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Chen C, Zhang E, Zhu C, Wei R, Ma L, Dong X, Li R, Sun F, Zhou Y, Cui Y, Liu Z. Comparative efficacy and safety of disease-modifying therapies in patients with relapsing multiple sclerosis: A systematic review and network meta-analysis. J Am Pharm Assoc (2003) 2023; 63:8-22.e23. [PMID: 36055929 DOI: 10.1016/j.japh.2022.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Currently, 19 disease-modifying therapies (DMTs) have been approved for the treatment of patients with relapsing forms of multiple sclerosis (RMS). OBJECTIVE The objective of this study was to conduct a systematic review and network meta-analysis to evaluate the efficacy and safety of DMTs in adults with RMS. METHODS We searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, the Food and Drug Administration, and European Medicines Agency websites for randomized controlled trials (RCTs) (from inception to July 2021). Eligible RCTs evaluated approved treatments for RMS as monotherapy and reported at least one of the primary outcome measures of interest. The primary outcome was efficacy (annualized relapse rate and 12-week confirmed disability progression) and safety (serious adverse events [AEs] and discontinuation due to AEs). We assessed the risk of bias (RoB) of included studies using the Cochrane RoB tool version 2.0 (https://www.bmj.com/content/343/bmj.d5928) for RCTs. Surface under the cumulative ranking (SUCRA) was used to rank therapies and to assess quality of general evidence, respectively. The Grading of Recommendations Assessment, Development and Evaluation framework was used to rank therapies and to assess quality of general evidence. RESULTS A total of 43 records represent 45 RCTs selected for network meta-analysis. In total, 30,720 participants (median of 732; interquartile range: 248-931) were included, of which 67% were female. By SUCRA analysis, alemtuzumab (94.3%) presented the highest probability of being the best alternative for annualized relapse rate, whereas ofatumumab (93.5%) presented the highest probability of being the best alternative for 12-week confirmed disability progression. Interferon beta-1b subcutaneous (87.0%) presented the highest probability of the best safety among all DMTs for serious AEs, whereas alemtuzumab (92.4%) presented the highest probability of the best safety among all DMTs for discontinuation due to AEs. CONCLUSION Network meta-analysis shows that alemtuzumab and ofatumumab present the highest efficacy among DMTs. Because there is little difference between these probabilities for many treatments, health professionals should use clinical shared decision making when formulating treatment plans with patients.
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Geiger M, Hayter E, Martin R, Spence D. Red blood cells in type 1 diabetes and multiple sclerosis and technologies to measure their emerging roles. J Transl Autoimmun 2022; 5:100161. [PMID: 36039310 PMCID: PMC9418496 DOI: 10.1016/j.jtauto.2022.100161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- M. Geiger
- Institute of Quantitative Health Sciences and Engineering, Michigan State University, East Lansing, MI 48824, USA
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - E. Hayter
- Department of Chemistry, Saint Louis University, St. Louis, MO 63103, USA
| | - R.S. Martin
- Department of Chemistry, Saint Louis University, St. Louis, MO 63103, USA
| | - D. Spence
- Institute of Quantitative Health Sciences and Engineering, Michigan State University, East Lansing, MI 48824, USA
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA
- Corresponding author. 775 Woodlot Drive, East Lansing, MI 48824, USA.
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Samjoo IA, Worthington E, Drudge C, Zhao M, Cameron C, Häring DA, Stoneman D, Klotz L, Adlard N. Efficacy classification of modern therapies in multiple sclerosis. J Comp Eff Res 2021; 10:495-507. [PMID: 33620251 DOI: 10.2217/cer-2020-0267] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background: The Association of British Neurologists (ABN) 2015 guidelines suggested classifying multiple sclerosis therapies according to their average relapse reduction. We sought to classify newer therapies (cladribine, ocrelizumab, ofatumumab, ozanimod) based on these guidelines. Materials & methods: Therapies were classified by using direct comparative trial results as per ABN guidelines and generating classification probabilities for each therapy based on comparisons versus placebo in a network meta-analysis for annualized relapse rate. Results: For both approaches, cladribine and ofatumumab were classified as high efficacy. Ocrelizumab and ozanimod (1.0 mg) were classified as moderate or high efficacy depending on the approach used. Conclusion: Cladribine and ofatumumab have an efficacy comparable with therapies classified in the ABN guidelines as high efficacy.
