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Zachariou V, Pappas C, Bauer CE, Shao X, Liu P, Lu H, Wang DJJ, Gold BT. Regional differences in the link between water exchange rate across the blood-brain barrier and cognitive performance in normal aging. GeroScience 2024; 46:265-282. [PMID: 37713089 PMCID: PMC10828276 DOI: 10.1007/s11357-023-00930-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/04/2023] [Indexed: 09/16/2023] Open
Abstract
The blood-brain barrier (BBB) undergoes functional changes with aging which may contribute to cognitive decline. A novel, diffusion prepared arterial spin labeling-based MRI technique can measure the rate of water exchange across the BBB (kw) and may thus be sensitive to age-related alterations in water exchange at the BBB. However, studies investigating relationships between kw and cognition have reported different directions of association. Here, we begin to investigate the direction of associations between kw and cognition in different brain regions, and their possible underpinnings, by evaluating links between kw, cognitive performance, and MRI markers of cerebrovascular dysfunction and/or damage. Forty-seven healthy older adults (age range 61-84) underwent neuroimaging to obtain whole-brain measures of kw, cerebrovascular reactivity (CVR), and white matter hyperintensity (WMH) volumes. Additionally, participants completed uniform data set (Version 3) neuropsychological tests of executive function (EF) and episodic memory (MEM). Voxel-wise linear regressions were conducted to test associations between kw and cognitive performance, CVR, and WMH volumes. We found that kw in the frontoparietal brain regions was positively associated with cognitive performance but not with CVR or WMH volumes. Conversely, kw in the basal ganglia was negatively associated with cognitive performance and CVR and positively associated with regional, periventricular WMH volume. These regionally dependent associations may relate to different physiological underpinnings in the relationships between kw and cognition in neocortical versus subcortical brain regions in older adults.
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Affiliation(s)
- Valentinos Zachariou
- Department of Neuroscience, College of Medicine, University of Kentucky, Lexington, KY, USA.
| | - Colleen Pappas
- Department of Neuroscience, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Christopher E Bauer
- Department of Neuroscience, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Xingfeng Shao
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Peiying Liu
- Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Danny J J Wang
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brian T Gold
- Department of Neuroscience, College of Medicine, University of Kentucky, Lexington, KY, USA
- Sanders-Brown Center On Aging, University of Kentucky, Lexington, KY, USA
- Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky, Lexington, KY, USA
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Lawless RD, McKnight CD, O’Grady KP, Combes AJE, Rogers BP. Detecting macromolecular differences of the CSF in low disability multiple sclerosis using quantitative MT MRI at 3T. Mult Scler J Exp Transl Clin 2023; 9:20552173231211396. [PMID: 38021451 PMCID: PMC10644741 DOI: 10.1177/20552173231211396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Background Imaging investigation of cerebrospinal fluid (CSF) in multiple sclerosis (MS) is understudied. Development of noninvasive methods to detect pathological CSF changes would have a profound effect on MS diagnosis and would offer insight into MS pathophysiology and mechanisms of neurological impairment. Objective We propose magnetization transfer (MT) MRI as a tool to detect macromolecular changes in spinal CSF. Methods MT and quantitative MT (qMT) data were acquired in the cervical region in 27 people with relapsing-remitting multiple sclerosis (pwRRMS) and 38 age and sex-matched healthy controls (HCs). MT ratio (MTR), the B1, B0, and R1 corrected qMT-derived pool size ratio (PSR) were quantified in the spinal cord and CSF of each group. Results Both CSF MTR and CSF qMT-derived PSR were significantly increased in pwRRMS compared to HC (p = 0.027 and p = 0.020, respectively). CSF PSR of pwRRMS was correlated to Expanded Disability Status Scale Scores (p = 0.045, R = 0.352). Conclusion Our findings demonstrate increased CSF macromolecular content in pwRRMS and link CSF macromolecular content with clinical impairment. This highlights the potential role of CSF in processing products of demyelination.
