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Bäckström F, Ahl M, Wickham J, Ekdahl CT. Reduced epilepsy development in synapsin 2 knockout mice with autistic behavior following early systemic treatment with interleukin-6 receptor antibody. Epilepsy Res 2023; 191:107114. [PMID: 36870094 DOI: 10.1016/j.eplepsyres.2023.107114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/09/2023] [Accepted: 02/23/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Individuals with autism spectrum disorder (ASD) have an increased risk of developing epilepsy. Both ASD and epilepsy have been associated with increased levels of immune factors in the blood, including the proinflammatory cytokine interleukin 6 (IL-6). Mice lacking the synapsin 2 gene (Syn2 KO) exhibit ASD-like behavior and develop epileptic seizures. Their brains display neuroinflammatory changes including elevated IL-6 levels. We aimed to investigate the effect of systemic IL-6 receptor antibody (IL-6R ab) treatment on seizure development and frequency in Syn2 KO mice. MATERIAL AND METHODS Weekly systemic (i.p.) injections of IL-6R ab or saline were given to Syn2 KO mice starting either early in life at 1 month of age, before seizure debut or at 3 months of age, directly after seizure debut and continued for 4 or 2 months, respectively. Seizures were provoked by handling the mice three times per week. The neuroinflammatory response and synaptic protein levels in the brain were determined by ELISA, immunohistochemistry and western blots. In an additional group of Syn2 KO mice, with IL-6R ab treatment early in life, ASD-related behavioral tests including social interaction and repetitive self-grooming, as well as cognitive memory and depressive-/anxiety-like tests, and actigraphy measurements of circadian sleep-awake rhythm were analyzed. RESULTS The IL-6R ab treatment reduced seizure development and frequency in Syn2 KO mice when initiated before, but not after, seizure debut. However, early treatment did not reverse the neuroinflammatory response or the imbalance in synaptic protein levels in the brain previously reported in Syn2 KO mice. The treatment did not affect social interaction, performance in memory, depressive-/anxiety-like tests or the sleep-awake rhythm of Syn2 KO mice. CONCLUSION These findings suggest the involvement of IL-6 receptor signaling during epilepsy development in Syn2 KO mice, without significant alterations of the immune reaction in the brain, and independently of cognitive performance, mood and circadian sleep-awake rhythm.
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Affiliation(s)
- Filip Bäckström
- Inflammation and Stem Cell Therapy Group, Division of Clinical Neurophysiology, Department of Clinical Sciences, Lund University, Lund, Sweden; Lund Epilepsy Center, Department of Clinical Sciences, Lund University, Lund, Sweden; Translational Neurogenetics Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Matilda Ahl
- Inflammation and Stem Cell Therapy Group, Division of Clinical Neurophysiology, Department of Clinical Sciences, Lund University, Lund, Sweden; Lund Epilepsy Center, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Jenny Wickham
- Inflammation and Stem Cell Therapy Group, Division of Clinical Neurophysiology, Department of Clinical Sciences, Lund University, Lund, Sweden; Lund Epilepsy Center, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Christine T Ekdahl
- Inflammation and Stem Cell Therapy Group, Division of Clinical Neurophysiology, Department of Clinical Sciences, Lund University, Lund, Sweden; Lund Epilepsy Center, Department of Clinical Sciences, Lund University, Lund, Sweden.