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Affiliation(s)
| | | | | | | | | | | | | | - Luisa Klotz
- Department of Neurology, University Hospital Münster, Westfälische-Wilhelms-University Münster, Münster, Germany
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Omraninava M, Mehranfar S, Vahedi P, Razi B, Imani D, Aslani S, Feyzinia S. Association between IL7 Receptor Alpha (Il7ra) gene rs6897932 polymorphism and the risk of Multiple Sclerosis: A meta-regression and meta-analysis. Mult Scler Relat Disord 2020; 48:102687. [PMID: 33348212 DOI: 10.1016/j.msard.2020.102687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/02/2020] [Accepted: 12/10/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND In this systematic review and meta-analysis, we aimed to find a consistent conclusion for the association between the interleukin 7 receptor alpha (IL7RA) gene rs6897932 single nucleotide polymorphism (SNP) and multiple sclerosis (MS) risk. METHODS Here, we performed a comprehensive systematic search in PubMed, Scopus, and Web of Science to find relevant studies published before November 2020 investigating the association between rs6897932 SNP and MS risk. In the pooled analysis, we determined the odds ratio (OR) and the corresponding 95% confidence interval (CI) for the association level between rs6897932 SNP and the risk of MS. RESULTS In the current meta-analysis 33 case-control studies (30 articles) containing 19351 patients and 21005 healthy controls certify the inclusion criteria. According to the pooled analysis, a statistically significant association of IL7RA gene rs6897932 SNP with MS risk was found across recessive model (OR= 0.84, 95% CI= 0.77-0.92, P< 0.001, FEM), allelic model (OR= 0.91, 95% CI= 0.85-0.99, P= 0. 02, REM), TT vs. CC model (OR= 0.79, 95% CI= 0.67-0.93, P= 0.005, REM). Moreover, the subgroup analysis based on the ethnicity indicated a negative significant association in Europeans; dominant model (OR= 0.88, 95% CI= 0.78-1.01, P= 0.06, REM), recessive model (OR= 0.79, 95% CI= 0.71-0.88, P< 0.001, REM), allelic model (OR= 0.88, 95% CI= 0.81-0.96, P= 0.003, REM), TT vs. CC model (OR= 0.74, 95% CI= 0.61-0.88, P<0.001, REM) models. Nonetheless, no significant association was detected in Asians and Americans. CONCLUSIONS IL7RA gene rs6897932 SNP decreases MS susceptibility in overall population and Europeans.
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Affiliation(s)
- Melodi Omraninava
- Department of Infectious Disease, Faculty of Medical Sciences, Sari Branch, Islamic Azad University, Sari, Iran
| | - Sahar Mehranfar
- Department of Genetics and Immunology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran; Social Determinant of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Parviz Vahedi
- Department of anatomical sciences, Maragheh University of Medical Sciences. Maragheh, Iran
| | - Bahman Razi
- Department of Hematology, School of Medicine, Tarbiat Modares University, Tehran, Iran
| | - Danyal Imani
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Aslani
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Feyzinia
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Rahat Breath and Sleep Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Samjoo IA, Worthington E, Drudge C, Zhao M, Cameron C, Häring DA, Stoneman D, Klotz L, Adlard N. Comparison of ofatumumab and other disease-modifying therapies for relapsing multiple sclerosis: a network meta-analysis. J Comp Eff Res 2020; 9:1255-1274. [DOI: 10.2217/cer-2020-0122] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: To compare the efficacy of ofatumumab to other disease-modifying therapies (DMTs) for relapsing multiple sclerosis (RMS). Materials & methods: A network meta-analysis was conducted to determine the relative effect of ofatumumab on annualized relapse rate and confirmed disability progression at 3 months and 6 months. Results: For each outcome, ofatumumab was as effective as other highly efficacious monoclonal antibody DMTs (i.e., alemtuzumab, natalizumab and ocrelizumab). Conclusion: Ofatumumab offers beneficial outcomes for RMS by reducing relapse and disability progression risk.
