodendrocyte Precursor Cell Differentiation is Associated With Tyro3 Receptor Upregulation. Front Pharmacol 2021; 12:698133. [PMID: 34276381 PMCID: PMC8277943 DOI: 10.3389/fphar.2021.698133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/15/2021] [Indexed: 11/13/2022] Open
Abstract
Remyelination in patients with multiple sclerosis frequently fails, especially in the chronic phase of the disease promoting axonal and neuronal degeneration and progressive disease disability. Drug-based therapies able to promote endogenous remyelination capability of oligodendrocytes are thus emerging as primary approaches to multiple sclerosis. We have recently reported that the co-ultramicronized composite of palmitoylethanolamide and the flavonoid luteolin (PEALut) promotes oligodendrocyte precursor cell (OPC) maturation without affecting proliferation. Since TAM receptor signaling has been reported to be important modulator of oligodendrocyte survival, we here evaluated the eventual involvement of TAM receptors in PEALut-induced OPC maturation. The mRNAs related to TAM receptors -Tyro3, Axl, and Mertk- were all present at day 2 in vitro. However, while Tyro3 gene expression significantly increased upon cell differentiation, Axl and Mertk did not change during the first week in vitro. Tyro3 gene expression developmental pattern resembled that of MBP myelin protein. In OPCs treated with PEALut the developmental increase of Tyro3 mRNA was significantly higher as compared to vehicle while was reduced gene expression related to Axl and Mertk. Rapamycin, an inhibitor of mTOR, prevented oligodendrocyte growth differentiation and myelination. PEALut, administered to the cultures 30 min after rapamycin, prevented the alteration of mRNA basal expression of the TAM receptors as well as the expression of myelin proteins MBP and CNPase. Altogether, data obtained confirm that PEALut promotes oligodendrocyte differentiation as shown by the increase of MBP and CNPase and Tyro3 mRNAs as well as CNPase and Tyro3 immunostainings. The finding that these effects are reduced when OPCs are exposed to rapamycin suggests an involvement of mTOR signaling in PEALut effects.
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Affiliation(s)
- Laura Facci
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Massimo Barbierato
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Mariella Fusco
- Scientific Information and Documentation Center, Epitech Group SpA, Padua, Italy
| | - Pietro Giusti
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Morena Zusso
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy.,IRCCS San Camillo Hospital, Venice, Italy
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113
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Panou Τ, Kavroulakis E, Mastorodemos V, Pouli S, Kalaitzakis G, Spyridaki E, Maris TG, Simos P, Papadaki E. Myelin content changes in Clinically Isolated Syndrome and Relapsing- Remitting Multiple Sclerosis: Associations with lesion type and severity of visuomotor impairment. Mult Scler Relat Disord 2021; 54:103108. [PMID: 34198031 DOI: 10.1016/j.msard.2021.103108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/26/2021] [Accepted: 06/20/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Cognitive disturbances occur in patients with Relapsing Remitting Multiple Sclerosis (RR-MS) and Clinically Isolated Syndrome (CIS). The Multi-Echo-Spin-Echo (MESE) T2-weighted sequence quantifies demyelination, the pathological hallmark of MS, but has not been used for the documentation of the potential relationship between anatomically specific demyelinating changes and cognitive impairment in MS. PURPOSE To identify markers of regional demyelination in patients with RR-MS and CIS in relation to clinical variables and severity of cognitive impairment. METHODS AND MATERIALS 37 RR-MS patients, 39 CIS patients and 52 healthy controls (HC) were examined using the MESE sequence. Long T2 and myelin water fraction (MWF) values were measured, serving as indices of intra/extracellular water content and myelin content, respectively, in focal white matter lesions and 12 normal appearing white matter (NAWM) areas of the patients and HC. A comprehensive neuropsychological assessment was administered to all patients. RESULTS RR-MS patients showed widespread long T2 increases and MWF reductions in NAWM, compared to the respective values of HC (p < 0.001), which correlated with total lesion volume. Among RR-MS patients illness duration correlated negatively with MWF in right hemisphere frontal and periventricular NAWM areas (and positively with corresponding long T2 values). MWF values were lower in the CIS, as compared to the HC group, in the temporal, frontal and periventricular NAWM areas. Focal demyelinating lesions displayed variable higher T2 and lower MWF values, compared to NAWM, closely corresponding to their intensity on T1 sequences. Reduced MWF values and increased long T2 values in right periventricular NAWM were significantly associated with poor visuomotor performance. CONCLUSION The MESE sequence affords accurate estimation of myelin and water content in NAWM and focal lesions in RR-MS and CIS patients, by means of the MWF and long T2 values, respectively, providing a sensitive index of demyelination associated with visuomotor deficits.
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Affiliation(s)
- Τheodora Panou
- Department of Psychiatry, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Eleftherios Kavroulakis
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Vasileios Mastorodemos
- Department of Neurology, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Styliani Pouli
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Georgios Kalaitzakis
- Department of Medical Physics, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Eirini Spyridaki
- Department of Psychiatry, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Thomas G Maris
- Department of Medical Physics, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece; Institute of Computer Science, Foundation of Research and Technology-Hellas, Voutes, Heraklion, Greece
| | - Panagiotis Simos
- Department of Psychiatry, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece; Institute of Computer Science, Foundation of Research and Technology-Hellas, Voutes, Heraklion, Greece
| | - Efrosini Papadaki
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece; Institute of Computer Science, Foundation of Research and Technology-Hellas, Voutes, Heraklion, Greece.
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114
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Habibi H, Sedighi B, Jahani Y, Hasani M, Iranpour A. Self-Care Practices and Related Factors in Patients with Multiple Sclerosis (MS) Based on the Health Belief Model. J Caring Sci 2021; 10:77-83. [PMID: 34222116 PMCID: PMC8242295 DOI: 10.34172/jcs.2021.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 01/26/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction: Self-care programs can raise health in patients with Multiple Sclerosis (MS). This study aimed to identify the self-care behaviors and determinants in patients with MS according to the Health Belief Model (HBM). Methods: In this cross-sectional study, we included 280 MS patients through convenience sampling method. The collection tool was a self-administered questionnaire based on HBM. The participants were the members of MS society in Kerman, Iran. The data were analyzed using descriptive statistics, path analysis, and multivariable linear regression in SPSS software Version 22. Results: The mean (SD) score for self-care practices was 2.86 (0.64), and medication adherence was the most conducted practice. The perceived benefits and cues to action exerted positive influence on self-care practices. The most frequent symptoms experienced by the participants were fatigue (82.5%), visual impairment (76.4%), headaches (72.1%), and muscle weakness (71.4%). The most important cues to action for self-care behavior were the physician (77%), media (52%), and other MS patients (32%). Conclusion: The quality of life (QOL) of MS patients is heavily influenced by self-care behaviors. In this study, only about half of the patients accomplished self-care behaviors, which seems to be insufficient. Since the perceived benefits and cues to action are the main predictors of self-care practices, intervention based on these two constructs can be utilized to promote self-care programs and QOL in MS patients. Health-care providers should pay more attention to these factors for promoting self-care behaviors.
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Affiliation(s)
- Hajar Habibi
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Behnaz Sedighi
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Yunes Jahani
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Marziyeh Hasani
- Department of Health Education and Promotion, School of Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abedin Iranpour
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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115
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Moussa M, Abou Chakra M, Papatsoris AG, Dabboucy B, Hsieh M, Dellis A, Fares Y. Perspectives on urological care in multiple sclerosis patients. Intractable Rare Dis Res 2021; 10:62-74. [PMID: 33996350 PMCID: PMC8122310 DOI: 10.5582/irdr.2021.01029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system. Lower urinary tract dysfunction due to MS includes a dysfunction of the storage phase or dysfunction of the voiding phase or a detrusor-sphincter dyssynergia. Baseline evaluation includes a voiding chart, an ultrasound scan of the urinary tract, urine culture, and an urodynamic study. For storage symptoms, antimuscarinics are the first-line treatment, and clean intermittent catheterization (CIC) is indicated if there is concomitant incomplete bladder emptying. Intradetrusor injections with botulinum toxin A (BTX-A), are recommended for refractory cases. Urinary diversion is rarely indicated. For patients with voiding symptoms, CIC and alpha-blockers are usually offered. Sexual dysfunction in patients with MS is multifactorial. Phosphodiesterase type 5 inhibitors are first-line therapies for MS-associated erectile dysfunction in both male and female patients. This review summarizes the epidemiology, pathogenesis, risk factors, genetic, clinical manifestations, diagnostic tests, and management of MS. Lastly, the urologic outcomes and therapies are reviewed.
