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Kousparou C, Fyrilla M, Stephanou A, Patrikios I. DHA/EPA (Omega-3) and LA/GLA (Omega-6) as Bioactive Molecules in Neurodegenerative Diseases. Int J Mol Sci 2023; 24:10717. [PMID: 37445890 DOI: 10.3390/ijms241310717] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/22/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
Neurodegenerative diseases are characterized by neuroinflammation, neuronal depletion and oxidative stress. They coincide with subtle chronic or flaring inflammation, sometimes escalating with infiltrations of the immune system cells in the inflamed parts causing mild to severe or even lethal damage. Thus, neurodegenerative diseases show all features of autoimmune diseases. Prevalence of neurodegenerative diseases has dramatically increased in recent decades and unfortunately, the therapeutic efficacy and safety profile of available drugs is moderate. The beneficial effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) polyunsaturated fatty acids (omega-3 PUFAs) are nowadays highlighted by a plethora of studies. They play a role in suppression of inflammation, gene expression, cellular membrane fluidity/permeability, immune functionality and intracellular/exocellular signaling. The role of omega-6 polyunsaturated fatty acids, such as linoleic acid (LA), gamma linolenic acid (GLA), and arachidonic acid (AA), on neuroprotection is controversial, as some of these agents, specifically AA, are proinflammatory, whilst current data suggest that they may have neuroprotective properties as well. This review provides an overview of the existing recent clinical studies with respect to the role of omega-3 and omega-6 PUFAs as therapeutic agents in chronic, inflammatory, autoimmune neurodegenerative diseases as well as the dosages and the period used for testing.
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Affiliation(s)
- Christina Kousparou
- School of Medicine, European University Cyprus, 6 Diogenous Str., 2404 Nicosia, Cyprus
| | - Maria Fyrilla
- School of Medicine, European University Cyprus, 6 Diogenous Str., 2404 Nicosia, Cyprus
| | - Anastasis Stephanou
- School of Medicine, European University Cyprus, 6 Diogenous Str., 2404 Nicosia, Cyprus
| | - Ioannis Patrikios
- School of Medicine, European University Cyprus, 6 Diogenous Str., 2404 Nicosia, Cyprus
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Hamdy E, Galeel AA, Ramadan I, Gaber D, Mustafa H, Mekky J. Iron deposition in multiple sclerosis: overall load or distribution alteration? Eur Radiol Exp 2022; 6:49. [PMID: 36074209 PMCID: PMC9458829 DOI: 10.1186/s41747-022-00279-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/14/2022] [Indexed: 11/14/2022] Open
Abstract
Background Though abnormal iron deposition has been reported in specific brain regions in multiple sclerosis (MS), no data exist about whether the overall quantity of iron in the brain is altered or not. We aimed to determine whether the noted aberrant iron deposition in MS brains was a problem of overall load or regional distribution in a cohort of MS patients. Methods An experienced neuroradiologist, a radiology software engineer, and four neurologists analysed data from quantitative susceptibility maps reconstructed from 3-T magnetic resonance brain images of 30 MS patients and 15 age- and sex-matched healthy controls. Global brain iron load was calculated, and the regional iron concentrations were assessed in 1,000 regions of interest placed in MS lesions in different locations, normal appearing white matter, thalami, and basal ganglia. Results Global brain iron load was comparable between patients and controls after adjustment for volume (p = 0.660), whereas the regional iron concentrations were significantly different in patients than in control (p ≤ 0.031). There was no significant correlation between global iron load and clinical parameters, whereas regional iron concentrations correlated with patients’ age, disease duration, and disability grade (p ≤ 0.039). Conclusions The aberrant iron deposition noted in MS seems to be a problem of regional distribution rather than an altered global brain iron load. Supplementary Information The online version contains supplementary material available at 10.1186/s41747-022-00279-9.
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Affiliation(s)
- Eman Hamdy
- Department of Neurology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Aya Abdel Galeel
- Department of Radiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ismail Ramadan
- Department of Neurology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Dina Gaber
- Department of Neurology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Jaidaa Mekky
- Department of Neurology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Prevalence of antinuclear antibody in patients with multiple sclerosis: a case-control study. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-021-00284-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Antinuclear antibody (ANA) is a common test for excluding alternative diagnoses. However, the significance of ANA testing in patients with multiple sclerosis (MS) remains unclear.
Objectives
To compare the prevalence of positive ANA antibody and its titer between patients with MS (cases) and non-MS patients who attended neurology clinics (control) in Saudi Arabia.