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Affiliation(s)
- Richard D Lawless
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Colin D McKnight
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kristin P O’Grady
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Anna JE Combes
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Baxter P Rogers
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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Sabe M, Sentissi O. Psychotic symptoms prior or concomitant to diagnosis of multiple sclerosis: a systematic review of case reports and case series. Int J Psychiatry Clin Pract 2022; 26:287-293. [PMID: 34487465 DOI: 10.1080/13651501.2021.1973506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We aimed to examine the clinical features of psychotic symptoms preceding or concomitant to multiple sclerosis (MS) diagnosis. METHOD From the 1st to 10th of January 2020 a systematic review was conducted through an electronic search of different databases. Results were limited to English, French, German, Italian and Spanish language articles. RESULTS We identified 599 titles, and included 32 cases from case-report and case series. One case report from our department was added. The mean age of first psychiatric symptoms was 25.8 ± 10.2 years, the mean age of MS diagnosis was 31.2 ± 10.7 years and the mean delay until MS diagnosis was 2.7 ± 3 years. Most reported symptoms were delusions (81%), auditory hallucinations (59%) and visual hallucinations (50%). Upon the MS diagnosis, immunosuppressive therapy was significantly more effective for psychotic symptoms than antipsychotics (OR = 9.0; 95%CI: 2.15-37; p = 0.002). Diffuse periventricular lesions were found in 95.6% of cases, with mostly temporal or frontal predominant lesions. In cases affected by predominant temporal lesions, 83% of cases presented visual hallucinations (p < 0.05). CONCLUSION Poor response or resistance to antipsychotics treatment should alert clinicians on the need to consider a differential diagnosis. Considering the impact of delay in MS diagnosis further research regarding this subject is warranted.KEY POINTSInsight into the occurrence of psychotic symptoms in multiple sclerosis (MS) is mainly limited to case reports and case series.Delay in MS management between initial psychotic symptoms and the MS diagnosis is 2.73 ± 3 years and 0.8 ± 1.2 years for patients presenting a first episode of psychosis.The resistance and poor response to antipsychotics found in most cases (75%) were associated with an excellent improvement (95%) of both psychiatric and neurologic symptoms with corticosteroids.Prospective studies are needed to investigate the spectrum of psychosis in MS.
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Affiliation(s)
- Michel Sabe
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, Thonex, Switzerland
| | - Othman Sentissi
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, Thonex, Switzerland
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Guerrero JM, Aguirre FS, Mota ML, Carrillo A. Advances for the Development of In Vitro Immunosensors for Multiple Sclerosis Diagnosis. BIOCHIP JOURNAL 2021. [DOI: 10.1007/s13206-021-00018-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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EkŞİ Z, ÇakiroĞlu M, Öz C, AralaŞmak A, Karadelİ HH, Özcan ME. Differentiation of relapsing-remitting and secondary progressive multiple sclerosis: a magnetic resonance spectroscopy study based on machine learning. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:789-796. [PMID: 33331515 DOI: 10.1590/0004-282x20200094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 06/04/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Magnetic resonance imaging (MRI) is the most important tool for diagnosis and follow-up in multiple sclerosis (MS). The discrimination of relapsing-remitting MS (RRMS) from secondary progressive MS (SPMS) is clinically difficult, and developing the proposal presented in this study would contribute to the process. OBJECTIVE This study aimed to ensure the automatic classification of healthy controls, RRMS, and SPMS by using MR spectroscopy and machine learning methods. METHODS MR spectroscopy (MRS) was performed on a total of 91 participants, distributed into healthy controls (n=30), RRMS (n=36), and SPMS (n=25). Firstly, MRS metabolites were identified using signal processing techniques. Secondly, feature extraction was performed based on MRS Spectra. N-acetylaspartate (NAA) was the most significant metabolite in differentiating MS types. Lastly, binary classifications (healthy controls-RRMS and RRMS-SPMS) were carried out according to features obtained by the Support Vector Machine algorithm. RESULTS RRMS cases were differentiated from healthy controls with 85% accuracy, 90.91% sensitivity, and 77.78% specificity. RRMS and SPMS were classified with 83.33% accuracy, 81.81% sensitivity, and 85.71% specificity. CONCLUSIONS A combined analysis of MRS and computer-aided diagnosis may be useful as a complementary imaging technique to determine MS types.