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Ahmad Fauzi A, Patrick Engkasan J. What are the effects of intravenous immunoglobulins on seizures and quality of life of people with epilepsy? A Cochrane Review summary with commentary. Dev Med Child Neurol 2021; 63:501-502. [PMID: 33559130 DOI: 10.1111/dmcn.14835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Aishah Ahmad Fauzi
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Julia Patrick Engkasan
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Abstract
BACKGROUND Epilepsy is a common neurological condition, with an estimated incidence of 50 per 100,000 persons. People with epilepsy may present with various types of immunological abnormalities, such as low serum immunoglobulin A (IgA) levels, lack of the immunoglobulin G (IgG) subclass and identification of certain types of antibodies. Intravenous immunoglobulin (IVIg) treatment may represent a valuable approach and its efficacy has important implications for epilepsy management. This is an update of a Cochrane review first published in 2011 and last updated in 2017. OBJECTIVES To examine the effects of IVIg on the frequency and duration of seizures, quality of life and adverse effects when used as monotherapy or as add-on treatment for people with epilepsy. SEARCH METHODS For the latest update, we searched the Cochrane Register of Studies (CRS Web) (20 December 2018), MEDLINE (Ovid, 1946 to 20 December 2018), Web of Science (1898 to 20 December 2018), ISRCTN registry (20 December 2018), WHO International Clinical Trials Registry Platform (ICTRP, 20 December 2018), the US National Institutes of Health ClinicalTrials.gov (20 December 2018), and reference lists of articles. SELECTION CRITERIA Randomised or quasi-randomised controlled trials of IVIg as monotherapy or add-on treatment in people with epilepsy. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the trials for inclusion and extracted data. We contacted study authors for additional information. Outcomes included percentage of people rendered seizure-free, 50% or greater reduction in seizure frequency, adverse effects, treatment withdrawal and quality of life. MAIN RESULTS We included one study (61 participants). The included study was a randomised, double-blind, placebo-controlled, multicentre trial which compared the treatment efficacy of IVIg as an add-on with a placebo add-on in patients with drug-resistant epilepsy. Seizure freedom was not reported in the study. There was no significant difference between IVIg and placebo in 50% or greater reduction in seizure frequency (RR 1.89, 95% CI 0.85 to 4.21; one study, 58 participants; low-certainty evidence). The study reported a statistically significant effect for global assessment in favour of IVIg (RR 3.29, 95% CI 1.13 to 9.57; one study, 60 participants; low-certainty evidence). No adverse effects were demonstrated. We found no randomised controlled trials that investigated the effects of IVIg monotherapy for epilepsy. Overall, the included study was rated at low to unclear risk of bias. Using GRADE methodology, the certainty of the evidence was rated as low. AUTHORS' CONCLUSIONS We cannot draw any reliable conclusions regarding the efficacy of IVIg as a treatment for epilepsy. Further randomised controlled trials are needed.
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Affiliation(s)
- JinSong Geng
- Medical School of Nantong UniversityEvidence‐based Medicine Center19 Qixiu Road, Medical School of NantongNantongJiangsuChina226001
| | - JianCheng Dong
- Medical School of Nantong UniversityEvidence‐based Medicine Center19 Qixiu Road, Medical School of NantongNantongJiangsuChina226001
| | - Youping Li
- West China Hospital, Sichuan UniversityChinese Cochrane Centre, Chinese Evidence‐Based Medicine CentreNo. 37, Guo Xue XiangChengduSichuanChina610041
| | - HengJian Ni
- Medical School of Nantong UniversityEvidence‐based Medicine Center19 Qixiu Road, Medical School of NantongNantongJiangsuChina226001
| | - Kui Jiang
- Medical School of Nantong UniversityEvidence‐based Medicine Center19 Qixiu Road, Medical School of NantongNantongJiangsuChina226001
| | - Li Li Shi
- Evidence‐based Medicine Center, Medical School of Nantong UniversityNantongChina
| | - GuoHua Wang
- Nantong UniversityInstitute of Nautical Medicine19 Qixiu RoadNantongJiangsuChina226001
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Abstract
BACKGROUND Epilepsy is a common neurological condition, with an estimated incidence of 50 per 100,000 persons. People with epilepsy may present with various types of immunological abnormalities, such as low serum immunoglobulin A (IgA) levels, lack of the immunoglobulin G (IgG) subclass and identification of certain types of antibodies. Intravenous immunoglobulin (IVIg) treatment may represent a valuable approach and its efficacy has important implications for epilepsy management. This is an updated version of the original Cochrane review published in Issue 1, 2011. OBJECTIVES To examine the effects of IVIg on the frequency and duration of seizures, quality of life and adverse effects when used as monotherapy or as add-on treatment for people with epilepsy. SEARCH METHODS For the latest update, we searched the Cochrane Epilepsy Group Specialized Register (2 February 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies Online (2 February 2017), MEDLINE (Ovid, 1946 to 2 February 2017), Web of Science (1898 to 2 February 2017), ISRCTN registry (2 February 2017), WHO International Clinical Trials Registry Platform (ICTRP, 2 February 2017), the US National Institutes of Health ClinicalTrials.gov (2 February 2017), and reference lists of articles. SELECTION CRITERIA Randomized or quasi-randomized controlled trials of IVIg as monotherapy or add-on treatment in people with epilepsy. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the trials for inclusion and extracted data. We contacted study authors for additional information. Outcomes included percentage of people rendered seizure-free, 50% or greater reduction in seizure frequency, adverse effects, treatment withdrawal and quality of life. MAIN RESULTS We included one study (61 participants). The included study was a randomized, double-blind, placebo-controlled, multi-centre trial which compared the treatment efficacy of IVIg as an add-on with a placebo add-on in patients with refractory epilepsy. There was no significant difference between IVIg and placebo in 50% or greater reduction in seizure frequency. The study reported a statistically significant effect for global assessment in favour of IVIg. No adverse effects were demonstrated. We found no randomized controlled trials that investigated the effects of IVIg monotherapy for epilepsy. Overall, the included study was rated as low/unclear risk of bias. Using GRADE methodology, the quality of the evidence was rated as low. AUTHORS' CONCLUSIONS We cannot draw any reliable conclusions regarding the efficacy of IVIg as a treatment for epilepsy. Further randomized controlled trials are needed.