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Affiliation(s)
- Mohamad Moussa
- Chairman of Urology Department, Lebanese University & Al Zahraa Hospital, University Medical Center, Beirut, Lebanon
| | - Mohamad Abou Chakra
- Urology Department, Lebanese University, Beirut, Lebanon
- Address correspondence to:Mohamad Abou Chakra, Faculty of Medicine, Department of Urology, Lebanese University. Beirut, Lebanon. E-mail:
| | - Athanasios G. Papatsoris
- 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Baraa Dabboucy
- Department of Neurosurgery, Lebanese University, Beirut, Lebanon
| | - Michael Hsieh
- Division of Urology, Children's National Hospital, Washington, USA
- Department of Urology, The George Washington University, Washington, USA
| | - Athanasios Dellis
- Department of Urology/General Surgery, Areteion Hospital, Athens, Greece
| | - Youssef Fares
- Department of Neurosurgery, Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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116
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DARVISHI SONIA, HAMIDI OMID, POOROLAJAL JALAL. Prediction of Multiple sclerosis disease using machine learning classifiers: a comparative study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E192-E199. [PMID: 34322636 PMCID: PMC8283630 DOI: 10.15167/2421-4248/jpmh2021.62.1.1651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 02/16/2021] [Indexed: 11/24/2022]
Abstract
Introduction Hamedan Province is one of Iran’s high-risk regions for Multiple Sclerosis (MS). Early diagnosis of MS based on an accurate system can control the disease. The aim of this study was to compare the performance of four machine learning techniques with traditional methods for predicting MS patients. Methods The study used information regarding 200 patients through a case-control study conducted in Hamadan, Western Iran, from 2013 to 2015. The performance of six classifiers was used to compare their performance in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR-) and total accuracy. Results Random Forest (RF) model illustrated better performance among other models in both scenarios. It had greater specificity (0.67), PPV (0.68) and total accuracy (0.68). The most influential diagnostic factors for MS were age, birth season and gender. Conclusions Our findings showed that despite all the six methods performed almost similarly, the RF model performed slightly better in terms of different criteria in prediction accuracy. Accordingly, this approach is an effective classifier for predicting MS in the early stage and control the disease.
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Affiliation(s)
- SONIA DARVISHI
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - OMID HAMIDI
- Department of Science, Hamedan University of Technology, Hamedan, Iran
- Correspondence: Omid Hamidi, Department of Science, Hamedan University of Technology, Hamedan, 65155 Iran - Tel.: +98 81 38411533 - E-mail:
| | - JALAL POOROLAJAL
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran - Modeling of Noncommunicable Disease Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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117
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Zeineddine M, Hajje AA, Hussein A, El Ayoubi N, Yamout B. Epidemiology of multiple sclerosis in Lebanon: A rising prevalence in the middle east. Mult Scler Relat Disord 2021; 52:102963. [PMID: 33934011 DOI: 10.1016/j.msard.2021.102963] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/26/2021] [Accepted: 04/10/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The epidemiology of multiple sclerosis (MS) has been studied in many countries of the Middle East but the prevalence and incidence of MS in Lebanon is still unknown. OBJECTIVES To determine the incidence and prevalence of MS in Lebanon. METHODS Lebanese patients diagnosed with MS between January 2018 and December 2018 were identified using the database of governmental third-party payers. The crude, age- and sex-specific 2018 prevalence and incidence among Lebanese patients were calculated. RESULTS 2248 MS patients were identified of whom 67.1% were women (female: male ratio 2:1) with a mean age of 41.8 ± 12.96 years. The 2018 prevalence of MS was 62.91 cases per 100,000 persons (95% CI: 60.41 - 65.41). The overall incidence of MS in Lebanon was 8.36 cases per 100,000 (95% CI: 7.45 - 9.27) with a mean age at onset of 34.5 ± 12.5 years. CONCLUSION This is the first study to assess prevalence and incidence of MS in Lebanon, confirming that Lebanon is a moderate to high-risk area for MS. Those high rates are commensurate with recently published studies from the Middle East, pointing to a significant rise in incidence and prevalence of this disease in our region.
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Affiliation(s)
- Maya Zeineddine
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
| | - Amal Al Hajje
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
| | - Ali Hussein
- Central Military Pharmacy, Lebanese Army Forces, Beirut, Lebanon
| | - Nabil El Ayoubi
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - Bassem Yamout
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
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118
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Danesh-Seta T, Emami F, Nasr-Esfahani MH, Ghaedi K, Aliomrani M. Bee Venom-Derived BBB Shuttle and its Correlation with Oligodendrocyte Proliferation Markers in Mice Model of Multiple Sclerosis. Neurotox Res 2021; 39:1181-1188. [PMID: 33871814 DOI: 10.1007/s12640-021-00361-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/04/2021] [Accepted: 04/07/2021] [Indexed: 12/14/2022]
Abstract
Multiple sclerosis is a chronic demyelinating disease with a functional disturbance in the immune system and axonal damages. It was shown that Apamin as a blood-brain barrier shuttle acts as a Ca2+ activated K+ channels (SK channels) blocker. In this study, the effects of Apamin on oligodendrocyte differentiation markers were evaluated on an induced model of MS. Briefly, C57BL/6 male mice (22 ± 5 g) except the control group were fed with 0.2% (w/w) cuprizone pellets for 6 weeks. After cuprizone withdrawal, mice were divided randomly into six groups. Apamin (100 µg/kg/BW) was administered intraperitoneally as a co-treatment during phase I (demyelination) or post-treatment phase II (remyelination) twice a week. Mice were anesthetized, perfused with phosphate-buffered saline, then fixed brains were coronally sectioned and the changes in oligodendrocytes markers such as Olig2, PDGFR-α, and BrdU incorporation were assessed by immunohistochemistry assay. Apamin administration increased Olig2+ cells in phase I as compared to the control group (p < 0.0001). Also, a decreasing trend in PDGFRa+ cells observed after cuprizone withdrawal (p < 0.001). 5-Bromo-2'-deoxyuridine (BrdU) incorporation test was confirmed stimulation of oligodendrocyte progenitor cell proliferation in phase I in the Apamin exposed group (p < 0.0001), especially at the subventricular zone. This study highlights the potential therapeutic effects of Apamin as a bee venom-derived peptide on oligodendrocyte precursor proliferation and elevation in myelin content in an oxidative induced multiple sclerosis model due to cuprizone exposure.
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Affiliation(s)
- Tannaz Danesh-Seta
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Emami
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Nasr-Esfahani
- Department of Animal Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Kamran Ghaedi
- Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
| | - Mehdi Aliomrani
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Isfahan Pharmaceutical Science Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. .,Iranian National Science Foundation, Tehran, Iran.
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119
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Mansoor F, Kumar V, Kumar S, Kaur N, Naz S, Shahid S, Anees F, Memon S, Rizwan A. Association Between Serum Vitamin D Levels and Frequency of Relapses in Patients With Multiple Sclerosis. Cureus 2021; 13:e14383. [PMID: 33987049 PMCID: PMC8110290 DOI: 10.7759/cureus.14383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction Multiple sclerosis (MS) is an immune-mediated inflammatory disease of the central nervous system affecting the myelin sheath of neurons with a wide range of symptoms. Among various risk factors studied that can increase the relapse, vitamin D is also a potential risk factor. In this study, we will determine the association between vitamin D status and frequency of relapses in patients with MS. Material and methods Seventy-four (74) patients with a confirmed diagnosis of MS, with more than one (01) relapse per year, for a minimum of two years, were included in the case group. Seventy-four (74) participants with a confirmed diagnosis of MS with one (01) or no relapse per year, for a minimum of two years, were included in the control group. After informed consent, the patient blood was drawn via phlebotomy and was sent to the lab for vitamin D levels. Results The mean serum vitamin D level was significantly lower in case group compared to control group (18.21 ± 4.21 ng/mL vs. 29.21 ± 5.72 ng/mL; p-value: < 0.0001). The number of participants with vitamin D level less than 30 ng/mL were significantly higher in patients with case group compared to control group (78.37% vs. 50.0%; p-value: 0.0003) Conclusion In this study, patients with more relapses per year had low level of serum vitamin D. There is emerging strong evidence that vitamin D plays an important role in the pathogenesis, progression, and disease burden of autoimmune disease, including MS.
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Affiliation(s)
- Farah Mansoor
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Vikash Kumar
- Neurology, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Suneel Kumar
- Neurology, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Navneet Kaur
- Internal Medicine, Adesh institute of Medical Sciences and Research, Bathinda, IND
| | - Sidra Naz
- Internal Medicine, University of Health Sciences, Lahore, PAK
| | - Simra Shahid
- Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Faryal Anees
- Obstetrics and Gynecology, Agha Khan University Hospital, Karachi, PAK.,Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Sidra Memon
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Amber Rizwan
- Family Medicine, Jinnah Post Graduate Medical Center, Karachi, PAK
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120
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Autologous hematopoietic stem cell transplantation in multiple sclerosis: a global approval and availability review. Bone Marrow Transplant 2021; 56:1754-1756. [PMID: 33824434 DOI: 10.1038/s41409-021-01276-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 01/21/2021] [Accepted: 03/18/2021] [Indexed: 11/09/2022]
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121
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Jouzizadeh M, Ghaderi AH, Cheraghmakani H, Baghbanian SM, Khanbabaie R. Resting-State Brain Network Deficits in Multiple Sclerosis Participants: Evidence from Electroencephalography and Graph Theoretical Analysis. Brain Connect 2021; 11:359-367. [PMID: 33780635 DOI: 10.1089/brain.2020.0857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Multiple sclerosis (MS) is a chronic inflammatory disease leading to demyelination and axonal loss in the central nervous system that causes focal lesions of gray and white matter. However, the functional impairments of brain networks in this disease are still unspecified and need to be clearer. Materials and Methods: In the present study, we investigate the resting-state brain network impairments for MS participants in comparison to a normal group using electroencephalography (EEG) and graph theoretical analysis with a source localization method. Thirty-four age- and gender-matched participants from each MS group and normal group participated in this study. We recorded 5 min of EEG in the resting-state eyes open condition for each participant. One min (15 equal 4-sec artifact-free segments) of the EEG signals were selected for each participant, and the Low-Resolution Electromagnetic Tomography software was employed to calculate the functional connectivity among whole cortical regions in six frequency bands (delta, theta, alpha, beta1, beta2, and beta3). Graph theoretical analysis was used to calculate the clustering coefficient (CL), betweenness centrality (BC), shortest path length (SPL), and small-world propensity (SWP) for weighted connectivity matrices. Nonparametric permutation tests were utilized to compare these measures between groups. Results: Significant differences between the MS group and the normal group in the average of BC and SWP were found in the alpha band. The significant differences in the BC were spread over all lobes. Conclusion: These results suggest that the resting-state brain network for the MS group is disrupted in local and global scales, and EEG has the capability of revealing these impairments.