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Affiliation(s)
- Imtiaz A Samjoo
- EVERSANA™, 204-3228 South Service Road, Burlington, Ontario L7N 3H8, Canada
| | - Evelyn Worthington
- EVERSANA™, 204-3228 South Service Road, Burlington, Ontario L7N 3H8, Canada
| | - Christopher Drudge
- EVERSANA™, 204-3228 South Service Road, Burlington, Ontario L7N 3H8, Canada
| | - Melody Zhao
- EVERSANA™, 204-3228 South Service Road, Burlington, Ontario L7N 3H8, Canada
| | - Chris Cameron
- EVERSANA™, 207-275 Charlotte Street, Sydney, Nova Scotia B1P 1C6, Canada
| | - Dieter A Häring
- Novartis Pharma AG, Fabrikstrasse 12, 4002 Basel, Switzerland
| | - Dee Stoneman
- Novartis Pharma AG, Fabrikstrasse 12, 4002 Basel, Switzerland
| | - Luisa Klotz
- Department of Neurology, University Hospital Münster, Westfälische-Wilhelms-University Münster, Münster, Germany
| | - Nicholas Adlard
- Novartis Pharma AG, Fabrikstrasse 12, 4002 Basel, Switzerland
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Silva T, Fragoso YD, Destro Rodrigues MFS, Gomes AO, da Silva FC, Andreo L, Viana A, Teixeira da Silva DDF, Chavantes MC, Tempestini Horliana ACR, De Angelis K, Deana AM, Branco LP, Santos Fernandes KP, Motta LJ, Mesquita-Ferrari RA, Bussadori SK. Effects of photobiomodulation on interleukin-10 and nitrites in individuals with relapsing-remitting multiple sclerosis - Randomized clinical trial. PLoS One 2020; 15:e0230551. [PMID: 32255785 PMCID: PMC7138327 DOI: 10.1371/journal.pone.0230551] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 03/02/2020] [Indexed: 12/26/2022] Open
Abstract
Objective Investigate the effects of photobiomodulation (PBM) on the expression of IL-10 and nitrites in individuals with Relapsing-Remitting multiple sclerosis (MS), as these biomarkers play a fundamental role in the physiopathology of the disease. The modulation of IL-10 and nitrites through treatment with PBM may be a novel treatment modality for MS. Methods A randomized, uncontrolled, clinical trial was conducted involving 14 individuals with a diagnosis of Relapsing-Remitting MS and a score of up to 6.0 on the Expanded Disability Status Scale (EDSS). The participants were randomized to two groups Group 1 –PBM in the sublingual region; Group 2 –PBM over the radial artery. Irradiation was administered with a wavelength of 808 nm and output power of 100 mW for 360 seconds twice a week, totaling 24 sessions. Peripheral blood was analyzed for the determination of serum levels of IL-10 and nitrites. Results After treatment with PBM, the expression of IL-10 increased in both the sublingual group (pre-treatment: 2.8 ± 1.4 pg/ml; post-treatment: 8.3 ± 2.4 pg/ml) and the radial artery group (pre-treatment: 2.7 pg/ml ± 1.4; post-treatment: 11.7 ± 3.8 pg/ml). In contrast, nitrite levels were not modulated in the sublingual group (pre-treatment: 65 ± 50 nmol/mg protein; post-treatment: 51 ± 42 nmol/mg protein) or the radial artery group (pre-treatment: 51 ± 16 nmol/mg protein; post-treatment: 42 ± 7 nmol/mg protein). Conclusion Treatment with PBM positively modulated the expression of IL-10 but had no effect on nitrite levels. Further studies should be conducted with a larger sample and a control group, as PBM may be a promising complementary treatment for the management of MS. This trial is registered at ClinicalTrials.gov. Identifier: NCT03360487.