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Affiliation(s)
- JinSong Geng
- Medical School of Nantong UniversityEvidence‐based Medicine Center19 Qixiu Road, Medical School of NantongNantongChina226001
| | - JianCheng Dong
- Medical School of Nantong UniversityEvidence‐based Medicine Center19 Qixiu Road, Medical School of NantongNantongChina226001
| | - Youping Li
- West China Hospital, Sichuan UniversityChinese Cochrane Centre, Chinese Evidence‐Based Medicine CentreNo. 37, Guo Xue XiangChengduChina610041
| | - Hengjian Ni
- Medical School of Nantong UniversityEvidence‐based Medicine Center19 Qixiu Road, Medical School of NantongNantongChina226001
| | - Kui Jiang
- Medical School of Nantong UniversityEvidence‐based Medicine Center19 Qixiu Road, Medical School of NantongNantongChina226001
| | - Li Li Shi
- Evidence‐based Medicine Center, Medical School of Nantong UniversityNantongChina
| | - GuoHua Wang
- Nantong UniversityInstitute of Nautical Medicine19 Qixiu RoadNantongChina226001
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Abstract
Much of the research for intravenous immunoglobulins (IVIG) use in epilepsy has focused on childhood epilepsies and the results have been inconclusive. As evidence for inflammation in epilepsy and epileptogenesis is accumulating, IVIG might have a role to play in adult epilepsy. Our literature review focuses on the purported mechanisms of IVIG, the link between inflammation and the various causes of adult epilepsy and the different steps of epileptogenesis at which inflammation might play a role. We also review the current clinical evidence supporting IVIG as a treatment for epilepsy in the adult population. Though there is interesting theoretical potential for treatment of refractory epilepsy in adults with IVIG, insufficient evidence exists to support its standard use. The question remains if IVIG should still be considered as an end-of-the-line option for patients with epilepsy poorly responsive to all other treatments.
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Frye RE, Rossignol D, Casanova MF, Brown GL, Martin V, Edelson S, Coben R, Lewine J, Slattery JC, Lau C, Hardy P, Fatemi SH, Folsom TD, MacFabe D, Adams JB. A review of traditional and novel treatments for seizures in autism spectrum disorder: findings from a systematic review and expert panel. Front Public Health 2013; 1:31. [PMID: 24350200 PMCID: PMC3859980 DOI: 10.3389/fpubh.2013.00031] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 08/20/2013] [Indexed: 01/20/2023] Open
Abstract
Despite the fact that seizures are commonly associated with autism spectrum disorder (ASD), the effectiveness of treatments for seizures has not been well studied in individuals with ASD. This manuscript reviews both traditional and novel treatments for seizures associated with ASD. Studies were selected by systematically searching major electronic databases and by a panel of experts that treat ASD individuals. Only a few anti-epileptic drugs (AEDs) have undergone carefully controlled trials in ASD, but these trials examined outcomes other than seizures. Several lines of evidence point to valproate, lamotrigine, and levetiracetam as the most effective and tolerable AEDs for individuals with ASD. Limited evidence supports the use of traditional non-AED treatments, such as the ketogenic and modified Atkins diet, multiple subpial transections, immunomodulation, and neurofeedback treatments. Although specific treatments may be more appropriate for specific genetic and metabolic syndromes associated with ASD and seizures, there are few studies which have documented the effectiveness of treatments for seizures for specific syndromes. Limited evidence supports l-carnitine, multivitamins, and N-acetyl-l-cysteine in mitochondrial disease and dysfunction, folinic acid in cerebral folate abnormalities and early treatment with vigabatrin in tuberous sclerosis complex. Finally, there is limited evidence for a number of novel treatments, particularly magnesium with pyridoxine, omega-3 fatty acids, the gluten-free casein-free diet, and low-frequency repetitive transcranial magnetic simulation. Zinc and l-carnosine are potential novel treatments supported by basic research but not clinical studies. This review demonstrates the wide variety of treatments used to treat seizures in individuals with ASD as well as the striking lack of clinical trials performed to support the use of these treatments. Additional studies concerning these treatments for controlling seizures in individuals with ASD are warranted.