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Affiliation(s)
- Ziya EkŞİ
- Sakarya University, Department of Computer Engineering, Sakarya, Turkey
| | - Murat ÇakiroĞlu
- Sakarya University, Department of Mechatronic Engineering, Sakarya, Turkey
| | - Cemil Öz
- Sakarya University, Department of Computer Engineering, Sakarya, Turkey
| | - Ayse AralaŞmak
- Memorial Bahçelievler Hospital, Department of Radiology, Istanbul, Turkey
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Sharquie IK, Gawwam GA, Abdullah SF. Serum Glial Fibrillary Acidic Protein: A Surrogate Marker of the Activity of Multiple Sclerosis. Medeni Med J 2020; 35:212-218. [PMID: 33110673 PMCID: PMC7584269 DOI: 10.5222/mmj.2020.48265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 09/12/2020] [Indexed: 11/08/2022] Open
Abstract
Objective Multiple sclerosis (MS) is a neurodegenerative disorder with various clinical types. Glial fibrillary acidic protein (GFAP) is significantly elevated in the cerebrospinal fluid (CSF) of MS patients compared with that of healthy controls. The aim of this study is to evaluate serum levels of GFAP in relation to disease activity in relapsing-remitting MS patients and to compare them with those of healthy controls. Method This study involved 58 MS patients of relapsing-remitting MS (RRMS) type, 22 in an active stage of the disease and 36 in remission, and 50 healthy individuals as age- and sex-matched controls. Blood samples were taken from the patients at the MS Clinic of the Baghdad Teaching Hospital, and the serum levels of GFAP were determined using the enzyme-linked immunosorbent assay (ELISA) technique. Results Mean GFAP serum levels in 22 patients presenting in the active state of the disease (6.47±3.39 ng/ml) and 36 cases in remission were (5.33±2.82 ng/ml) (p=0.074) were determined as indicated. When RRMS patients (n=58) were compared with the healthy controls (n=50, 1.89±1.21), the difference in serum levels of GFAP was statistically significant (p<0.001). The area under the curve of the serum measures of GFAP obtained through the receiver operating characteristics was 0.903, which was also statistically significant (p<0.001). Conclusion GFAP biomarker is an indicator of disease activity in RRMS patients, and its serum level may correlate with the state of remission or exacerbation.
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Affiliation(s)
- Inas K Sharquie
- University of Baghdad, College of Medicine, Department of Microbiology & Immunology, Baghdad, Iraq
| | - Gheyath Al Gawwam
- University of Baghdad, College of Medicine, Baghdad Teaching Hospital, Department of Neurology, Baghdad, Iraq
| | - Shatha F Abdullah
- University of Baghdad, College of Medicine, Department of Microbiology & Immunology, Baghdad, Iraq
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A Multiple N-Glucosylated Peptide Epitope Efficiently Detecting Antibodies in Multiple Sclerosis. Brain Sci 2020; 10:brainsci10070453. [PMID: 32679694 PMCID: PMC7408607 DOI: 10.3390/brainsci10070453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/07/2020] [Accepted: 07/10/2020] [Indexed: 11/21/2022] Open
Abstract
Diagnostics of Multiple Sclerosis (MS) are essentially based on the gold standard magnetic resonance imaging. Few alternative simple assays are available to follow up disease activity. Considering that the disease can remain elusive for years, identification of antibodies fluctuating in biological fluids as relevant biomarkers of immune response is a challenge. In previous studies, we reported that anti-N-glucosylated (N-Glc) peptide antibodies that can be easily detected in Solid-Phase Enzyme-Linked ImmunoSorbent Assays (SP-ELISA) on MS patients’ sera preferentially recognize hyperglucosylated adhesin of non-typeable Haemophilus Influenzae. Since multivalency can be useful for diagnostic purposes to allow an efficient coating in ELISA, we report herein the development of a collection of Multiple N-glucosylated Peptide Epitopes (N-Glc MEPs) to detect anti-N-Glc antibodies in MS. To this aim, a series of N-Glc peptide antigens to be represented in the N-GlcMEPs were tested in competitive ELISA. We confirmed that the epitope recognized by antibodies shall contain at least 5-mer sequences including the fundamental N-Glc moiety. Using a 4-branched dendrimeric lysine scaffold, we selected the N-Glc MEP 24, carrying the minimal epitope Asn(Glc) anchored to a polyethylene glycol-based spacer (PEG) containing a 19-atoms chain, as an efficient multivalent probe to reveal specific and high affinity anti-N-Glc antibodies in MS.