Methods
A case-control review of ANA results for all patients who attended a neurology MS clinic. We compared a convenience sample of patients with MS with individuals with general neurology problems and no known autoimmune diseases.
Results
There were 115 and 103 participants in the MS and control group, respectively. The mean age in the MS and control group was 33.76 ± 8.96 years and 34.95 ± 8.56 years, respectively. In the MS group, 25.22%, 60%, 11.30%, and 3.48% were negative, mildly positive, moderately positive, and strongly positive for ANA, respectively. In the control group, there were 34.95%, 54.37%, and 10.68% were negative, mild positive, and moderate positive, respectively. There were numerically, but not significantly, more positive cases in the MS group (74.78%) than in the control group (65.05%) (p = .117).
Conclusion
ANA testing in routine MS screening for excluding alternative diagnoses should be discouraged unless there is a remarkable history or clinical examination finding. Mild positive ANA is common among patients with MS and does not significantly differ from the general population.
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Jorge A, André A, Rocha AL, Figueiredo C, Santos M, Freitas E, Sousa L, Shamasna M, Salgado V, de Sá J, Cerqueira J, Vale J, Sá MJ, Correia I. Defining the prodromal phase of multiple sclerosis based on healthcare access in a Portuguese population - ProdMS study. Mult Scler Relat Disord 2021; 55:103154. [PMID: 34348212 DOI: 10.1016/j.msard.2021.103154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system. Prodromal symptoms and higher healthcare use have been suggested in patients who later develop MS. OBJECTIVES Assess the healthcare utilization pattern of relapsing-remitting MS (RRMS) patients in the five years prior to MS diagnosis. METHODS Retrospective, multicentric study. Demographic and clinical data, drug prescriptions and diagnostic tests were collected from electronic health records five-years previous to MS diagnosis and compared with national data. RESULTS Included 168 patients, 112 (66.7%) female, median age 34±11 years. The mean number of healthcare use per patient per year was 3.14±2,69, most of them in primary healthcare (47%). Most frequent symptoms were musculoskeletal (22%), gastrointestinal (17%), sensitive (14%) and sensory organs (14%). Median number of diagnostic tests per patient was 6 (IQR 7), and drug prescriptions per patient was 6 (IQR 9). Most frequently prescribed drugs were analgesic/anti-inflammatories, antibiotics and anxiolytics and there was a high request rate of MRIs. CONCLUSION RRMS patients had a high frequency of healthcare utilization when compared to national data. This supports the current evidence showing a prodromal phase in MS.
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Affiliation(s)
- André Jorge
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - Ana André
- Neurology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | - Ana Luísa Rocha
- Neurology Department, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Carlos Figueiredo
- Neurology Department, Hospital Professor Doutor Fernando Fonseca, Lisboa, Portugal
| | - Mónica Santos
- Neurology Department, Centro Hospitalar e Universitário de Lisboa Norte, Lisboa, Portugal
| | - Eduardo Freitas
- Neurology Department, Unidade Local de Saúde Alto Minho, Viana do Castelo, Portugal; Neurology Department, Hospital de Braga, Braga, Portugal
| | - Lívia Sousa
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Motasem Shamasna
- Neurology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | - Vasco Salgado
- Neurology Department, Hospital Professor Doutor Fernando Fonseca, Lisboa, Portugal
| | - João de Sá
- Neurology Department, Centro Hospitalar e Universitário de Lisboa Norte, Lisboa, Portugal
| | - João Cerqueira
- Neurology Department, Unidade Local de Saúde Alto Minho, Viana do Castelo, Portugal; Neurology Department, Hospital de Braga, Braga, Portugal
| | - José Vale
- Neurology Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Maria José Sá
- Neurology Department, Centro Hospitalar Universitário São João, Porto, Portugal; Faculty of Health Sciences, Universidade Fernando Pessoa, Porto, Portugal
| | - Inês Correia
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Aktas O, Kümpfel T. [From neuromyelitis optica to neuromyelitis optica spectrum disorder: from clinical syndrome to diagnistic classification]. DER NERVENARZT 2021; 92:307-316. [PMID: 33728474 DOI: 10.1007/s00115-021-01098-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 12/30/2022]
Abstract
Neuromyelitis optica spectrum disorder (NMOSD), derived from NMO or Devic's disease, is considered as a distinct disease since the discovery of a novel and pathogenic serum autoantibody targeting aquaporin‑4 (AQP4-IgG) and is distinguished from classical multiple sclerosis (MS). With the continuous extension of knowledge on the clinical manifestations, the previously narrow diagnostic term NMO became NMOSD, which has also been used in the diagnostic criteria since 2015. The current diagnostic criteria enable the early diagnosis of NMOSD in patients with and without AQP4-IgG. Typical clinical manifestations include involvement of the spinal cord, optic nerve and brainstem. Typically patients with the disease also present with neuropathic pain, painful tonic spasms and also other unusual manifestations in NMOSD. Especially in AQP4-IgG positive NMOSD patients, the coexistence with other autoimmune diseases is frequently observed. In most cases NMOSD follows a relapsing course with exacerbation-free periods sometimes lasting years and can be manifested first in advanced adulthood. A subset of AQP4-IgG negative NMOSD patients have been found to harbor autoantibodies targeting myelin oligodendrocyte glycoprotein (MOG), which is considered as a distinct disease entity: these MOG antibody-associated disorders (MOGAD) can present with clinical syndromes resembling both NMOSD and MS and are currently the subject of intensive research.