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Affiliation(s)
- Richard E. Frye
- Arkansas Children’s Hospital Research Institute, Little Rock, AR, USA
| | | | | | - Gregory L. Brown
- Autism Recovery and Comprehensive Health Medical Center, Franklin, WI, USA
| | - Victoria Martin
- Autism Recovery and Comprehensive Health Medical Center, Franklin, WI, USA
| | | | - Robert Coben
- New York University Brain Research Laboratory, New York, NY, USA
| | - Jeffrey Lewine
- MIND Research Network, University of New Mexico, Albuquerque, NM, USA
| | - John C. Slattery
- Arkansas Children’s Hospital Research Institute, Little Rock, AR, USA
| | - Chrystal Lau
- Arkansas Children’s Hospital Research Institute, Little Rock, AR, USA
| | - Paul Hardy
- Hardy Healthcare Associates, Hingham, MA, USA
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Wang S, Huang G, Wang Y, Huang T, Lin S, Gu J. Up-regulation of immunoglobulin G gene expression in the hippocampus of rats subjected to acute immobilization stress. J Neuroimmunol 2013; 258:1-9. [PMID: 23531367 DOI: 10.1016/j.jneuroim.2013.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 02/11/2013] [Accepted: 02/12/2013] [Indexed: 02/05/2023]
Abstract
Immunoglobulin G (IgG) is thought to be produced by matured B lymphocytes, however, it was recently found to be synthesized in neurons of the brain, especially showing higher expression level in the hippocampus. To study the possible effects of IgG in the hippocampus, we examined IgG protein and mRNA expressions in rat hippocampal neurons with immunohistochemistry, immunofluorescence, in situ hybridization and laser microdissection-assisted RT-PCR. Increased IgG expressions at both protein and mRNA levels were detected in the hippocampus of an acute immobilization stress model of rat. No change was observed in the cortex or the thalamus. Furthermore, the microtubule-associated protein 2 (MAP2) and β III tubulin proteins did not show significant changes. Based on these findings, we hypothesize that hippocampal IgG may play a key role in adverse circumstances such as stress. The finding of increased IgG expression in the hippocampus following stress may also provide possibilities for developing antidepressant medication.
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Affiliation(s)
- Sheng Wang
- Provincial Key Laboratory of Infectious Diseases and Immunopathology, Department of Pathology and Pathophysiology, Shantou University Medical College, Shantou, Guangdong, China.
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Vignoli T, Nehlig A, Massironi SG, Coimbra RDCS, Mazzacoratti MDGN, Silva IR, Neto EFDC, Persike DS, Fernandes MJDS. Consequences of pilocarpine-induced status epilepticus in immunodeficient mice. Brain Res 2012; 1450:125-37. [PMID: 22405727 DOI: 10.1016/j.brainres.2012.02.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 02/01/2012] [Accepted: 02/12/2012] [Indexed: 12/16/2022]
Abstract
Systemic injection of pilocarpine in rodents induces status epilepticus (SE) and reproduces the main characteristics of temporal lobe epilepsy (TLE). Different mechanisms are activated by SE contributing to cell death and immune system activation. We used BALB/c nude mice, a mutant that is severely immunocompromised, to characterize seizure pattern, neurochemical changes, cell death and c-Fos activation secondarily to pilocarpine-induced SE. The behavioral seizures were less severe in BALB/c nude than in BALB/c wild type mice. However, nude mice presented more tonic-clonic episodes and higher mortality rate during SE. The c-Fos expression was most prominent in the caudate-putamen, CA3 (p<0.05), dentate gyrus, entorhinal cortex (p<0.001), basolateral nucleus of amygdala (p<0.01) and piriform cortex (p<0.05) of BALB/c nude mice than of BALB/c. Besides, nude mice subjected to SE presented high number of Fluorojade-B (FJB) stained cells in the piriform cortex, amygdala (p<0.05) and hilus (p<0.001) in comparison with BALB/c mice. A significant increase in the level of glutamate and GABA was found in the hippocampus and cortex of BALB/c mice presenting SE in comparison to controls. However, the level of glutamate was higher in the brains of BALB nude mice than in the brains of BALB/c wild type mice, while the levels of GABA were unchanged. These results indicate that the brains of immunodeficient nude mice are more vulnerable to the deleterious effects of pilocarpine-induced SE as they present intense activation, increased glutamate levels and more cell death.