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Simonsen CS, Flemmen HØ, Lauritzen T, Berg-Hansen P, Moen SM, Celius EG. The diagnostic value of IgG index versus oligoclonal bands in cerebrospinal fluid of patients with multiple sclerosis. Mult Scler J Exp Transl Clin 2020; 6:2055217319901291. [PMID: 32030196 PMCID: PMC6977237 DOI: 10.1177/2055217319901291] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/26/2019] [Accepted: 12/23/2019] [Indexed: 12/22/2022] Open
Abstract
Background Diagnostic criteria for multiple sclerosis have been developed to guide the diagnostic process. In the latest revision of the McDonald criteria, the presence of oligoclonal bands may replace the need for dissemination in time. The aim of this study is to investigate if the less time-consuming analysis of immunoglobulin G index in cerebrospinal fluid can safely predict the findings of oligoclonal bands. Methods This is a retrospective study of patients with multiple sclerosis at three hospitals in South-East Norway where lumbar puncture is performed routinely. We included patients diagnosed with multiple sclerosis after 2005 with known oligoclonal band status and an immunoglobulin G index score. Results Of 1295 patients diagnosed during or after 2005, 93.8% were oligoclonal band positive at diagnosis. Of 842 multiple sclerosis patients with known immunoglobulin G index and oligoclonal band status, 93.3% were oligoclonal band positive and 76.7% had an elevated immunoglobulin G index. The positive predictive value of a high immunoglobulin G index when oligoclonal bands are positive was 99.4% (95% confidence interval 98.4–99.8%). The negative predictive value of a normal immunoglobulin G index when oligoclonal bands are negative was 26.5% (95% confidence interval 23.5–29.9%). Conclusion An immunoglobulin G index >0.7 has a positive predictive value >99% for oligoclonal bands. An elevated immunoglobulin G index adds diagnostic value versus oligoclonal bands and saves time in the diagnostic process.
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Affiliation(s)
| | | | | | | | | | - Elisabeth Gulowsen Celius
- Department of Neurology, Oslo University Hospital, Norway.,Institute of Clinical Medicine, University of Oslo, Norway
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Abstract
OBJECTIVES To assess the etiology of cerebrospinal fluid (CSF) pleocytosis in critical care patients with seizure(s) or status epilepticus (SE). Many previous studies, some performed decades ago, concluded that CSF pleocytosis may be entirely attributable to seizure activity. METHODS We undertook a retrospective chart review of adult patients with an admitting or acquired diagnosis of seizure(s) or SE in critical care units at the Winnipeg Health Sciences Centre between 2009 and 2012. Patients were identified through a critical care information database at a tertiary care center. We limited our study to patients who had lumbar punctures at our center within 5 days of seizure(s) or SE. RESULTS Of 426 patients with seizures in critical care units, 51 met the inclusion criteria. Seizure subtypes included focal seizures (5 or 10%), generalized seizures (14 or 27%), and SE (32 or 63%). Twelve (seven with SE) of the 51 (24%) were found to have CSF pleocytosis. A probable etiological cause for the CSF pleocytosis was identified in all 12 cases. CONCLUSIONS We conclude that seizures do not directly induce a CSF pleocytosis. Instead, the CSF pleocytosis more likely reflects the underlying acute or chronic brain process responsible for the seizure(s). This was not readily apparent in early studies without magnetic resonance imaging (MRI) of the brain and currently available laboratory investigations. An etiological cause of CSF pleocytosis must always be sought when patients present with seizures and it should never be assumed that seizures are the cause.
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Llorens F, Schmitz M, Gloeckner SF, Kaerst L, Hermann P, Schmidt C, Varges D, Zerr I. Increased albumin CSF/serum ratio in dementia with Lewy bodies. J Neurol Sci 2015; 358:398-403. [PMID: 26476775 DOI: 10.1016/j.jns.2015.10.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 10/02/2015] [Accepted: 10/06/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alterations in the CSF/serum albumin ratio (Qalb) is currently recognized as one of the most reliable markers of blood-brain barrier impairment and blood-CSF barrier permeability, but its potential role as a biomarker in the differential diagnosis of neurological diseases has been poorly analysed. METHODS We evaluated Qalb and core CSF biomarkers (Tau, p-Tau and Aβ42) in a large patient population of neurological and neurodegenerative cases. Diagnostic test evaluation was assessed by ROC-AUC analysis. RESULTS In the differential diagnostic analysis, increased Qalb was found in dementia with Lewy bodies (DLB) patients compared to other diseases, either individually or stratified in non-dementia and dementia groups. When clinical groups were analysed individually and compared to controls, Qalb was also increased in stroke and Parkinson's disease dementia (PDD) cases, but not in Parkinson's disease (PD). Qalb in DLB cases correlate with CSF Aβ42 levels but not with Tau and p-Tau levels. Due to the lower CSF Aβ42 levels in DLB compared to PD and PDD, the potential clinical applicability of Qalb with respect to the DLB diagnosis is increased in combination with CSF Aβ42 analysis. CONCLUSIONS The present study demonstrates increased Qalb in synucleinopathies associated with dementia revealing a potential new clinical approach for the differential diagnosis of DLB.