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Affiliation(s)
- Mojtaba Jouzizadeh
- Department of Physics, Babol Noshirvani University of Technology, Babol, Iran
| | - Amir Hossein Ghaderi
- Department of Psychology and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Hamed Cheraghmakani
- Department of Neurology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Reza Khanbabaie
- Department of Physics, Babol Noshirvani University of Technology, Babol, Iran.,Department of Physics, I.K. Barber School of Arts and Sciences, University of British Columbia, Kelowna, British Columbia, Canada
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122
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Sharma S, Nozohouri S, Vaidya B, Abbruscato T. Repurposing metformin to treat age-related neurodegenerative disorders and ischemic stroke. Life Sci 2021; 274:119343. [PMID: 33716063 DOI: 10.1016/j.lfs.2021.119343] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/22/2021] [Accepted: 03/03/2021] [Indexed: 12/13/2022]
Abstract
Aging is a risk factor for major central nervous system (CNS) disorders. More specifically, aging can be inked to neurodegenerative diseases (NDs) because of its deteriorating impact on neurovascular unit (NVU). Metformin, a first line FDA-approved anti-diabetic drug, has gained increasing interest among researchers for its role in improving aging-related neurodegenerative disorders. Additionally, numerous studies have illustrated metformin's role in ischemic stroke, a cerebrovascular disorder in which the NVU becomes dysfunctional which can lead to permanent life-threatening disabilities. Considering metformin's beneficial preclinical actions on various disorders, and the drug's role in alleviating severity of these conditions through involvement in commonly characterized cellular pathways, we discuss the potential of metformin as a suitable drug candidate for repurposing in CNS disorders.
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Affiliation(s)
- Sejal Sharma
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center (TTUHSC), Amarillo, TX, USA
| | - Saeideh Nozohouri
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center (TTUHSC), Amarillo, TX, USA
| | - Bhuvaneshwar Vaidya
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center (TTUHSC), Amarillo, TX, USA
| | - Thomas Abbruscato
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center (TTUHSC), Amarillo, TX, USA.
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Maghrebi O, Hanachi M, Bahrini K, Kchaou M, Jeridi C, Belal S, Ben Sassi S, Barbouche MR, Souiai O, Belghith M. Differential Gene Expression Patterns in Blood and Cerebrospinal Fluid of Multiple Sclerosis and Neuro-Behçet Disease. Front Genet 2021; 12:638236. [PMID: 33719347 PMCID: PMC7954360 DOI: 10.3389/fgene.2021.638236] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/05/2021] [Indexed: 11/13/2022] Open
Abstract
Inflammatory demyelinating disorders of the central nervous system are debilitating conditions of the young adult, here we focus on multiple sclerosis (MS) and neuro-Behçet disease (NBD). MS is an autoimmune disorder of the central nervous system. NBD, a neurological manifestation of an idiopathic chronic relapsing multisystem inflammatory disease, the behçet disease. The diagnosis of MS and NBD relies on clinical symptoms, magnetic resonance imaging and laboratory tests. At first onset, clinical and imaging similarities between the two disorders may occur, making differential diagnosis challenging and delaying appropriate management. Aiming to identify additional discriminating biomarker patterns, we measured and compared gene expression of a broad panel of selected genes in blood and cerebrospinal fluid (CSF) cells of patients suffering from NBD, MS and non inflammatory neurological disorders (NIND). To reach this aim, bivariate and multivariate analysis were applied. The Principal Analysis Component (PCA) highlighted distinct profiles between NBD, MS, and controls. Transcription factors foxp3 in the blood along with IL-4, IL-10, and IL-17 expressions were the parameters that are the main contributor to the segregation between MS and NBD clustering. Moreover, parameters related to cellular activation and inflammatory cytokines within the CSF clearly differentiate between the two inflammatory diseases and the controls. We proceeded to ROC analysis in order to identify the most distinctive parameters between both inflammatory neurological disorders. The latter analysis suggested that IL-17, CD73 in the blood as well as IL-1β and IL-10 in the CSF were the most discriminating parameters between MS and NBD. We conclude that combined multi-dimensional analysis in blood and CSF suggests distinct mechanisms governing the pathophysiology of these two neuro-inflammatory disorders.
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Affiliation(s)
- Olfa Maghrebi
- Laboratory of Transmission, Control and Immunobiology of Infections, Institut Pasteur de Tunis, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.,Tunis El Manar University, Tunis, Tunisia
| | - Mariem Hanachi
- Laboratory of Bioinformatics, Biomathematics and Biostatistics-LR16IPT09, Institut Pasteur de Tunis, Tunis, Tunisia.,Faculty of Science of Bizerte, University of Carthage, Jarzouna, Tunisia
| | - Khadija Bahrini
- Laboratory of Transmission, Control and Immunobiology of Infections, Institut Pasteur de Tunis, Tunis, Tunisia.,Tunis El Manar University, Tunis, Tunisia
| | - Mariem Kchaou
- Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.,Charles Nicolle Hospital, Tunis, Tunisia
| | - Cyrine Jeridi
- Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.,Department of Neurology, Mongi Ben Hmida National Institute of Neurology, Tunis, Tunisia
| | - Samir Belal
- Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.,Department of Neurology, Mongi Ben Hmida National Institute of Neurology, Tunis, Tunisia
| | - Samia Ben Sassi
- Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.,Department of Neurology, Mongi Ben Hmida National Institute of Neurology, Tunis, Tunisia
| | - Mohamed-Ridha Barbouche
- Laboratory of Transmission, Control and Immunobiology of Infections, Institut Pasteur de Tunis, Tunis, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Oussama Souiai
- Tunis El Manar University, Tunis, Tunisia.,Laboratory of Bioinformatics, Biomathematics and Biostatistics-LR16IPT09, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Meriam Belghith
- Laboratory of Transmission, Control and Immunobiology of Infections, Institut Pasteur de Tunis, Tunis, Tunisia.,Tunis El Manar University, Tunis, Tunisia
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Palavra F, Figueiroa S, Correia AS, Tapadinhas F, Cerqueira J, Guerreiro RP, de Sá J, Sá MJ, Almeida S, Mota P, Sousa L. TyPed study: Natalizumab for the treatment of pediatric-onset multiple sclerosis in Portugal. Mult Scler Relat Disord 2021; 51:102865. [PMID: 33714125 DOI: 10.1016/j.msard.2021.102865] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/08/2021] [Accepted: 02/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND A significant proportion of pediatric-onset multiple sclerosis (POMS) patients do not respond to first-line disease-modifying therapies. Clinical trials showed that natalizumab is effective and safe in adults, but there are limited clinical trial data for children. Natalizumab is currently prescribed off-label for POMS. We aimed to characterize the effectiveness, safety and tolerability of natalizumab in all POMS cases treated in Portugal (from 2007 to 2018). METHODS Data from clinical records were retrospectively collected for all POMS cases treated with natalizumab in Portugal. RESULTS Twenty-one patients were included, 14 (67%) of which were female. The median age at POMS diagnosis was 13 years old. The median duration of treatment with natalizumab was 2 years and 3 months. Median Expanded Disability Status Scale score decreased from 1.5 to 1.0 after 24 months. The Annualized Relapse Rate decreased from 1.31 events/patient/year before treatment with natalizumab to 0 after 12 months of treatment and to 0.04 after 24 months. No gadolinium-enhancing lesions or new or enlarged T2 hyperintense lesions were observed in 8/8 patients (100%) after 12 months, and 4/5 (80%) after 24 months. There was one possible serious adverse event, which did not require dose adjustment. Five patients discontinued treatment due to positive anti-JCV (JC virus) antibody JC serostatus. CONCLUSION Natalizumab may be an effective and safe disease-modifying therapy for POMS. Our results are in line with data published for the adult population, as well as with similar observational studies in pediatric populations in other regions.
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Affiliation(s)
- Filipe Palavra
- Centre for Child Development - Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra; Laboratory of Pharmacology and Experimental Therapeutics, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
| | - Sónia Figueiroa
- Neuropediatrics Unit, Centro Materno-Infantil do Norte, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Ana Sofia Correia
- Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental; CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Fernando Tapadinhas
- Department of Pediatrics, Hospital de Faro, Centro Hospitalar e Universitário do Algarve, Faro, Portugal
| | - João Cerqueira
- Department of Neurology, Hospital de Braga; 2CA - Clinical Academic Centre Braga; School of Medicine, University of Minho, Braga, Portugal
| | - Rui Pedro Guerreiro
- Department of Neurology, Hospital de São Bernardo, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - João de Sá
- Department of Neurology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - Maria José Sá
- Department of Neurology, Centro Hospitalar e Universitário de São João; Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
| | | | | | - Lívia Sousa
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Xu L, Chen L, Wang S, Feng J, Liu L, Liu G, Wang J, Zhan S, Fan D. Urban prevalence of multiple sclerosis in China: A population-based study in six provinces. Eur J Neurol 2021; 28:1636-1644. [PMID: 33539586 DOI: 10.1111/ene.14764] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 01/03/2021] [Accepted: 01/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Multiple sclerosis (MS) is a rare neurological disease addressed by only few epidemiological studies in China. This population-based study aimed to estimate the prevalence of MS in China by using national medical insurance databases. METHODS Data from the Urban Employee Basic Medical Insurance database and the Urban Residence Basic Medical Insurance database, which were collected during 2012 to 2016 and included approximately 0.20 billion residents in six provinces, were used in this population-based study. The prevalent patients with MS were identified via diagnostic text or disease codes. RESULTS The crude prevalence in 2016 was 2.44 per 100,000 population (95% confidence interval (CI) 2.18-2.72), with the prevalence in females being higher than that in males. The standardized prevalence (based on 2010 Chinese census data) was 2.29 (95% CI 2.21-2.38). The prevalence in both sexes in 2016 increased up to the age range of 30-34 years. Subsequently, the female prevalence declined with increasing age, but male prevalence stabilized with increasing age. During the 5-year time period, prevalence ranged from 2.32 (95% CI 2.06-2.60) in 2015 to 2.91 (95% CI 2.39-3.47) in 2012. CONCLUSIONS The prevalence of MS in China was lower than that in Europe and North America. The temporal trend of prevalence in China was also observed to be stable. As the first prevalence study of MS in mainland China, this population-based study can provide useful information for worldwide healthcare services and prevention of MS.
