Plasma lipoproteins, apolipoproteins, and proteins concerned with lipid metabolism

Favorable Effects of Tacrolimus Monotherapy on Myasthenia Gravis Patients

Background and Purpose: Tacrolimus (TAC) has been proven to be a rapid-acting, steroid-sparing agent for myasthenia gravis (MG) therapy. However, evidence related to the effectiveness of TAC alone is rare. Therefore, this study was performed to investigate the effect of TAC monotherapy in MG patients.

Methods: Forty-four MG patients who received TAC monotherapy were retrospectively analyzed. A mixed effect model was used to analyze improvements in MG-specific activities of daily living scale (MG-ADL), quantitative MG score (QMG) and MG-ADL subscores. Kaplan-Meier analysis was used to estimate the cumulative probability of minimal manifestations (MM) or better. Adverse events (AEs) were recorded for safety analyses.

Results: Of the patients receiving TAC monotherapy, MG-ADL scores were remarkably improved at 3, 6 and 12 months compared with scores at baseline (mean difference and 95% CIs: −3.29 [−4.94, −1.64], −3.97 [−5.67, −2.27], and −4.67 [−6.48, −2.85], respectively). QMG scores significantly decreased at 6 and 12 months, with mean differences and 95% CIs of −4.67(−6.88, −2.45) and −5.77 (−7.55, −4.00), respectively. Estimated median period to achieve “MM or better” was 5.0 (95% CIs, 2.8, 7.2) months. Ocular MG (OMG) and generalized MG (GMG) showed similar therapeutic effects in cumulative probabilities of “MM or better” (P-value = 0.764). A better response was observed in MG-ADL subscores for ptosis and bulbar symptoms. AEs occurred in 37.5% of patients and were generally mild and reversible.

Conclusions: TAC monotherapy is a promising option to rapidly alleviate all symptoms of MG, especially for ptosis and bulbar symptoms.

Total glycosaminoglycans in the plasma of adults: effects of age and gender, and relationship to plasma lipids: a preliminary study

Plasma glycosaminoglycans and lipids have been measured in the plasma of 92 fasted males and females. In the males, glycosaminoglycans correlated significantly with age (r = 0.39), triglycerides (r = 0.44), and cholesterol (r = 0.30). When the effect of age was allowed for, the significance of the correlation between glycosaminoglycans and triglycerides was maintained (r = 0.36). Glycosaminoglycan levels are higher in females than in males. The correlation of glycosaminoglycans with age in women was only marginally significant. In both men and women the effect of age is attributable principally to an increase in glycosaminoglycan concentration in those over 54 years. The only lipid fraction correlating with glycosaminoglycans in females was VLDL cholesterol (r = 0.34) and by stepwise linear regression allowing for the effect of age, this significance was retained (beta = 0.34).

Plasma lipoprotein changes in humans induced by beta-interferon

Two groups of patients were administered either 4.5 X 10(6) U or 90 X 10(6) U each of recombinant DNA-derived interferon-beta serine (IFN-beta ser) i.v. daily for 10 days. IFN-beta ser affected lipoprotein lipids of patients in a dose dependent fashion. A decrease in plasma total cholesterol concentration occurred 24 h after therapy was initiated, regardless of dose. A dose-related decrease in plasma cholesterol concentration of 9% and 23% for patients on the low dose and high dose respectively occurred after 9 days of therapy. The plasma total cholesterol concentration decrease resulted primarily from a decrease in LDL cholesterol of 28% and 50% for patients on low and high doses respectively of IFN-beta ser. HDL-cholesterol was not significantly affected by IFN-beta ser administration. A dose-related increase in plasma triglyceride concentration occurred during IFN-beta ser, increasing 74% for patients on low dose and 136% for patients on high doses. This increase was only observed after 9 days on IFN-beta ser. Cholesterol reduction and triglyceride increases followed different time courses indicating different mechanisms may be involved.