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Affiliation(s)
- Franc Llorens
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.
| | - Matthias Schmitz
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | | | - Lisa Kaerst
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany
| | - Peter Hermann
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany
| | - Christian Schmidt
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany
| | - Daniela Varges
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany
| | - Inga Zerr
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
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Iannitti T, Kerr BJ, Taylor BK. Mechanisms and pharmacology of neuropathic pain in multiple sclerosis. Curr Top Behav Neurosci 2014; 20:75-97. [PMID: 24590824 PMCID: PMC4464806 DOI: 10.1007/7854_2014_288] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The neuropathic pain of multiple sclerosis is quite prevalent and severely impacts quality of life. A few randomized, placebo-controlled, blinded clinical trials suggest that cannabis- and anticonvulsant-based treatments provide partial pain relief, but at the expense of adverse events. An even smaller, but emerging, number of translational studies are using rodent models of experimental autoimmune encephalomyelitis (EAE), which exhibit pain-like behaviors resembling those of Multiple sclerosis (MS) patients. These studies not only support the possible effectiveness of anticonvulsants, but also compel further clinical trials with serotonin-norepinephrine reuptake inhibitors, the immunosuppressant drug rapamycin, or drugs which interfere with glutamatergic neurotransmission. Future behavioral studies in EAE models are essential toward a new pharmacotherapy of multiple sclerosis pain.
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Affiliation(s)
- T Iannitti
- Department of Physiology, School of Medicine, University of Kentucky Medical Center, Lexington, KY, 40536-0298, USA
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12
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Holewinski RJ, Jin Z, Powell MJ, Maust MD, Van Eyk JE. A fast and reproducible method for albumin isolation and depletion from serum and cerebrospinal fluid. Proteomics 2013; 13:743-50. [PMID: 23300121 DOI: 10.1002/pmic.201200192] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 12/10/2012] [Accepted: 12/11/2012] [Indexed: 12/21/2022]
Abstract
Analysis of serum and plasma proteomes is a common approach for biomarker discovery, and the removal of high-abundant proteins, such as albumin and immunoglobins, is usually the first step in the analysis. However, albumin binds peptides and proteins, which raises concerns as to how the removal of albumin could impact the outcome of the biomarker study while ignoring the possibility that this could be a biomarker subproteome itself. The first goal of this study was to test a new commercially available affinity capture reagent from Protea Biosciences and to compare the efficiency and reproducibility to four other commercially available albumin depletion methods. The second goal of this study was to determine if there is a highly efficient albumin depletion/isolation system that minimizes sample handling and would be suitable for large numbers of samples. Two of the methods tested (Sigma and ProteaPrep) showed an albumin depletion efficiency of 97% or greater for both serum and cerebrospinal fluid (CSF). Isolated serum and CSF albuminomes from ProteaPrep spin columns were analyzed directly by LC-MS/MS, identifying 128 serum (45 not previously reported) and 94 CSF albuminome proteins (17 unique to the CSF albuminome). Serum albuminome was also isolated using Vivapure anti-HSA columns for comparison, identifying 105 proteins, 81 of which overlapped with the ProteaPrep method.