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Affiliation(s)
- Lu Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lu Chen
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jingnan Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lili Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Guozhen Liu
- Peking University Health Information Technology Co. Ltd, Beijing, China
| | - Jinxi Wang
- Beijing Healthcom Data Technology Co. Ltd, Beijing, China
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.,Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China
| | - Dongsheng Fan
- Department of Neurology, Peking University Third Hospital, Beijing, China
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Zhang Q, Dai X, Zhang H, Zeng Y, Luo K, Li W. Recent advances in development of nanomedicines for multiple sclerosis diagnosis. Biomed Mater 2021; 16:024101. [PMID: 33472182 DOI: 10.1088/1748-605x/abddf4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Multiple sclerosis (MS) is a neurodegenerative disease with a high morbidity and disease burden. It is characterized by the loss of the myelin sheath, resulting in the disruption of neuron electrical signal transmissions and sensory and motor ability deficits. The diagnosis of MS is crucial to its management, but the diagnostic sensitivity and specificity are always a challenge. To overcome this challenge, nanomedicines have recently been employed to aid the diagnosis of MS with an improved diagnostic efficacy. Advances in nanomedicine-based contrast agents in magnetic resonance imaging scanning of MS lesions, and nanomedicine-derived sensors for detecting biomarkers in the cerebrospinal fluid biopsy, or analyzing the composition of exhaled breath gas, have demonstrated the potential of using nanomedicines in the accurate diagnosis of MS. This review aims to provide an overview of recent advances in the application of nanomedicines for the diagnosis of MS and concludes with perspectives of using nanomedicines for the development of safe and effective MS diagnostic nanotools.
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Affiliation(s)
- Qin Zhang
- Department of Radiology, Department of Postgraduate Students, and Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China. West China School of Medicine, Sichuan University, Chengdu 610041, People's Republic of China. These authors contributed equally to this work
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Association between familial Mediterranean fever and multiple sclerosis: A case series from the JIR cohort and systematic literature review. Mult Scler Relat Disord 2021; 50:102834. [PMID: 33609923 DOI: 10.1016/j.msard.2021.102834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/19/2021] [Accepted: 02/05/2021] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Familial Mediterranean fever (FMF) is the most frequent monogenic autoinflammatory disorder; and leads to the uncontrolled production of interleukin (IL)-1β. Multiple sclerosis (MS) is an inflammatory disease of the central nervous system; and its development seems to be partly correlated with IL-1β levels. It is hypothesized that FMF could be associated with MS. We aim to describe the features of patients displaying both diseases and to investigate the MEFV mutation rate in MS patients. METHODS Patients with definite MS were retrieved from the cohort of FMF patients in the Reference Center for Rare Auto-inflammatory Diseases and Amyloidosis (CEREMAIA). We also performed a systematic literature review of articles from PubMed that were published from 1990 to 2020. RESULTS Twenty-four patients were included in the case series: five patients (1.3%) from our cohort of 364 and 19 patients from the literature. The sex ratio was 2:1. The mean age at diagnosis of FMF was 19 years old; and that for MS was 29 years old. Seven studies investigating the MEFV mutation rate in MS patients were included. Three studies found a higher mutation rate in MS patients than in the control group. CONCLUSION FMF and MS features were comparable to those of patients with unrelated diseases; and MEFV mutation carriage was not positively correlated with MS. However; MS prevalence in FMF patients was higher than was expected in a healthy population. To a lesser extent; FMF prevalence in MS patients was higher than expected in a healthy population and the difference might not be significant. These data suggest that FMF could be associated with MS; and further studies are needed to investigate a potential causal association.
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Cheshmavar M, Mirmosayyeb O, Badihian N, Badihian S, Shaygannejad V. Rituximab and glatiramer acetate in secondary progressive multiple sclerosis: A randomized clinical trial. Acta Neurol Scand 2021; 143:178-187. [PMID: 32897569 DOI: 10.1111/ane.13344] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/10/2020] [Accepted: 08/29/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Treatment options for secondary progressive multiple sclerosis (SPMS) are limitedly investigated. We aimed to compare the efficacy of rituximab (RTX) and glatiramer acetate (GA) in SPMS patients. METHOD This open, randomized clinical trial was conducted on 84 SPMS patients, assigned to receive RTX or GA for 12 months. In RTX group, patients received 1 g intravenous RTX primarily and then every 6-months. In GA group, patients received 40 mg of GA 3-times/week subcutaneously. We measured EDSS as the primary outcome and neuroimaging findings, relapse rate (RR), and side effects as the secondary outcomes. RESULTS Seventy-three patients completed the study (37 and 36 in RTX and GA groups, respectively). The mean EDSS increased from 3.05 ± 1.01 to 4.14 ± 0.91 in RTX group (p < 0.001) and from 3.22 ± 1.20 to 4.60 ± 0.67 in GA group (p < 0.001). No statistically significant difference was observed in EDSS between two groups (F(1, 67) = 3.377; p = 0.071). The number of active lesions in brain and cervical spine decreased with no difference between groups (p > 0.05). Also, RR decreased in both groups without significant difference between them (F(1, 67) = 0.390; p = 0.534). Non-serious complications were observed in both groups. CONCLUSION Neither RTX nor GA affects EDSS in SPMS patients. They are equally effective in the relapse control of these patients.
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Affiliation(s)
- Masoumeh Cheshmavar
- Isfahan Neurosciences Research Center Alzahra Research Institute Isfahan University of Medical Sciences Isfahan Iran
- Department of Neurology School of Medicine Isfahan University of Medical Sciences Isfahan Iran
| | - Omid Mirmosayyeb
- Isfahan Neurosciences Research Center Alzahra Research Institute Isfahan University of Medical Sciences Isfahan Iran
- Department of Neurology School of Medicine Isfahan University of Medical Sciences Isfahan Iran
| | - Negin Badihian
- Isfahan Neurosciences Research Center Alzahra Research Institute Isfahan University of Medical Sciences Isfahan Iran
- Child Growth and Development Research Center Research Institute for Primordial Prevention of Non‐Communicable Disease Isfahan University of Medical Sciences Isfahan Iran
| | - Shervin Badihian
- Department of Neurology Johns Hopkins University School of Medicine Baltimore MD USA
| | - Vahid Shaygannejad
- Isfahan Neurosciences Research Center Alzahra Research Institute Isfahan University of Medical Sciences Isfahan Iran
- Department of Neurology School of Medicine Isfahan University of Medical Sciences Isfahan Iran
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129
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Yazdanpanah M, Jalilian N, Abdollah Zadeh R, Sahraian MA, Noori-Daloii MR. Investigating the association of polymorphisms of ANKRD55 and MMEL1 with susceptibility to multiple sclerosis in Iranian population. Int J Neurosci 2021; 132:1037-1042. [PMID: 33491520 DOI: 10.1080/00207454.2020.1860964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Multiple sclerosis (MS) is an autoimmune neurological disability in which immune cells attack the myelin sheaths that protect nerve fibers. The pathogenesis of the disease involves both complex genetic effects as well as multifaceted gene-environment interactions. In the present study, we examined the association of two Single nucleotide polymorphisms (SNPs) in ANKRD55 (rs6859219) and MMEL (rs3748816) with MS in the Iranian population. ANKRD55 is specifically expressed in human peripheral blood mononuclear cells and CD4 + T cells, while MMEL1is involved in the degradation of both neuropeptides and β-amyloid. METHODS In this case-control study, 110 patients with MS and 110 matched healthy controls were enrolled. The Participants were genotyped for ANKRD55 and MMEL1 SNPs using PCR-RFLP and Real-Time TaqMan SNP Genotyping respectively. The results were finally analyzed using SPSS software version 22. RESULTS Our results did not show significant differences in allelic frequencies of two SNPs among cases and controls (P-Value >0.05). However, for ANKRD55 (rs6859219), CA genotype was shown to have a protective effect (p = 0.035 and OR = 0.55), while CC genotype was a susceptive genotype to MS (p = 0.036 and OR = 1.8). There was no significant difference in genotypic frequencies of SNP rs3748816 in MMEL1. CONCLUSION We could successfully replicate the association of ANKRD55 (rs6859219) with susceptibility to MS in the Iranian population. Our result can provide an insight into better understanding the pathogenesis of MS and also improve the genetic counseling for patients affected with multiple sclerosis in Iran.