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Affiliation(s)
- Tamiris Silva
- Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | | | | | | | | | - Lucas Andreo
- Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | - Ariane Viana
- Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | | | | | | | - Kátia De Angelis
- Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil
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Jahan-Abad AJ, Karima S, Shateri S, Baram SM, Rajaei S, Morteza-Zadeh P, Borhani-Haghighi M, Salari AA, Nikzamir A, Gorji A. Serum pro-inflammatory and anti-inflammatory cytokines and the pathogenesis of experimental autoimmune encephalomyelitis. Neuropathology 2019; 40:84-92. [PMID: 31709666 DOI: 10.1111/neup.12612] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 01/05/2023]
Abstract
Experimental autoimmune encephalomyelitis (EAE) as an experimental model of multiple sclerosis (MS) is characterized by demyelination, infiltration of inflammatory cells into the nervous system and dysregulation of serum inflammatory cytokines. We investigated the correlation of serum cytokines and other inflammatory markers with the EAE pathogenesis. After EAE induction, the levels of different serum cytokine/inflammatory mediators were measured. Furthermore, motor functions, myelination, and lymphocyte infiltration in EAE mice were also assessed. Our results revealed that the serum concentrations of T-helper 1 (Th1) and Th17 cytokines, interleukin (IL)-6, IL-1β, IL-1α and prostaglandin E2 in EAE mice were significantly higher than controls. The ratios of pro- to anti-inflammatory cytokines were different between the EAE and the control group. A statistically significant positive correlation was found between the IL-6/IL-10 ratio and the EAE severity, demyelination rate, and lymphocyte infiltration in EAE mice. Results indicate that the profiles of serum pro- and anti-inflammatory cytokines might be useful as biomarkers for monitoring the pathological manifestation of EAE. Furthermore, evaluating the dynamic interplay of serum cytokine levels and the correlation with pathogenic mechanisms of EAE may provide diagnostic and therapeutic insights for MS and some other inflammatory disorders.
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Affiliation(s)
- Ali J Jahan-Abad
- Department of Clinical Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
| | - Saeed Karima
- Department of Clinical Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
| | - Somayeh Shateri
- Department of Clinical Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
| | - Somayeh M Baram
- Department of Clinical Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.,Department of Scientific Services, HealthWeX Clinical Research Ltd. Co., Tehran, Iran
| | - Shima Rajaei
- Department of Clinical Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.,Department of Scientific Services, HealthWeX Clinical Research Ltd. Co., Tehran, Iran
| | | | | | - Ali-Akbar Salari
- Drug Applied Research Center, Tabriz University of Medical Sciences, Iran
| | - Abdolrahim Nikzamir
- Department of Clinical Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
| | - Ali Gorji
- Shefa Neuroscience Research Center, Khatam Alnbia Hospital, Tehran, Iran.,Department of Neurology and Department of Neurosurgery, Westfälische Wilhelms-Universität Münster, Münster, Germany
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Lubina-Dąbrowska N, Stepień A, Sulkowski G, Dąbrowska-Bouta B, Langfort J, Chalimoniuk M. Effects of IFN-β1a and IFN-β1b treatment on the expression of cytokines, inducible NOS (NOS type II), and myelin proteins in animal model of multiple sclerosis. Arch Immunol Ther Exp (Warsz) 2017; 65:325-338. [PMID: 28299403 PMCID: PMC5511332 DOI: 10.1007/s00005-017-0458-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 02/09/2017] [Indexed: 12/28/2022]
Abstract
The aim of this study was to investigate the effects of interferon (IFN)-β1a and IFN-β1b treatment on inflammatory factors and myelin protein levels in the brain cortex of the Lewis rat experimental autoimmune encephalomyelitis (EAE), animal model of multiple sclerosis. To induce EAE, rat were immunized with inoculums containing spinal cord guinea pig homogenized in phosphate-buffered saline and emulsified in Freund's complete adjuvant containing 110 µg of the appropriate antigen in 100 µl of an emulsion and additionally 4-mg/ml Mycobacterium tuberculosis (H37Ra). The rats were treated three times per week with subcutaneous applications of 300,000 units IFN-β1a or IFN-β1b. The treatments were started 8 days prior to immunization and continued until day 14 after immunization. The rats were killed on the 14th day of the experiment. EAE induced dramatic increase in interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-concentrations and inducible nitric oxide synthase (iNOS) expression in the brain, which closely corresponded to the course of neurological symptoms and the loss of weight. Both IFN-β1b and IFN-β1a treatments inhibited the pro-inflammatory cytokines (IL-6, IL-1β, TNF-α and IFN-γ), decreased the activation of astrocytes, increased the myelin protein level in the brain cortex, and improved the neurological status of EAE rats by different mechanisms; IFN-β1a reduced iNOS expression, at least in part, by the enhancement of IL-10, while IFN-β1b diminished IL-10 concentration and did not decrease EAE-induced iNOS expression.