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Affiliation(s)
- Ronald J Holewinski
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21224, USA
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13
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Immunoglobulin-Mediated Neuro-Cognitive Impairment: New Data and a Comprehensive Review. Clin Rev Allergy Immunol 2013; 45:248-55. [DOI: 10.1007/s12016-013-8357-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Real-Fernández F, Passalacqua I, Peroni E, Chelli M, Lolli F, Papini AM, Rovero P. Glycopeptide-based antibody detection in multiple sclerosis by surface plasmon resonance. SENSORS 2012; 12:5596-607. [PMID: 22778603 PMCID: PMC3386702 DOI: 10.3390/s120505596] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 04/13/2012] [Accepted: 04/27/2012] [Indexed: 11/16/2022]
Abstract
In multiple sclerosis (MS) the gold standard for the diagnosis and prognosis is, up to now, the use of magnetic resonance imaging markers. No alternative simpler assays proven of use, except for cerebrospinal fluid analysis, have been provided in MS diagnosis. Therefore, there is a need to develop non-invasive, sensitive, simple new techniques for the clinical routine. Herein we present the evaluation of the feasibility of a glycopeptide-based biosensor to detect MS specific antibodies in sera using the surface plasmon resonance technology. The previously described glycopeptide antigen CSF114(Glc) has been immobilized on a gold sensor chip and the method has been optimized for real-time specific autoantibody detection directly in sera. A population of 60 healthy blood donors and 61 multiple sclerosis patients has been screened. The receiver operating characteristic (ROC)-based analysis has established the optimal diagnostic cut-off value for the method obtaining a sensitivity of 36% and a specificity of 95%. Sample sera have been also screened with a previously validated ELISA.
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Affiliation(s)
- Feliciana Real-Fernández
- Laboratory of Peptide & Protein Chemistry & Biology, Polo Scientifico e Tecnologico, University of Florence; I-50019 Sesto Fiorentino (FI), Italy.
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Vrethem M, Kvarnström M, Stenstam J, Cassel P, Gustafsson M, Landtblom AM, Ernerudh J. Cytokine mapping in cerebrospinal fluid and blood in multiple sclerosis patients without oligoclonal bands. Mult Scler 2011; 18:669-73. [DOI: 10.1177/1352458511424903] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Objective: Since there are clinical and genetic differences between MS patients with intrathecal oligoclonal bands (OCB+) in the cerebrospinal fluid (CSF) compared with those without (OCB−), the aim was to find out if OCB− patients showed a different pattern of cytokine immune activation compared with OCB+ patients. Methods: The study included 25 MS patients (10 OCB− and 15 OCB+) and 13 controls. A panel of cytokines was measured; IL-1β, IL-6, IL-8/CXCL8, IL-10, TNF and GM-CSF in serum, CSF and in supernatants from polyclonally stimulated blood mononuclear cells, where also levels of IL-12p40, IL-13, IL-15, IL-17 and IFN-γ were measured. The concentrations of soluble (s) VCAM-1 and sCD14 were measured in serum and CSF. Results: In general, there were no extensive differences in cytokine concentrations between the OCB− and OCB+ groups. Conclusion: OCB− MS patients do not seem to constitute a separate entity concerning inflammatory parameters measured as cytokine concentrations in CSF and blood.
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Affiliation(s)
- M Vrethem
- Department of Neurology, Division of Neuroscience, Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden
- Clinical Neurophysiology, Division of Neuroscience, Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden
| | - M Kvarnström
- Division of Inflammatory Medicine, Unit of Autoimmunity and Immune Regulation, Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden
| | - J Stenstam
- Division of Inflammatory Medicine, Unit of Autoimmunity and Immune Regulation, Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden
| | - P Cassel
- Division of Inflammatory Medicine, Unit of Autoimmunity and Immune Regulation, Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden
| | - M Gustafsson
- Department of Neurology, Division of Neuroscience, Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden
| | - AM Landtblom
- Department of Neurology, Division of Neuroscience, Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden
- Neurology Unit, Motala General Hospital, Sweden
| | - J Ernerudh
- Department of Neurology, Division of Neuroscience, Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden
- Division of Inflammatory Medicine, Unit of Autoimmunity and Immune Regulation, Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden
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Sato F, Tanaka H, Hasanovic F, Tsunoda I. Theiler's virus infection: Pathophysiology of demyelination and neurodegeneration. ACTA ACUST UNITED AC 2011; 18:31-41. [PMID: 20537875 DOI: 10.1016/j.pathophys.2010.04.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Revised: 02/28/2010] [Accepted: 04/08/2010] [Indexed: 02/08/2023]
Abstract
Multiple sclerosis (MS) has been suggested to be an autoimmune demyelinating disease of the central nervous system (CNS), whose primary target is either myelin itself, or myelin-forming cells, the oligodendrocytes. Although axonal damage occurs in MS, it is regarded as a secondary event to the myelin damage. Here, the lesion develops from the myelin (outside) to the axons (inside) "Outside-In model". The Outside-In model has been supported by an autoimmune model for MS, experimental autoimmune (allergic) encephalomyelitis (EAE). However, recently, (1) EAE-like disease has also been shown to be induced by immune responses against axons, and (2) immune responses against axons and neurons as well as neurodegeneration independent of inflammatory demyelination have been reported in MS, which can not be explained by the Outside-In model. Theiler's murine encephalomyelitis virus (TMEV)-induced demyelinating disease (TMEV-IDD) is a viral model for MS. In TMEV infection, axonal injury precedes demyelination, where the lesion develops from the axons (inside) to the myelin (outside) "Inside-Out model". The initial axonal damage could result in the release of neuroantigens, inducing autoimmune responses against myelin antigens, which potentially attack the myelin from outside the nerve fiber. Thus, the Inside-Out and Outside-In models can make a "vicious" immunological cycle or initiate an immune cascade.