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Affiliation(s)
- Mahboobeh Yazdanpanah
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Jalilian
- Department of Clinical Biochemistry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rasoul Abdollah Zadeh
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Jalusic KO, Ellenberger D, Rommer P, Stahmann A, Zettl U, Berger K. Effect of applying inclusion and exclusion criteria of phase III clinical trials to multiple sclerosis patients in routine clinical care. Mult Scler 2021; 27:1852-1863. [PMID: 33467978 PMCID: PMC8521377 DOI: 10.1177/1352458520985118] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background: Newly approved, drug-modifying therapies are associated with still unknown adverse events, although clinical trials leading to approval have strict inclusion and exclusion criteria and analyse safety and efficacy. Objectives: The aim of this study was to analyse the eligibility of multiple sclerosis (MS) patients treated in routine care into the phase III clinical trial of the respective drug. Methods: In total, 3577 MS patients with 4312 therapies were analysed. Patients with primary-progressive MS were excluded. Inclusion and exclusion criteria of phase III clinical trials in relapsing–remitting MS were adopted and subsequently applied. A comparison in clinical and sociodemographic characteristics was made between patient who met the criteria and those who did not. Results: 83% of registered patients would not have been eligible to the respective phase III clinical trial. Relapse was the single most frequent criterion not fulfilled (74.7%), followed by medication history (21.2%). Conclusion: The majority of MS patients treated in routine care would not have met clinical trials criteria. Thus, the efficacy and safety of therapies in clinical trials can differ from those in the real world. Broader phase III inclusion criteria would increase their eligibility and contribute to a better generalizability of the results in clinical trials.
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Affiliation(s)
- Kris Oliver Jalusic
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - David Ellenberger
- MS Forschungs- und Projektentwicklungs-gGmbH, German MS Register, Hannover, Germany
| | - Paulus Rommer
- Department of Neurology, University Medicine Rostock, Rostock, Germany/Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Alexander Stahmann
- MS Forschungs- und Projektentwicklungs-gGmbH, German MS Register, Hannover, Germany
| | - Uwe Zettl
- Department of Neurology, University Medicine Rostock, Rostock, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
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Brown LJ, Li J, Brunner M, Snoke M, La HA. Societal costs of primary progressive multiple sclerosis in Australia and the economic impact of a hypothetical disease-modifying treatment that could delay disease progression. J Med Econ 2021; 24:140-149. [PMID: 33461357 DOI: 10.1080/13696998.2021.1872585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIMS Primary progressive multiple sclerosis (PPMS) has a progressive course of disability with continuous neurological worsening. We investigated societal costs of PPMS in Australia and the economic impact of increasing the independence of people with PPMS through delaying disease progression. METHODS This prevalence-based retrospective cost-of-illness analysis used observational data from publicly available secondary data sources and literature findings. Direct and indirect costs of PPMS were considered. A replica estimated population was created using the National Centre for Social and Economic Modelling (NATSEM) microsimulation model of the Australian tax and transfer system (STINMOD+). Using a budget impact analysis approach, we modelled the effect on PPMS costs of an effective hypothetical disease-modifying treatment (DMT) that delays disease progression by a year from mild to moderate and a further year from moderate to severe PPMS. RESULTS An estimated 31,650 Australians have multiple sclerosis (MS) including 4,430 with PPMS. The proportion with PPMS was estimated to increase with age and disease severity. Overall 25% of males with MS, and 10% of females, were estimated to have PPMS. Societal cost of PPMS in Australia in 2018 was estimated at AU$418.1 million. Indirect costs contributed 67.5% of total costs, attributable to reduced workforce participation and need for informal care. The modelled DMT was estimated to create savings of AU$14.9 million (3.6%). Fewer people had moderate and severe PPMS resulting in major cost savings, partially offset by increased costs of treatment, care and support for a relative increase in the number of people with mild PPMS and their increased productivity losses. LIMITATIONS Publicly available data may be incomplete. The potential cost of the DMT was not considered. CONCLUSIONS The economic burden of PPMS was estimated at AU$418 million in 2018. An effective DMT that delayed progression from disease severity states by one year could provide significant cost savings.
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Affiliation(s)
- Laurie J Brown
- National Centre for Social and Economic Modelling (NATSEM), Institute for Governance and Policy Analysis, University of Canberra, Canberra, ACT, Australia
| | - Jinjing Li
- National Centre for Social and Economic Modelling (NATSEM), Institute for Governance and Policy Analysis, University of Canberra, Canberra, ACT, Australia
| | | | - Martin Snoke
- Roche Products Pty Limited, Sydney, NSW, Australia
| | - Hai A La
- National Centre for Social and Economic Modelling (NATSEM), Institute for Governance and Policy Analysis, University of Canberra, Canberra, ACT, Australia
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Ozanimod to Treat Relapsing Forms of Multiple Sclerosis: A Comprehensive Review of Disease, Drug Efficacy and Side Effects. Neurol Int 2020; 12:89-108. [PMID: 33287177 PMCID: PMC7768354 DOI: 10.3390/neurolint12030016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/20/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022] Open
Abstract
Multiple sclerosis (MS) is a prevalent and debilitating neurologic condition characterized by widespread neurodegeneration and the formation of focal demyelinating plaques in the central nervous system. Current therapeutic options are complex and attempt to manage acute relapse, modify disease, and manage symptoms. Such therapies often prove insufficient alone and highlight the need for more targeted MS treatments with reduced systemic side effect profiles. Ozanimod is a novel S1P (sphingosine-1-phosphate) receptor modulator used for the treatment of clinically isolated syndrome, relapsing–remitting, and secondary progressive forms of multiple sclerosis. It selectively modulates S1P1 and S1P5 receptors to prevent autoreactive lymphocytes from entering the CNS where they can promote nerve damage and inflammation. Ozanimod was approved by the US Food and Drug Administration (US FDA) for the management of multiple sclerosis in March 2020 and has been proved to be both effective and well tolerated. Of note, ozanimod is associated with the following complications: increased risk of infections, liver injury, fetal risk, increased blood pressure, respiratory effects, macular edema, and posterior reversible encephalopathy syndrome, among others. Further investigation including head-to-head clinical trials is warranted to evaluate the efficacy of ozanimod compared with other S1P1 receptor modulators.
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Hajibabaei M, Kajbaf B, Esmaeili M, Harirchian MH, Montazeri A. Impact of an Existential-Spiritual Intervention Compared with a Cognitive-Behavioral Therapy on Quality of Life and Meaning in Life among Women with Multiple Sclerosis. IRANIAN JOURNAL OF PSYCHIATRY 2020; 15:322-330. [PMID: 33240382 PMCID: PMC7610069 DOI: 10.18502/ijps.v15i4.4298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: Multiple sclerosis (MS) is a chronic neurological disease that could aggressively affect patients’ quality of life in most instances. This study aimed to compare the effectiveness of an existential-spiritual psychotherapy with a cognitive-behavioral therapy on quality of life and meaning in life in women with multiple sclerosis. Method: A convenience sample of 43 women with multiple sclerosis participated in this quasi-experimental study. They were randomly assigned into 3 groups: an existential-spiritual intervention, a cognitive-behavioral intervention, and the control group. Participants were assessed for outcome measures (quality of life and meaning in life) at 3 points in time: pretest, posttest, and 5-months follow-up. The Multiple Sclerosis Quality of Life-54 (MSQOL-54) and the Meaning in Life Questionnaires (MLQ) were used as outcome measures. To compare outcomes among the study groups, repeated measures analysis of variance was performed. Results: The results showed that while no difference was observed for the control group, scores for meaning in life improved significantly for existential-spiritual intervention and cognitive-behavioral therapy (p = 0.027, p = 0.039). Also, both mental (p < 0.001, p = 0.014) and physical (p = 0.001, p = 0.013) health dimensions of quality of life increased significantly in the 2 intervention groups. However, the results indicated that women in the existential-spiritual intervention group showed greater improvement in some aspects of meaning in life (search for meaning) and quality of life (role physical and role emotional, pain and energy) compared to women in the cognitive-behavioral intervention group. However, the latter group showed better improvements on 2 subscales (physical function and health distress). Conclusion: Both existential-spiritual and cognitive-behavioral interventions can improve quality of life and meaning in life among women with multiple sclerosis. However, the findings suggest that although both interventions were effective, the existential-spiritual intervention resulted in more positive improvements in some aspects of meaning in life and quality of life.
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Affiliation(s)
- Marzieh Hajibabaei
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.,Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Kajbaf
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Maryam Esmaeili
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Mohammad Hossein Harirchian
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran.,School of Humanity Sciences, University of Science and Culture, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran
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134
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Zanini D, Jezdimirovic T, Stajer V, Ostojic J, Maksimovic N, Ostojic SM. Dietary supplementation with L-carnosine improves patient-reported outcomes, autonomic nervous system performance, and brain metabolism in 3 adult patients with multiple sclerosis. Nutr Res 2020; 84:63-69. [PMID: 33189432 DOI: 10.1016/j.nutres.2020.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 09/10/2020] [Accepted: 09/24/2020] [Indexed: 12/31/2022]
Abstract
This pilot trial reports the effects of L-carnosine administration on autonomic nervous system performance, brain metabolism, and various patient- and clinician-reported outcomes in a case series of patients with multiple sclerosis (MS). We hypothesized that medium-term L-carnosine supplementation would improve selected patient- and clinician-reported outcomes in MS patients, with no negative effects on self-reported side effects. L-carnosine (2 g/day) was administered orally for 8 weeks in 2 women and one man suffering from MS. The intensity of symptoms and signs of MS after L-carnosine administration diminished in 5 out of 7 domains in CASE 1, in 3 out of 7 domains in CASE 2, and one domain in CASE 3; general fatigue was reduced in all 3 cases at the follow-up. This was accompanied by an improved walking distance to exhaustion in all patients, with values improved for 51.1% in CASE 1, 19.5% in CASE 2, and 2.1% in CASE 3 at 8-week follow-up. Tests of autonomic cardiovascular reflexes demonstrate normalized parasympathetic modulation and balanced sympathetic function after L-carnosine intervention in all MS cases. An increase in serum total antioxidant capacity (TAC) was found at 8-week follow-up in all patients (from 4.6 to 49.6%); this was accompanied by lower blood lactate at post-administration in all cases (23.5% on average). Single-voxel 1.5 T MR spectroscopy revealed increased brain choline-contained compounds (18.9% on average), total creatine (21.2%), and myo-inositol levels (12.3%) in girus cinguli at 8-week follow-up in all MS cases. This case study demonstrates that an 8-week intervention with L-carnosine appears to be a safe and beneficial therapeutic strategy with regard to the reduction of presence and severity of symptoms of MS.