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Affiliation(s)
- Thiago Vignoli
- Departamento de Neurologia e Neurocirurgia, Disciplina de Neurologia Experimental, Universidade Federal de São Paulo, SP, Brazil
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Abstract
BACKGROUND Epilepsy is a common neurological condition, with an estimated incidence of 50 per 100,000 persons. People with epilepsy may present with various types of immunological abnormalities, such as low serum IgA level, lack of IgG subclass and identification of certain types of antibodies. Intravenous immunoglobulin (IVIg) treatment may represent a valuable approach and its efficacy has important implications for epilepsy management. OBJECTIVES To examine the effects of IVIg on the frequency and duration of seizures, quality of life and adverse effects, when used as monotherapy or as add-on treatment for people with epilepsy. SEARCH STRATEGY We searched the Cochrane Epilepsy Group Specialized Register (14 June 2010), the Cochrane Central Register of Controlled Trials (Issue 2 of 4, The Cochrane Library, 2010), MEDLINE (1950 to June 2010), Web of Science (14 June 2010), Current Controlled Trials (11 June 2010), the National Research Register (NRR) archive (11 June 2010), the US National Institutes of Health (Clinicaltrials.gov) (11 June 2010) and reference lists of articles. SELECTION CRITERIA Randomized or quasi-randomized controlled trials of IVIg as monotherapy or add-on treatment in people with epilepsy. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the trials for inclusion and extracted data. We contacted study authors for additional information. Outcomes included percentage of people rendered seizure-free, 50% or greater reduction in seizure frequency, adverse effects, treatment withdrawal and quality of life. MAIN RESULTS We included one study (61 patients). We found no randomized controlled trials that investigated the effects of IVIg monotherapy for epilepsy. The included study was a randomized, double-blind, placebo-controlled, multi-center trial which compared the treatment efficacy of IVIg as an add-on with a placebo add-on in patients with refractory epilepsy. There was no significant difference between IVIg and placebo in 50% or greater reduction in seizure frequency. The study reported a statistically significant effect for global assessment in favor of IVIg. No adverse effects were demonstrated. AUTHORS' CONCLUSIONS No reliable conclusions can be drawn regarding the efficacy of IVIg as a treatment for epilepsy. Further randomized controlled trials are needed.
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Affiliation(s)
- Jinsong Geng
- Evidence-based Medicine Center, Medical School of Nantong University, 19 Qixiu Road, Nantong, Jiangsu, China, 226001
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Liimatainen S, Peltola M, Fallah M, Kharazmi E, Haapala AM, Peltola J. The high prevalence of antiphospholipid antibodies in refractory focal epilepsy is related to recurrent seizures. Eur J Neurol 2009; 16:134-41. [DOI: 10.1111/j.1468-1331.2008.02373.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Billiau AD, Witters P, Ceulemans B, Kasran A, Wouters C, Lagae L. Intravenous Immunoglobulins in Refractory Childhood-Onset Epilepsy: Effects on Seizure Frequency, EEG Activity, and Cerebrospinal Fluid Cytokine Profile. Epilepsia 2007; 48:1739-1749. [PMID: 17521345 DOI: 10.1111/j.1528-1167.2007.01134.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Several studies have reported favorable effects of intravenous immunoglobulins (IVIG) in refractory epilepsy. Evidence substantiating an immunomodulatory action is scarce. In an open-label study, we prospectively investigated the effect of IVIG on clinical, EEG and serum/CSF immunological parameters in patients with refractory childhood-onset epilepsy. METHODS Thirteen patients (median age 6.9 years; range 1.6-25.8) with refractory seizures despite 3-4 antiepileptic drug regimens were given IVIG (Sandoglobulin, ZLB-Behring, add-on, 4 x 400 mg/kg/3 weeks). Seizure frequency, 24-h video-EEG, and CSF/serum immunological parameters and cytokine profiles (IL-6/IL-8/IL-12/IL-10) were documented before and after completion of the course. RESULTS Seizure frequency was reduced by > or = 50% in four, and by 25%-50% in three patients. In contrast, variation in automatically recorded spike counts (1-h-wake and -sleep) did not correlate with clinical improvement. Serum immunological parameters showed variable deviations in eight patients (e.g., IgG(2) deficiency) and CSF immunoblotting showed oligoclonal bands in two patients. Blood-brain barrier permeability was normal in 12 patients. IL-6 and IL-8 were clearly detectable in CSF of all patients; the levels were significantly higher than those in plasma but remained unaffected by IVIG treatment. CONCLUSIONS Despite unchanged EEG spike counts, substantial reductions in seizure frequency occurred in 7 of 13 patients, suggesting that IVIG hinder progression of central epileptic activity into clinical seizures. Intrathecal presence of IL-8 and IL-6 was documented in all patients, but was unaffected by IVIG, suggesting that their production is directly related to electrical seizure activity and that IVIG may act through interference with immune pathways downstream to IL-6 and IL-8.