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Affiliation(s)
- Natalia Lubina-Dąbrowska
- Neurology Clinic, Military Institute of Medicine, Warsaw, Poland
- Department of Cellular Signalling, Mossakowski Medical Research Centre, Polish Academy of Sciences, Pawińskiego 5, 02-106, Warsaw, Poland
| | - Adam Stepień
- Neurology Clinic, Military Institute of Medicine, Warsaw, Poland
| | - Grzegorz Sulkowski
- Laboratory of Pathoneurochemistry, Department of Neurochemistry, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
| | - Beata Dąbrowska-Bouta
- Laboratory of Pathoneurochemistry, Department of Neurochemistry, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
| | - Józef Langfort
- Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
- Department of Sports Training, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Małgorzata Chalimoniuk
- Department of Cellular Signalling, Mossakowski Medical Research Centre, Polish Academy of Sciences, Pawińskiego 5, 02-106, Warsaw, Poland.
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Assessment of Serum Nitrogen Species and Inflammatory Parameters in Relapsing-Remitting Multiple Sclerosis Patients Treated with Different Therapeutic Approaches. BIOMED RESEARCH INTERNATIONAL 2016; 2016:4570351. [PMID: 28078290 PMCID: PMC5204117 DOI: 10.1155/2016/4570351] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/20/2016] [Accepted: 11/08/2016] [Indexed: 11/17/2022]
Abstract
The role of nitric oxide and its reactive derivatives (NO x ) is well known in the pathogenesis of multiple sclerosis, which is an inflammatory disease while NO x seems to be important in coordinating inflammatory response. The purpose of the present study was to assess serum NO x as one of the nitrogen species and inflammatory parameters in relapsing-remitting multiple sclerosis patients and to compare the effectiveness of various types of disease-modifying therapies that reduce nitric oxide and inflammatory biomarkers. Elevated NO x level was observed in patients who received the first-line disease-modifying therapy (interferons beta-1a and beta-1b) in comparison with the subjects treated with the second-line disease-modifying therapy (natalizumab; fingolimod) and healthy controls without significant differences in C-reactive protein and interleukin-1 beta. A negative correlation was observed between serum NO x level and the duration of multiple sclerosis confirmed in the whole study population and in subjects treated with the first-line agents. Only serum NO x , concentration could reveal a potential efficacy of disease-modifying therapy with a better reduction in NO x level due to the second-line agents of disease-modifying therapy.
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Ibitoye R, Kemp K, Rice C, Hares K, Scolding N, Wilkins A. Oxidative stress-related biomarkers in multiple sclerosis: a review. Biomark Med 2016; 10:889-902. [PMID: 27416337 DOI: 10.2217/bmm-2016-0097] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To provide an up-to-date review of oxidative stress biomarkers in multiple sclerosis and thus identify candidate molecules with greatest promise as biomarkers of diagnosis, disease activity or prognosis. METHOD A semi-systematic literature search using PubMed and other databases. RESULTS Nitric oxide metabolites, superoxide dismutase, catalase, glutathione reductase, inducible nitric oxide synthase, protein carbonyl, 3-nitrotyrosine, isoprostanes, malondialdehyde and products of DNA oxidation have been identified across multiple studies as having promise as diagnostic, therapeutic or prognostic markers in MS. CONCLUSION Heterogeneity of study design, particularly patient selection, limits comparability across studies. Further cohort studies are needed, and we would recommend promising markers be incorporated into future clinical trials to prospectively validate their potential.