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Affiliation(s)
- Dragana Zanini
- FSPE Applied Bioenergetics Lab, University of Novi Sad, 21000 Novi Sad, Serbia
| | | | - Valdemar Stajer
- FSPE Applied Bioenergetics Lab, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Jelena Ostojic
- FSPE Applied Bioenergetics Lab, University of Novi Sad, 21000 Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Nebojsa Maksimovic
- FSPE Applied Bioenergetics Lab, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Sergej M Ostojic
- FSPE Applied Bioenergetics Lab, University of Novi Sad, 21000 Novi Sad, Serbia; Faculty of Health Sciences, University of Pecs, H-7621 Pecs, Hungary.
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135
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Multiple sclerosis in Pakistan: Current status and future perspective. J Neurol Sci 2020; 418:117066. [PMID: 32823132 DOI: 10.1016/j.jns.2020.117066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/20/2020] [Accepted: 07/27/2020] [Indexed: 11/20/2022]
Abstract
Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) which commonly leads to disability. We reviewed articles on MS from Pakistan using PubMed, Google Scholar and Pak Medinet to present different aspects of the disease and the status of disease modifying treatments in Pakistan and South Asia. MS is not as uncommon in Pakistan as it has been previously thought to be. Estimated prevalence of MS in Pakistan may be 10 per 100,000 population. Data suggests that most features of MS found in Pakistan are similar to those found in the West. These features include a female preponderance, mean age of onset in the third decade of life and similar risk factors including viral infections, smoking, and vitamin D deficiency, as well as genetic risk factors. Relapsing-remitting multiple sclerosis (RRMS) is the most common disease pattern seen in Pakistan which is also consistent with data from other regions. Treatment modalities in Pakistan include immunomodulatory and immunosuppressive drugs. In order to improve care for MS patients in Pakistan, it is extremely important to obtain a population-based prevalence of MS in the country and a national MS registry, along with implementing programs for patients' awareness and the training of doctors, especially internists. There are many disease modifying therapies (DMT) available in Pakistan but no data is available on the utilization and impact of these DMTs.
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136
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Vermersch P, Suchet L, Colamarino R, Laurendeau C, Detournay B. An analysis of first-line disease-modifying therapies in patients with relapsing-remitting multiple sclerosis using the French nationwide health claims database from 2014–2017. Mult Scler Relat Disord 2020; 46:102521. [DOI: 10.1016/j.msard.2020.102521] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/18/2020] [Indexed: 10/23/2022]
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137
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Salari N, Rasoulpoor S, Hosseinian-Far A, Razazian N, Mansouri K, Mohammadi M, Vaisi-Raygani A, Jalali R, Shabani S. Association between serum paraoxonase 1 activity and its polymorphisms with multiple sclerosis: a systematic review. Neurol Sci 2020; 42:491-500. [PMID: 33095366 DOI: 10.1007/s10072-020-04842-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/17/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Human serum paraoxonase (PON) is an enzyme that is synthesized by the liver and enters the bloodstream, and it is transmitted by high-density lipoproteins (HDL). Paraoxonase 1 (PON1) is a hydrolytic enzyme with a wide range of substrates and the ability to protect against lipid oxidation. In this study, due to the activity of PON1 in the brain and its antioxidant effects on the reduction of neurological disorders in the central nervous system, the role of PON1 and its polymorphisms related to multiple sclerosis has been examined to enhance treatment methods. METHODS This article is a systematic review. In this study, the role of PON1 and its polymorphisms in multiple sclerosis (MS) has been investigated. Articles published in Persian and international databases of SID, Google Scholar, ISI (WoS), Magiran, PubMed, Scopus, IranDoc, Science Direct, and Iran Medix were examined, using the search keywords of Paraoxonase 1, polymorphism, multiple sclerosis, and PON1. RESULTS PON1 is undoubtedly a potential factor in the pathogenesis of multiple sclerosis, and it plays an important role in protecting antioxidants in the blood. Oxidative stress and lipid peroxidation are factors in the pathogenesis of MS. Both inflammatory cytokines and oxidative stress have a detrimental effect on PON1. However, reducing the activity of PON1 may help to restore the pathogenesis of the disease. CONCLUSION Decreased PON1 activity and PON1 polymorphism are associated with several neurological diseases, including ischemic stroke, white matter lesions (WMLs), amyotrophic lateral sclerosis (ALS), dementia, and Parkinson's disease. PON1-55M alleles in Italians and PON1-192Q alleles in Poles were associated with a high risk of MS. Moreover, PON1-55 and PON1-192 polymorphisms were not associated with MS onset age, nor its evolutionary type.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shna Rasoulpoor
- Medical Biology Research Centre, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amin Hosseinian-Far
- Department of Business Systems & Operations, University of Northampton, Northampton, UK
| | - Nazanin Razazian
- Department of Neurology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kamran Mansouri
- Medical Biology Research Centre, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Aliakbar Vaisi-Raygani
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rostam Jalali
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shervin Shabani
- Medical Biology Research Centre, Kermanshah University of Medical Sciences, Kermanshah, Iran
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138
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Asouri M, Sahraian MA, Karimpoor M, Fattahi S, Motamed N, Doosti R, Amirbozorgi G, Sadaghiani S, Mahboudi F, Akhavan-Niaki H. Molecular Detection of Epstein-Barr Virus, Human Herpes Virus 6, Cytomegalovirus, and Hepatitis B Virus in Patients with Multiple Sclerosis. Middle East J Dig Dis 2020; 12:171-177. [PMID: 33062222 PMCID: PMC7548094 DOI: 10.34172/mejdd.2020.179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic disease with significant morbidity. A wide spectrum of risk factors has been suggested that triggers the development of MS. Among them, several viral infections have been implicated to play a role in MS pathogenesis. We aimed to evaluate the relationship between viral diseases, including Epstein–Barr virus (EBV), human herpes virus 6 (HHV-6), cytomegalovirus (CMV), and hepatitis B virus (HBV) and MS in the present case-control study. METHODS About 100 patients with confirmed MS and age- and sex-matched individuals were selected as case and control groups, respectively. The patients were randomly selected from individuals diagnosed by neurologists based on the clinical signs and symptoms and imaging procedures. RESULTS More than 100 patients with MS and patients who were referred for other causes were analyzed for the presence of DNA of EBV, HHV6, CMV, and HBV separately. 9.37% of the control group had a positive test for the DNA of EBV in a real-time polymerase chain reaction (PCR), while the frequency of positive test result was zero in the case group (p = 0.0012). HBV DNA was not detected in both the case and control groups. The prevalence of CMV was 0.88 and zero in the control and case groups, respectively (p = 0.3410). For HHV6, 9.73 % of the control group had a positive result, while this test was positive in 5.88% of the patients with MS (p = 0.2959). CONCLUSION We detected a significantly higher number of individuals with DNA of EBV in their blood among the control group compared with the case group. In conclusion, the results suggest a surprisingly adverse association between MS and EBV, and no association was found between the presence of DNA of HBV, CMV, and HHV6 and MS.
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Affiliation(s)
- Mohsen Asouri
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran.,North Research Center, Pasteur Institute of Iran, Amol, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center; Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Karimpoor
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Sadegh Fattahi
- North Research Center, Pasteur Institute of Iran, Amol, Iran
| | - Nima Motamed
- Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Rozita Doosti
- Multiple Sclerosis Research Center; Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shokufeh Sadaghiani
- Multiple Sclerosis Research Center; Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Mahboudi
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Haleh Akhavan-Niaki
- Zoonoses Research Center, North Research Center, Pasteur Institute of Iran, Amol, Iran.,Department of Genetics, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
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139
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Alnahdi MA, Alsulayhim AK, Bin Salem AH, Masuadi E, Al Malik Y. Patterns and Outcomes of Complementary and Alternative Medicine Use Among Adult Patients With Multiple Sclerosis. Cureus 2020; 12:e10825. [PMID: 33173632 PMCID: PMC7645302 DOI: 10.7759/cureus.10825] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disease that causes demyelination of the central nervous system. No treatment has been shown to be curative; thus, we assume that the tendency for patients with MS to use unconventional therapies, such as complementary and alternative medicine (CAM), might increase. The aim of this study was to explore the pattern of CAM use among patients with MS at a tertiary health care center in Saudi Arabia (SA). This was a questionnaire-based observational cross-sectional study that targeted adult patients diagnosed with MS at King Abdulaziz Medical City in Riyadh, SA, from 2018 to 2019. The sample size included 176 patients, and a consecutive non-probability sampling technique was used to engage them during their appointments. An Arabic questionnaire was used to evaluate patients' use of CAM. The mean age of participants was 34.6 ± 10.9 years, females represented the majority 125 (71%) of participants, and 89% of the participants reported using CAM at least once, with one or more modalities being used. Prayer, Salat, was the most frequent modality (60%) followed by supplication, Dua'a (59%), Ruqia, reciting Holy Quran (52%), and vitamins (44%). Symptomatic improvement was reported by 49 (27.8%) of dietary supplement users and 81 (46%) of non-dietary supplement medicine users. The study found a high prevalence of CAM utilization among Saudi adult patients with MS, which exceeded internationally reported rates. Although some patients described some improvement in their symptoms, further research is needed to evaluate the effectiveness of CAM.