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Affiliation(s)
- An D Billiau
- Laboratory of Experimental Transplantation, University of Leuven, Leuven, BelgiumPediatric Rheumatology, University Hospital Gasthuisberg, Leuven, BelgiumPediatric Rheumatology, University Hospital Gasthuisberg, Leuven, BelgiumLab of Experimental Immunology, KULeuven, Leuven, Belgium
| | - Peter Witters
- Laboratory of Experimental Transplantation, University of Leuven, Leuven, BelgiumPediatric Rheumatology, University Hospital Gasthuisberg, Leuven, BelgiumPediatric Rheumatology, University Hospital Gasthuisberg, Leuven, BelgiumLab of Experimental Immunology, KULeuven, Leuven, Belgium
| | - Berten Ceulemans
- Laboratory of Experimental Transplantation, University of Leuven, Leuven, BelgiumPediatric Rheumatology, University Hospital Gasthuisberg, Leuven, BelgiumPediatric Rheumatology, University Hospital Gasthuisberg, Leuven, BelgiumLab of Experimental Immunology, KULeuven, Leuven, Belgium
| | - Ahmad Kasran
- Laboratory of Experimental Transplantation, University of Leuven, Leuven, BelgiumPediatric Rheumatology, University Hospital Gasthuisberg, Leuven, BelgiumPediatric Rheumatology, University Hospital Gasthuisberg, Leuven, BelgiumLab of Experimental Immunology, KULeuven, Leuven, Belgium
| | - Carine Wouters
- Laboratory of Experimental Transplantation, University of Leuven, Leuven, BelgiumPediatric Rheumatology, University Hospital Gasthuisberg, Leuven, BelgiumPediatric Rheumatology, University Hospital Gasthuisberg, Leuven, BelgiumLab of Experimental Immunology, KULeuven, Leuven, Belgium
| | - Lieven Lagae
- Laboratory of Experimental Transplantation, University of Leuven, Leuven, BelgiumPediatric Rheumatology, University Hospital Gasthuisberg, Leuven, BelgiumPediatric Rheumatology, University Hospital Gasthuisberg, Leuven, BelgiumLab of Experimental Immunology, KULeuven, Leuven, Belgium
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Francis GS, Freedman MS, Antel JP. Failure of intravenous immunoglobulin to arrest progression of multiple sclerosis: a clinical and MRI based study. Mult Scler 1997; 3:370-6. [PMID: 9493636 DOI: 10.1177/135245859700300602] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Due to the modest benefit, inconvenience and high cost of currently available therapies for MS, it is appropriate to seek alternative treatments. Based on anecdotal evidence suggestive of benefit for i.v.IG in MS, we conducted an open-label, unblinded protocol of i.v.IG in nine MS patients. The patients were given induction doses of i.v.IG followed by monthly boosters for 1 year and had clinical, MRI and CSF analyses performed. Patients included were both progressive and relapsing. There was no clinical benefit nor apparent MRI benefit utilizing this protocol. During treatment the majority of patients continued to progress or have attacks and MRI demonstrated continued accumulation of T2-weighted lesions. CSF was unaffected by treatment.
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Affiliation(s)
- G S Francis
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, Quebec, Canada
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13
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Engelen BGMV, Renier WO, Weemaes CRM. MATTERS ARISING: Van Engelen et al reply:. J Neurol Psychiatry 1995. [DOI: 10.1136/jnnp.59.1.105-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mann AC. MATTERS ARISING: Mann replies:. Journal of Neurology, Neurosurgery and Psychiatry 1995. [DOI: 10.1136/jnnp.59.1.105-a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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