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Affiliation(s)
- Richard Ibitoye
- Institute of Clinical Neurosciences, University of Bristol/Level 1, Learning & Research, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Kevin Kemp
- Institute of Clinical Neurosciences, University of Bristol/Level 1, Learning & Research, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Claire Rice
- Institute of Clinical Neurosciences, University of Bristol/Level 1, Learning & Research, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Kelly Hares
- Institute of Clinical Neurosciences, University of Bristol/Level 1, Learning & Research, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Neil Scolding
- Institute of Clinical Neurosciences, University of Bristol/Level 1, Learning & Research, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Alastair Wilkins
- Institute of Clinical Neurosciences, University of Bristol/Level 1, Learning & Research, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
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11
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Tavakolpour S. Interleukin 7 receptor polymorphisms and the risk of multiple sclerosis: A meta-analysis. Mult Scler Relat Disord 2016; 8:66-73. [PMID: 27456877 DOI: 10.1016/j.msard.2016.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 04/17/2016] [Accepted: 05/01/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is considered as the most common chronic inflammatory neurologic disorder diagnosed in young adults. Both environmental and genetic factors may influence risk of MS development. Interleukin 7 receptor (IL7R) is one of the most studied gene polymorphism on MS that may play a possible role in MS development. The most studied polymorphism of IL7R gene is "rs6897932" polymorphism on IL7Rα gene (IL7RA). METHODS PubMed, Scopus, and Google scholar databases were searched for all of related studies on the association of IL7RA polymorphism with single nucleotide polymorphism (SNP) ID of "rs6897932" and the risk of MS through August 07, 2015. After exclusion of irrelevant articles, 11 eligible studies were selected, which were analyzed to determine an association between the MS and IL7R T244I polymorphism (rs6897932). For identification of this association, odds ratios (ORs) and 95% confidence interval (95% CI) were calculated. Four models of allelic (T vs. C), co-dominant genotype (TT vs. CC), dominant (TT+CT vs. CC), and recessive genotypes (TT vs. CT+CC) were considered to check the possible role of rs6897932 polymorphism in MS. A sensitivity analysis was conducted to find the reliability of this study. Furthermore, funnel plots were used to evaluate publication bias. RESULTS A total of 11 case-control studies were identified through this meta-analysis, which containing 6752 cases and 7349 controls. In overall, the frequency of the C allele was found to be higher in patients with MS compared to healthy controls (75.66% vs. 72.19%). T allele was significantly associated with the decreased risk of MS in a random effect model (T vs. C: OR=0.84, 95% CI=0.77-0.92, P-value <0.001). In the co-dominant, dominant, and recessive genotypes models, a significant association between the IL7R T244I polymorphism and MS risk was demonstrated (TT vs. CC: OR=0.70, 95% CI=0.61-0.80, P-value <0.001; TT+CT vs. CC: OR=0.82, 95% CI=0.73-0.92, P-value <0.001; TT vs. CT+CC: OR=0.76, 95% CI=0.66-0.87, P-value <0.001). Sensitivity analysis revealed that this study is reliable. There was no evidence of publication bias. CONCLUSION It was demonstrated that the IL7R T244I polymorphism was associated with susceptibility to MS. However, more well-designed studies with large sample size are needed to validate this association between this single nucleotide polymorphism and MS.
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Affiliation(s)
- Soheil Tavakolpour
- Iran University of Medical Sciences, Tehran, Iran; Neuroscience Research center, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran.
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Farrokhi M, Etemadifar M, Jafary Alavi MS, Zarkesh-Esfahani SH, Behjati M, Rezaei A, Amani-Beni A. TNF-alpha Production by Peripheral Blood Monocytes in Multiple Sclerosis Patients and Healthy Controls. Immunol Invest 2015. [DOI: 10.3109/08820139.2015.1059851] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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13
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Retinoic acid enhances the levels of IL-10 in TLR-stimulated B cells from patients with relapsing-remitting multiple sclerosis. J Neuroimmunol 2014; 278:11-8. [PMID: 25595247 DOI: 10.1016/j.jneuroim.2014.11.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 11/07/2014] [Accepted: 11/20/2014] [Indexed: 01/31/2023]
Abstract
We have explored the beneficial effects of retinoic acid (RA) on B cells from multiple sclerosis (MS) patients. When co-stimulated via the toll-like receptors (TLRs) TLR9 and RP105, MS B cells secreted less of the anti-inflammatory cytokine interleukin 10 (IL-10) compared to B cells from healthy controls. Importantly, RA enhanced the secretion of IL-10 by MS-derived B cells without affecting the levels of the pro-inflammatory cytokine TNF-α. RA revealed the same ability to induce IL-10 as did interferon-β-1b (IFN-β-1b), and B-cells from patients treated with glatiramer acetate or IFN-β-1b still displayed the beneficial effects of RA on the IL-10/TNF-α ratio.