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Affiliation(s)
- Muhannad A Alnahdi
- Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Medicine, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Abdullah K Alsulayhim
- Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Medicine, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Ahmed H Bin Salem
- Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Medicine, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Emad Masuadi
- Medical Education, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Statistician, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Yaser Al Malik
- Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Medicine, King Abdullah International Medical Research Center, Riyadh, SAU.,Neurology, King Abdulaziz Medical City, National Guard - Health Affairs, Riyadh, SAU
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140
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Lattanzi S, Rocchi C, Danni M, Taffi R, Cerqua R, Carletti S, Silvestrini M. Long-term outcome in multiple sclerosis patients treated with fingolimod. Mult Scler Relat Disord 2020; 45:102416. [DOI: 10.1016/j.msard.2020.102416] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/22/2020] [Accepted: 07/20/2020] [Indexed: 11/16/2022]
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141
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Kouchaki E, Namdari M, Khajeali N, Etesam F, Asgarian FS. Prevalence of Suicidal Ideation in Multiple Sclerosis Patients: Meta-Analysis of International Studies. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:655-663. [PMID: 32865151 DOI: 10.1080/19371918.2020.1810839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this study is to estimate the worldwide prevalence of suicidal ideation in multiple sclerosis patients. Two researchers selected words such as "epidemiology" or "prevalence" or "incidence" and "suicidal ideation in multiple sclerosis" and searched them as relevant keywords in international databases such as PubMed, Web of Science CINAHL, Embase, Psyc INFO, and Scopus. A point prevalence with 95% confidence interval was estimated. The variances of each study were calculated using the binomial distribution formula. Heterogeneity among the studies was tested by a Q-Cochran test with a significance level less than 0.1. Index of changes attributed to heterogeneity (I2) was assessed. From among the 170 total articles found from 2011 to February 2019, we pooled and analyzed the data of eight final eligible studies, based on the inclusion criteria. The prevalence of suicidal ideation in multiple sclerosis patients was estimated as 13% (CI 95% = 0.09-0.17). A subgroup analysis was conducted based on the type of countries; it revealed that prevalence is higher in developed countries (15%; CI 95% = 0.1-0.2). Pooled worldwide prevalence of suicidal ideation in the MS population was calculated at 13% by random effect. It is recommended that training, counseling, and psychological support be used to help these patients.
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Affiliation(s)
- Ebrahim Kouchaki
- Physiology Research Center, Kashan University of Medical Sciences , Kashan, Iran
| | - Mahshid Namdari
- Department of Community Oral Health, Dental School, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Nasrin Khajeali
- Education and Research Education Development Center, North Khorasan University of Medical Science , Bojnurd, Iran
| | - Farnaz Etesam
- Baharloo Hospital, Tehran University of Medical Sciences , Tehran, Iran
| | - Fatemeh Sadat Asgarian
- Social Determinants of Health (SDH) Research Center, Kashan University of Medical Sciences , Kashan, Iran
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142
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Zeng Y, Li Z, Zhu H, Gu Z, Zhang H, Luo K. Recent Advances in Nanomedicines for Multiple Sclerosis Therapy. ACS APPLIED BIO MATERIALS 2020; 3:6571-6597. [PMID: 35019387 DOI: 10.1021/acsabm.0c00953] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Yujun Zeng
- Huaxi MR Research Center (HMRRC), Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zhiqian Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Hongyan Zhu
- Huaxi MR Research Center (HMRRC), Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zhongwei Gu
- Huaxi MR Research Center (HMRRC), Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Hu Zhang
- Amgen Bioprocessing Centre, Keck Graduate Institute, Claremont, California 91711, United States
| | - Kui Luo
- Huaxi MR Research Center (HMRRC), Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
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143
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Kabaeva AR, Boyko AN, Kulakova OG, Favorova OO. [Radiologically isolated syndrome: prognosis and predictors of conversion to multiple sclerosis]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:7-12. [PMID: 32844624 DOI: 10.17116/jnevro20201200727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Increased sensitivity and availability of magnetic resonance imaging (MRI) in neurological routine practice led to the fact that more and more experts began to encounter changes typical for multiple sclerosis (MS) according to MRI in the absence of anamnestic and clinical indications of damage to the central nervous system (CNS). This nosological form has been defined as a radiologically isolated syndrome (RIS). More and more RIS cases convert to MS (up to 30% in the first 5 years after RIS diagnosis). At the moment, there are no biological markers that allow combining RIS and MS into one pathological process and early treatment with disease-modifying drugs (DMT). Prospective studies are actively being conducted to identify demographic, clinical, neuroimaging and biochemical conversion predictors. The identification of the molecular biological RIS features, combining these changes with MS, is an urgent scientific task and will allow timely initiation of therapy of the pathological process already at the subclinical stage.
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Affiliation(s)
- A R Kabaeva
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A N Boyko
- Pirogov Russian National Research Medical University, Moscow, Russia.,Federal Center of Cerebrovascular Pathology and Stroke, Moscow, Russia
| | - O G Kulakova
- Pirogov Russian National Research Medical University, Moscow, Russia.,Institute of Experimental Cardiology of National Medical Research Center of Cardiology, Moscow, Russia
| | - O O Favorova
- Pirogov Russian National Research Medical University, Moscow, Russia.,Institute of Experimental Cardiology of National Medical Research Center of Cardiology, Moscow, Russia
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144
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Gerhardsson L, Hou L, Pettersson K. Work-related exposure to organic solvents and the risk for multiple sclerosis-a systematic review. Int Arch Occup Environ Health 2020; 94:221-229. [PMID: 32880046 PMCID: PMC7872988 DOI: 10.1007/s00420-020-01564-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/25/2020] [Indexed: 11/12/2022]
Abstract
Purpose Multiple sclerosis (MS) is a chronic progressive neurological disorder. Several environmental factors have been discussed as possible causing agents, e.g. organic solvents, whose impact on the disease is analysed in this review.
Methods Systematic search strategies were used to identify high-quality studies of workers exposed to organic solvents, published up to September 30, 2019, in databases, such as PubMed, Cochrane library and Scopus. The exposure was in most studies obtained by questionnaires, supplemented with telephone interviews. The diagnosis MS was mainly detemined following a thorough neurological examination. Finally, fourteen case–control studies and two cohort studies met the inclusion criteria and were included in the meta-analysis. Random effects models were used to pool the results of the studies. Results The odds ratios from the 14 case–control studies included in the meta-analysis ranged from 0.12–4.0. Five case–control studies and one cohort study showed a significant association between the development of multiple sclerosis and exposure to organic solvents. The results from the other nine case–control studies and from one of the two cohort studies did not reach statistical significance. The pooled data from the 14 case–control studies gave an OR of 1.44 (95% CI 1.03–1.99), which shows a moderately increased risk of developing MS after exposure to organic solvents. Conclusions The final interpretation of the result is that organic solvents may be slightly associated with an increased risk to develop MS. In addition, other factors, e.g. genetic markers and smoking, may contribute to the development of the disease.
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Affiliation(s)
- Lars Gerhardsson
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16A, Box 414, 405 30, Gothenburg, Sweden.
| | - Linda Hou
- Institute of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Feelgood Occupational Health Care AB, Gothenburg City, Sweden
| | - Kjell Pettersson
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16A, Box 414, 405 30, Gothenburg, Sweden
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145
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Lattanzi S, Acciarri MC, Danni M, Taffi R, Cerqua R, Rocchi C, Silvestrini M. Cerebral hemodynamics in patients with multiple sclerosis. Mult Scler Relat Disord 2020; 44:102309. [DOI: 10.1016/j.msard.2020.102309] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 10/24/2022]
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146
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Joodi Khanghah O, Nourazarian A, Khaki-Khatibi F, Nikanfar M, Laghousi D, Vatankhah AM, Moharami S. Evaluation of the Diagnostic and Predictive Value of Serum Levels of ANT1, ATG5, and Parkin in Multiple Sclerosis. Clin Neurol Neurosurg 2020; 197:106197. [PMID: 32890892 DOI: 10.1016/j.clineuro.2020.106197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Multiple Sclerosis (MS) is a disease of the central nervous system, which ultimately may lead to various disabilities in patients. No definitive cure has yet been developed for the disease. MRI is the method of choice for imaging MS plaques, which would be useful in disease diagnosis as it becomes progressive. Therefore, this study aimed to investigate the serum levels of ANT1 (adenine nucleotide translocase 1), ATG5 (autophagy-related protein 5), and Parkin in patients with MS, all of which play essential roles in MS pathophysiology, as novel serum biomarkers for early diagnosis of the disease. DESIGN AND METHODS Forty patients in the early stages of the disease, and 40 healthy individuals were selected as the case and control groups. Upon sampling, the serum levels of the biomarkers were measured. RESULTS The results indicated that autophagy, mitophagy, and mitochondrial apoptosis were different in the case and control groups. The oxidative stress level evaluation revealed low concertation of total antioxidant status (TAS) in the MS patients, while a partial increase accompanied the malondialdehyde (MDA). No significant correlation was observed between oxidative stress and autophagy or mitophagy factors. CONCLUSION According to the results obtained from this study, the evaluation of serum levels of ANT1, ATG5, and Parkin could be applied in the diagnosis and follow-up of MS patients.