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Affiliation(s)
- Orhan Aktas
- Klinik für Neurologie, Universitätsklinikum Düsseldorf, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Tania Kümpfel
- Institut für klinische Neuroimmunologie, LMU Klinikum, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland.
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Patel C, Thomas G, Zomorodi N, Zagon IS, McLaughlin PJ. β-endorphin and opioid growth factor as biomarkers of physical ability in multiple sclerosis. Mult Scler Relat Disord 2021; 50:102868. [PMID: 33677409 DOI: 10.1016/j.msard.2021.102868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/26/2021] [Accepted: 02/22/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is an autoimmune-mediated degenerative disorder with increased peripheral inflammation disrupting the blood brain barrier. With increasing MS-related healthcare costs, the requirement to validate minimally invasive biomarkers has become imperative. METHODS Relapsing-remitting MS patients on disease modifying therapies were consented at the Penn State Health MS Clinic to provide blood samples for analyses of serum cytokines and endogenous opioid peptides, as well as to complete the MSQOL-54 survey. RESULTS Serum OGF levels in MS patients on glatiramer acetate (mean = 326 pg/ml), dimethyl fumarate (mean = 193.3 pg/ml) and natalizumab (mean = 393.4 pg/ml) were significantly elevated (p < 0.01) compared to healthy controls (mean = 98.46 pg/ml). Individuals with elevated OGF levels also had increased levels of TNFα (r = 0.78) and IL-17A (r = 0.81). Only patients treated with glatiramer acetate had significant (p < 0.01) elevations in serum β-endorphin levels. Analyses of MS-QoL 54 data showed no significant differences in physical or mental composite scores between treatment groups. However, serum levels of β-endorphin had a direct correlation with physical health composite score (r = 0.70) in all treatments. Serum vitamin D levels had an indirect relationship with 25-foot walk test times (r = 0.47). CONCLUSION Both regression and cohort data suggest that serum levels of OGF, β-endorphin, and vitamin D are potential biomarkers for physical disease status in MS.
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Affiliation(s)
- Chirag Patel
- Department of Neural and Behavioral Sciences, Hershey, PA 17033, USA
| | - Gary Thomas
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA
| | - Naseem Zomorodi
- Department of Neural and Behavioral Sciences, Hershey, PA 17033, USA
| | - Ian S Zagon
- Department of Neural and Behavioral Sciences, Hershey, PA 17033, USA
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Grgić S, Dominović-Kovačević A, Đajić V, Vukojević Z, Tadić D, Račić D, Vujković Z. Prognostic significance of intrathecal oligoclonal immunoglobulin G in multiple sclerosis. SCRIPTA MEDICA 2020. [DOI: 10.5937/scriptamed51-27558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction/Aim: Detection of intrathecal oligoclonal bands of immunoglobulin G (OB IgG), in addition to diagnostic, has a predictive significance in multiple sclerosis (MS). The aim of the study was to determine the prognostic significance of OB IgG and to correlate the presence of OB IgG with the progression of disability in MS patients. Methods: A retrospective-prospective cohort study included 177 MS patients examined at the Centre for MS, Clinic of Neurology, University Clinical Centre of the Republic of Srpska. In all patients, demographic data, clinical parameters, Expanded Disability Status Scale (EDSS) score, isoelectric focusing (IEF) of cerebrospinal fluid (CSF), cyto-biochemical analysis of CSF, evoked potentials (EP) and magnetic resonance (MR) of the head were analysed. MS patients were divided in two groups: with and without intrathecal synthesis of oligoclonal IgG. According to the EDSS determined in both groups, the relation between the degree of functional disability and the presence of OB in the CSF and also with characteristics of the cyto-biochemical profile were analysed. Methods of descriptive and analytical statistics, analysis of variance, chi-square test, Bonferroni's post hoc test, correlation and regression analysis were used in the analysis of the results. Results: In the examined cohort of MS patients, the sensitivity of IEF was 96.6 %. There was a statistically significant association between the detectability of intrathecally synthesised IgG and EDSS score (p = 0.004) so that individuals who do not have intrathecally synthesised IgG had lower EDSS scores. MS patients with a CSF protein concentration > 0.40 g/L were 2.45 times more likely to enter secondary progression and 2.51 times more likely to achieve EDSS 4.0. Conclusion: IEF is a very sensitive diagnostic and prognostic method for MS patients, which indicates a more benign course of MS in patients without oligoclonal bands in the CSF.