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Derfuss T, Curtin F, Guebelin C, Bridel C, Rasenack M, Matthey A, Du Pasquier R, Schluep M, Desmeules J, Lang AB, Perron H, Faucard R, Porchet H, Hartung HP, Kappos L, Lalive PH. A phase IIa randomised clinical study of GNbAC1, a humanised monoclonal antibody against the envelope protein of multiple sclerosis-associated endogenous retrovirus in multiple sclerosis patients. Mult Scler 2014; 21:885-93. [DOI: 10.1177/1352458514554052] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 08/20/2014] [Indexed: 11/16/2022]
Abstract
Background: GNbAC1 is an immunoglobulin (IgG4) humanised monoclonal antibody against multiple sclerosis-associated retrovirus (MSRV)-Env, a protein of endogenous retroviral origin, expressed in multiple sclerosis (MS) lesions, which is pro-inflammatory and inhibits oligodendrocyte precursor cell differentiation. Objective: This is a randomised, double-blind placebo-controlled dose-escalation study followed by a six-month open-label phase to test GNbAC1 in MS patients. The primary objective was to assess GNbAC1 safety in MS patients, and the other objectives were pharmacokinetic and pharmacodynamic assessments. Methods: Ten MS patients were randomised into two cohorts to receive a single intravenous infusion of GNbAC1/placebo at doses of 2 or 6 mg/kg. Then all patients received five infusions of GNbAC1 at 2 or 6 mg/kg at four-week intervals in an open-label setting. Safety, brain magnetic resonance imaging (MRI), pharmacokinetics, immunogenicity, cytokines and MSRV RNA expression were studied. Results: All patients completed the study. GNbAC1 was well tolerated in all patients. GNbAC1 pharmacokinetics is dose-linear with mean elimination half-life of 27–37 d. Anti-GNbAC1 antibodies were not detected. Cytokine analysis did not indicate an adverse effect. MSRV-transcripts showed a decline after the start of treatment. Nine patients had stable brain lesions at MRI. Conclusion: The safety, pharmacokinetic profile, and pharmacodynamic responses to GNbAC1 are favourable in MS patients over a six-month treatment period.
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Affiliation(s)
- Tobias Derfuss
- Neurology Department, Basel University Hospital, Switzerland
| | | | | | - Claire Bridel
- Department of Clinical Neurosciences, Geneva University Hospital, Switzerland
| | - Maria Rasenack
- Neurology Department, Basel University Hospital, Switzerland
| | - Alain Matthey
- Pharmacology and Toxicology Division, Geneva University Hospital, Switzerland
| | | | - Myriam Schluep
- Neurology Department, Lausanne University Hospital, Switzerland
| | - Jules Desmeules
- Pharmacology and Toxicology Division, Geneva University Hospital, Switzerland
| | | | | | | | - Hervé Porchet
- GeNeuro SA, Switzerland/Pharmacology Department, University of Pretoria, South Africa
| | | | - Ludwig Kappos
- Neurology Department, Basel University Hospital, Switzerland
| | - Patrice H Lalive
- Department of Clinical Neurosciences, Geneva University Hospital, Switzerland/Department of Genetic and Laboratory Medicine, Geneva University Hospital, Switzerland/Department of Pathology and Immunology, University of Geneva, Switzerland
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Hu S, Chen Y, Sun XD, Li FJ, Shu QF, Liu XL, Jiang SF. Association between IL-6-174G/C polymorphism and risk of multiple sclerosis: a meta-analysis. Genet Test Mol Biomarkers 2013; 18:127-30. [PMID: 24328460 DOI: 10.1089/gtmb.2013.0387] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE Interleukin-6 (IL-6) is a pleiotropic cytokine and important mediator of many inflammatory processes, which might affect susceptibility to multiple sclerosis (MS). The aim of this study was to assess the effect of IL-6-174G/C polymorphism on the risk of MS using a meta-analysis. MATERIALS AND METHODS The Pubmed, ISI Web of Science, Wanfang, VIP, and China National Knowledge Infrastructure databases were screened and six studies were included in the meta-analysis. Pooled odds ratios (ORs) with corresponding 95% confidence intervals (CI) were calculated to evaluate the association between the IL-6-174G/C polymorphism and risk of MS. RESULTS No significant association between the IL-6-174G/C polymorphism and risk of MS was observed in overall analyses. With stratification according to ethnicity, we found that carriers with the IL-6-174CC genotype had a 1.87-fold increased risk for the development of MS in Asians (recessive model: OR=1.87, 95% CI, 1.08-3.24), but not in Caucasians. CONCLUSION This meta-analysis provides evidence that the IL-6-174G/C polymorphism may be a risk factor for the development of MS in Asians. Further association studies with a larger sample size are required to confirm the result in different populations.
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Affiliation(s)
- Shan Hu
- 1 Air Force Centre of Aviation Medical Evaluation and Training in Hangzhou , Hangzhou, China
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