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Affiliation(s)
- Omid Joodi Khanghah
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran; Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Nourazarian
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran; Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Fatemeh Khaki-Khatibi
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran; Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Nikanfar
- Department of Neurology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Delara Laghousi
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Sepideh Moharami
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran; Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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147
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Vancamp P, Butruille L, Demeneix BA, Remaud S. Thyroid Hormone and Neural Stem Cells: Repair Potential Following Brain and Spinal Cord Injury. Front Neurosci 2020; 14:875. [PMID: 32982671 PMCID: PMC7479247 DOI: 10.3389/fnins.2020.00875] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/28/2020] [Indexed: 12/22/2022] Open
Abstract
Neurodegenerative diseases are characterized by chronic neuronal and/or glial cell loss, while traumatic injury is often accompanied by the acute loss of both. Multipotent neural stem cells (NSCs) in the adult mammalian brain spontaneously proliferate, forming neuronal and glial progenitors that migrate toward lesion sites upon injury. However, they fail to replace neurons and glial cells due to molecular inhibition and the lack of pro-regenerative cues. A major challenge in regenerative biology therefore is to unveil signaling pathways that could override molecular brakes and boost endogenous repair. In physiological conditions, thyroid hormone (TH) acts on NSC commitment in the subventricular zone, and the subgranular zone, the two largest NSC niches in mammals, including humans. Here, we discuss whether TH could have beneficial actions in various pathological contexts too, by evaluating recent data obtained in mammalian models of multiple sclerosis (MS; loss of oligodendroglial cells), Alzheimer’s disease (loss of neuronal cells), stroke and spinal cord injury (neuroglial cell loss). So far, TH has shown promising effects as a stimulator of remyelination in MS models, while its role in NSC-mediated repair in other diseases remains elusive. Disentangling the spatiotemporal aspects of the injury-driven repair response as well as the molecular and cellular mechanisms by which TH acts, could unveil new ways to further exploit its pro-regenerative potential, while TH (ant)agonists with cell type-specific action could provide safer and more target-directed approaches that translate easier to clinical settings.
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Affiliation(s)
- Pieter Vancamp
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, Paris, France
| | - Lucile Butruille
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, Paris, France
| | - Barbara A Demeneix
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, Paris, France
| | - Sylvie Remaud
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, Paris, France
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148
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Kern DM, Cepeda MS. Treatment patterns and comorbid burden of patients newly diagnosed with multiple sclerosis in the United States. BMC Neurol 2020; 20:296. [PMID: 32781983 PMCID: PMC7418327 DOI: 10.1186/s12883-020-01882-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/06/2020] [Indexed: 01/15/2023] Open
Abstract
Background The treatment landscape for multiple sclerosis (MS) is quickly evolving. Understanding real-world treatment patterns of patients is necessary to identifying potential gaps in care. Methods Patients with incident MS were identified from a large national claims database during 1/1/2014–6/30/2019. Patients had ≥2 diagnoses for MS or an inpatient hospitalization with a primary diagnosis of MS. Patients were required to have enrollment in the database ≥1 year prior to and ≥ 1 year following their first MS diagnosis. Treatment sequences were captured for all available disease modifying therapies (DMTs) during all available follow-up. Presence of comorbid conditions were captured during the one year prior to and following (and including) the index date; absolute change in prevalence from the pre- to post-index periods was calculated. Results We identified 5691 patients with incident MS. Common comorbidities included physical symptoms (e.g., pain, weakness, fatigue), mental health conditions (anxiety, depression), and cardiovascular/metabolic conditions (hypertension, hyperlipidemia, diabetes, obesity). Just 1994 (35.0%) of patients received a DMT at any time during follow-up. Of those receiving a DMT, 28.2% went on to receive a second line of therapy, 5.8% received a third, and just 0.9% went on to a fourth line. Use of more than one DMT concomitantly occurred in just 1.8% of all treated patients. Glatiramer and dimethyl fumarate were by far the most common first-line treatments received accounting for nearly 62% of patients receiving a DMT. Conclusion Approximately two-thirds of patients newly diagnosed with MS did not receive a DMT and the disease is accompanied by a significant comorbid burden.
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Affiliation(s)
- David M Kern
- Janssen Research and Development, 1125 Trenton Harbourton Rd, Titusville, NJ, 08560, USA.
| | - M Soledad Cepeda
- Janssen Research and Development, 1125 Trenton Harbourton Rd, Titusville, NJ, 08560, USA
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149
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Kotsopoulos N, Connolly MP, Dort T, Kavaliunas A. The fiscal consequences of public health investments in disease-modifying therapies for the treatment of multiple sclerosis in Sweden. J Med Econ 2020; 23:831-837. [PMID: 32400258 DOI: 10.1080/13696998.2020.1757457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background and aims: The economic consequences of multiple sclerosis (MS) are broader than those observed within the health system. The progressive nature suggests that people will not be able to live a normal productive life and will gradually require public benefits to maintain living standards. This study investigates the public economic impact of MS and how investments in disease-modifying therapies (DMTs) influence the lifetime costs to government attributed to changes in lifetime tax revenue and disability benefits based on improved health status linked to delayed disease progression.Methods: Disease progression rates from previous MS Markov cohort models were applied to interferon beta-1a, peginterferon beta-1a, dimethyl fumarate, and natalizumab using a public economic framework. The established relationship between expanded disability status scale and work-force participation, annual earnings, and disability rates for each DMT were applied. Subsequently, we assessed the effect of DMTs on discounted governmental costs consisting of health service costs, social insurance and disability costs, and changes in lifetime tax revenues.Results: Fiscal benefits attributed to informal care and community services savings for interferon beta-1a, peginterferon beta-1a, dimethyl fumarate, and natalizumab were SEK340,387, SEK486,837, SEK257,330, and SEK958,852 compared to placebo, respectively. Tax revenue gains linked to changes in lifetime productivity for interferon beta-1a, peginterferon beta-1a, dimethyl fumarate, and natalizumab were estimated to be SEK27,474, SEK39,659, SEK21,661, and SEK75,809, with combined fiscal benefits of cost savings and tax revenue increases of SEK410,039, SEK596,592, SEK326,939, and SEK1,208,023, respectively.Conclusion: The analysis described here illustrates the broader public economic benefits for government attributed to changes in disease status. The lifetime social insurance transfer costs were highest in non-treated patients, and lower social insurance costs were demonstrated with DMTs. These findings suggest that focusing cost-effectiveness analysis only on health costs will likely underestimate the value of DMTs.
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Affiliation(s)
- Nikolaos Kotsopoulos
- Health Economics, Global Market Access Solutions Sarl, St-Prex, Switzerland
- Department of Economics, University of Athens, Athens, Greece
| | - Mark P Connolly
- Health Economics, Global Market Access Solutions Sarl, St-Prex, Switzerland
- Unit of Pharmacoepidemiology & Pharmacoeconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Thibaut Dort
- Global Value & Access, Biogen International GmbH, Baar, Switzerland
| | - Andrius Kavaliunas
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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150
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Arevalo-Villalobos JI, Govea-Alonso DO, Bañuelos-Hernández B, González-Ortega O, Zarazúa S, Rosales-Mendoza S. Inducible expression of antigens in plants: a study focused on peptides related to multiple sclerosis immunotherapy. J Biotechnol 2020; 318:51-56. [PMID: 32387449 DOI: 10.1016/j.jbiotec.2020.03.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 11/26/2022]
Abstract
Multiple sclerosis (MS) affects 2.3 million patients worldwide with no effective treatments available thus far. Depletion of autoreactive T-cells is considered the basis for immunotherapeutic approaches. For this purpose the peptides BV5S2, BV6S5, and BV13S1 have been identified as candidates for the development of a MS vaccine. Herein, the plant-based simultaneous production of these peptides is described as an effort to generate a new model of MS immunotherapy. A polyprotein comprising the sequence of the target peptides was designed having the picornaviral 2A sequence in between to mediate the release of the individual peptides upon translation. A codon optimized gene was cloned in vectors mediating constitutive (CaMV35S promoter) or inducible (AlcA promoter) expression. No transgenic tobacco plants were recovered from the constitutive vector suggesting toxicity of the target peptides. In contrast, several transformed lines were obtained with the inducible vector. The individual BV5S2, BV6S5, and BV13S1 peptides were detected in transformed lines upon ethanol-mediated induction and a quantitative analysis based on a OVA conjugate carrying the three peptides revealed accumulation levels up to 0.5 μg g-1 FW leaves. The plant-made peptides were able to induce humoral responses in orally immunized mice. This platform will be useful in the development of alternative immunotherapies against MS having low cost and safety as main attributes. Moreover the platform represents an attractive alternative for the expression of antigens having detrimental effects in plants.
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Affiliation(s)
- Jaime I Arevalo-Villalobos
- Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 6, San Luis Potosí, 78210, Mexico; Sección de Biotecnología, Centro de Investigación en Ciencias de la Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, Av. Sierra Leona 550, Lomas 2ª Sección, San Luis Potosí, 78210, Mexico
| | - Dania O Govea-Alonso
- Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 6, San Luis Potosí, 78210, Mexico; Sección de Biotecnología, Centro de Investigación en Ciencias de la Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, Av. Sierra Leona 550, Lomas 2ª Sección, San Luis Potosí, 78210, Mexico
| | - Bernardo Bañuelos-Hernández
- Escuela de Veterinaria, Universidad De La Salle Bajío, Avenida Universidad 602, Lomas del Campestre, 37150, León, Guanajuato, Mexico
| | - Omar González-Ortega
- Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 6, San Luis Potosí, 78210, Mexico
| | - Sergio Zarazúa
- Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 6, San Luis Potosí, 78210, Mexico
| | - Sergio Rosales-Mendoza
- Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 6, San Luis Potosí, 78210, Mexico; Sección de Biotecnología, Centro de Investigación en Ciencias de la Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, Av. Sierra Leona 550, Lomas 2ª Sección, San Luis Potosí, 78210, Mexico.
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