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Affiliation(s)
- Fumitaka Sato
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center, School of Medicine in Shreveport, Shreveport, LA 71130, USA
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Pawate S, Sriram S. The role of infections in the pathogenesis and course of multiple sclerosis. Ann Indian Acad Neurol 2010; 13:80-6. [PMID: 20814489 PMCID: PMC2924524 DOI: 10.4103/0972-2327.64622] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 04/13/2010] [Accepted: 04/14/2010] [Indexed: 11/04/2022] Open
Abstract
Interplay between susceptibility genes and environmental factors is considered important player in the genesis of multiple sclerosis (MS). Among environmental factors, a role for an infectious pathogen has long been considered central to the disease process. This opinion has support both from epidemiological data and the findings of immunological abnormalities in spinal fluid that reflect an immune response to an as yet undetermined antigen, possibly a pathogen, in the cerebrospinal fluid. Our review will outline the current understanding of the role of infection in the causation and progression of MS. We will review the data that point to an infectious cause of MS and consider the specific agents Chlamydophila (Chlamydia) pneumoniae, Human Herpes Virus 6, and Epstein-Barr Virus, that are implicated in either the development or progression of MS.
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Affiliation(s)
- Siddharama Pawate
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
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González-Andrade F, Alcaraz-Alvarez JL. Disease-modifying therapies in relapsing-remitting multiple sclerosis. Neuropsychiatr Dis Treat 2010; 6:365-73. [PMID: 20856600 PMCID: PMC2938285 DOI: 10.2147/ndt.s11079] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
CLINICAL QUESTION What is the best current disease-modifying therapy for relapsing-remitting multiple sclerosis? RESULTS The evidence shows that the most effective disease-modifying therapy for delaying short- to medium-term disability progression, prevention of relapses, reducing the area and activity of lesions on magnetic resonance imaging, with the least side effects, is high-dose, high-frequency subcutaneous interferon-β1a 44 μg three times per week. IMPLEMENTATION The pitfalls in treatment of MS can be avoided by remembering the following points: The most effective therapy to prevent or delay the appearance of permanent neurological disability with the fewest side effects should be chosen, and treatment should not be delayed.Adherence to treatment should be monitored closely, and needs comprehensive patient information and education to establish long-term adherence, which is a critical determinant of long-term outcome.The correct approach to the disease includes disease management, symptom management, and patient management. A combination of tools is necessary to ease the various symptoms, which fall into three broad categories, i.e. rehabilitation, pharmacological, and procedural.It is important to understand that no treatment modality should be used alone, unless it is in itself sufficient to remedy the particular symptom/problem.
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Affiliation(s)
- Fabricio González-Andrade
- Department of Medicine, Metropolitan Hospital, Av. Mariana de Jesús Oe8 y Occidental, 170125, Quito, Ecuador.
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Urso E, Le Pera M, Bossio S, Sprovieri T, Qualtieri A. Quantification of thymosin β4 in human cerebrospinal fluid using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Anal Biochem 2010; 402:13-9. [DOI: 10.1016/j.ab.2010.03.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 01/27/2010] [Accepted: 03/22/2010] [Indexed: 10/19/2022]
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