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Historical and Current Concepts Regarding Urodynamics in Multiple Sclerosis Patients. CURRENT BLADDER DYSFUNCTION REPORTS 2019. [DOI: 10.1007/s11884-019-00525-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Pape K, Zipp F. [Milestone or missed opportunity? : Commentary on the revision of the McDonald criteria 2017]. DER NERVENARZT 2019; 90:183-184. [PMID: 30729270 DOI: 10.1007/s00115-019-0682-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Katrin Pape
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Frauke Zipp
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
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Scheu S, Ali S, Mann-Nüttel R, Richter L, Arolt V, Dannlowski U, Kuhlmann T, Klotz L, Alferink J. Interferon β-Mediated Protective Functions of Microglia in Central Nervous System Autoimmunity. Int J Mol Sci 2019; 20:E190. [PMID: 30621022 PMCID: PMC6337097 DOI: 10.3390/ijms20010190] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/23/2018] [Accepted: 12/28/2018] [Indexed: 02/07/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) leading to demyelination and axonal damage. It often affects young adults and can lead to neurological disability. Interferon β (IFNβ) preparations represent widely used treatment regimens for patients with relapsing-remitting MS (RRMS) with therapeutic efficacy in reducing disease progression and frequency of acute exacerbations. In mice, IFNβ therapy has been shown to ameliorate experimental autoimmune encephalomyelitis (EAE), an animal model of MS while genetic deletion of IFNβ or its receptor augments clinical severity of disease. However, the complex mechanism of action of IFNβ in CNS autoimmunity has not been fully elucidated. Here, we review our current understanding of the origin, phenotype, and function of microglia and CNS immigrating macrophages in the pathogenesis of MS and EAE. In addition, we highlight the emerging roles of microglia as IFNβ-producing cells and vice versa the impact of IFNβ on microglia in CNS autoimmunity. We finally discuss recent progress in unraveling the underlying molecular mechanisms of IFNβ-mediated effects in EAE.
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Affiliation(s)
- Stefanie Scheu
- Institute of Medical Microbiology and Hospital Hygiene, University of Düsseldorf, 40225 Düsseldorf, Germany.
| | - Shafaqat Ali
- Institute of Medical Microbiology and Hospital Hygiene, University of Düsseldorf, 40225 Düsseldorf, Germany.
- Department of Psychiatry and Psychotherapy, University of Münster, 48149 Münster, Germany.
- Cells in Motion, Cluster of Excellence, University of Münster, 48149 Münster, Germany.
| | - Ritu Mann-Nüttel
- Institute of Medical Microbiology and Hospital Hygiene, University of Düsseldorf, 40225 Düsseldorf, Germany.
| | - Lisa Richter
- Institute of Medical Microbiology and Hospital Hygiene, University of Düsseldorf, 40225 Düsseldorf, Germany.
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University of Münster, 48149 Münster, Germany.
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, University of Münster, 48149 Münster, Germany.
| | - Tanja Kuhlmann
- Institute of Neuropathology, University Hospital Münster, 48149, Münster, Germany.
| | - Luisa Klotz
- Department of Neurology, University of Münster, 48149 Münster, Germany.
| | - Judith Alferink
- Department of Psychiatry and Psychotherapy, University of Münster, 48149 Münster, Germany.
- Cells in Motion, Cluster of Excellence, University of Münster, 48149 Münster, Germany.
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