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Ferrero S, Esposito F, Pretta S, Ragni N. Fetal risks related to the treatment of multiple sclerosis during pregnancy and breastfeeding. Expert Rev Neurother 2014; 6:1823-31. [PMID: 17181429 DOI: 10.1586/14737175.6.12.1823] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In women with multiple sclerosis, pregnancy does not have a long-term adverse effect on lifetime disability; however, there is an increased risk of relapses during the postpartum. Therapies taken during pregnancy may have adverse effects on pregnancy outcome. The small number of pregnancies included in most studies, particularly those evaluating the risks related to the administration of immunomodulating drugs, do not allow firm conclusions to be drawn with regards to their safety. Therefore, until more information regarding safety is available, glatiramer acetate, mitoxantrone and interferon-beta should be discontinued before an anticipated pregnancy. By contrast, glucocorticoids can be used to treat acute relapses during pregnancy.
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Affiliation(s)
- Simone Ferrero
- Department of Obstetrics and Gynaecology, San Martino Hospital and University of Genoa, Largo R. Benzi 1, 16132 Genoa, Italy.
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Blagosklonny MV. Validation of anti-aging drugs by treating age-related diseases. Aging (Albany NY) 2009; 1:281-8. [PMID: 20157517 PMCID: PMC2806014 DOI: 10.18632/aging.100034] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2008] [Accepted: 03/28/2009] [Indexed: 01/18/2023]
Abstract
Humans die from
age-related diseases, which are deadly manifestations of the aging process.
In order to extend life span, an anti-aging drug must delay age-related
diseases. All together age-related diseases are the best biomarker
of aging. Once a drug is used for treatment of any one chronic disease, its
effect against other diseases (atherosclerosis, cancer, prostate
enlargement, osteoporosis, insulin resistance, Alzheimer's and Parkinson's
diseases, age-related macular degeneration) may be evaluated in the same
group of patients. If the group is large, then the anti-aging effect could
be validated in a couple of years. Startlingly, retrospective analysis of
clinical and preclinical data reveals four potential anti-aging modalities.
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Li Z, Yao H, Ma Y, Dong Q, Chen Y, Peng Y, Zheng BJ, Huang JD, Chan CY, Lin MC, Sung JJ, Yuen KY, Kung HF, He ML. Inhibition of HBV gene expression and replication by stably expressed interferon-alpha1 via adeno-associated viral vectors. J Gene Med 2008; 10:619-27. [PMID: 18383553 PMCID: PMC7166674 DOI: 10.1002/jgm.1174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Interferon‐α2 (IFNα2) is routinely used for anti‐hepatitis B virus (HBV) treatment. However, the therapeutic efficiency is unsatisfactory, particularly in East Asia. Such inefficiency might be a result of the short half‐life, relatively low local concentration and strong side‐effects of interferons. Frequent and repeated injection is also a big burden for patients. In the present study, a single dose of vector‐delivered IFNα1 was tested for its anti‐HBV effects. Methods Adeno‐associated viral vector (AAV‐IFNα1) was generated to deliver the IFNα1 gene into hepatocytes. IFNα1, hepatitis B surface (HBsAg) and e (HBeAg) antigens were measured by enzyme‐linked immunosorbent assay and/or western blotting. The level of viral DNA was measured by quantitative real‐time polymerase chain reaction. Results AAV‐IFNα1 effectively transduced HBV‐producing cells (HepAD38) and mouse hepatocytes, where IFNα1 was expressed in a stable manner. Both intracellular and extracellular HBsAg and HBeAg were significantly reduced in vitro. In the HBV‐producing mice, the concentration of IFNα1 in the liver was eight‐fold higher than that in plasma. Compared with control groups, HBeAg/HBsAg antigen levels were reduced by more than ten‐fold from day 1–5, and dropped to an undetectable level on day 9 in the AAV‐IFNα1 group. Concurrently, the level of viral DNA decreased over 30‐fold for several weeks. Conclusions A single dose administration of AAV‐IFNα1 viral vector displayed prolonged transgene expression and superior antiviral effects both in vitro and in vivo. Therefore, the use of AAV‐IFNα1 might be a potential alternative strategy for anti‐HBV therapy. Copyright © 2008 John Wiley & Sons, Ltd.
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Affiliation(s)
- Zhi Li
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
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Fragoso YD, Peres M. Prevalence of multiple sclerosis in the city of Santos, SP. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2007. [DOI: 10.1590/s1415-790x2007000400005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: To assess the prevalence of multiple sclerosis (MS) in the city of Santos, SP. METHOD: Evaluation of data from the Reference Center for MS of the coastal region of the State of São Paulo, from the Regional Association of Patients with MS (APEMBS), with active participation of all neurologists and neurosurgeons of the city, data from IBGE, from the city council, and from EMPLASA. The protocol proposed by the BCTRIMS (already used in other similar studies) was used for data collection and analysis, June 30th 2005 being established as the prevalence day. RESULTS: Santos has an area of 280.3 km², with 418,316 inhabitants (1.49 inhabitant per km²). A total of 65 patients were identified, attaining the prevalence of 15.54/100.000. The most frequent initial symptom of the disease was optical neuritis (28.8%). CONCLUSION: data from the city of Santos are similar to those already observed, but as yet not published, in other cities of the State of São Paulo and of Brazil.
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Affiliation(s)
- Yara Dadalti Fragoso
- Universidade Metropolitana de Santos; Reference Center for Multiple Sclerosis for the coastal region of the State of São Paulo
| | - Maristela Peres
- Universidade Metropolitana de Santos; Reference Center for Multiple Sclerosis for the coastal region of the State of São Paulo
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Abstract
Multiple sclerosis (MS) represents the prototypic inflammatory autoimmune disorder of the CNS. It is the most common cause of neurological disability in young adults and exhibits considerable clinical, radiological and pathological heterogeneity. Increased understanding of the immunopathological processes underlying this disease, advances in biotechnology and the development of powerful magnetic resonance imaging (MRI) technologies, together with improvements in clinical trial design, have led to a variety of valuable therapeutic approaches to MS. Therapy for MS has changed dramatically over the past decade, yielding significant progress in the treatment of relapsing remitting and secondary progressive forms; however, most of the clinically relevant therapeutic approaches are not yet available as oral formulations. A substantial number of preliminary and pivotal reports have provided promising results for oral therapies, and various phase III clinical trials are currently being initiated or are already underway evaluating the efficacy of a variety of orally administered agents, including cladribine, teriflunomide, laquinimod, fingolimod and fumaric acid. It is hoped that these trials will advance the development of oral therapies for MS.
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Affiliation(s)
- Bernd C Kieseier
- Department of Neurology, Heinrich-Heine University, Düsseldorf, Germany.
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Phillips SM, Bhopale MK, Constantinescu CS, Ciric B, Hilliard B, Ventura E, Lavi E, Rostami A. Effect of DAB(389)IL-2 immunotoxin on the course of experimental autoimmune encephalomyelitis in Lewis rats. J Neurol Sci 2007; 263:59-69. [PMID: 17603081 DOI: 10.1016/j.jns.2007.05.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2006] [Revised: 04/26/2007] [Accepted: 05/08/2007] [Indexed: 12/11/2022]
Abstract
Activated T cells express the high affinity interleukin 2 receptor (IL-2R also CD25) that binds interleukin 2 (IL-2) and transduces signals important for the proliferation and survival of these cells. We investigated the effect of the genetically engineered immunotoxin DAB(389)IL-2 on experimental autoimmune encephalomyelitis (EAE), an autoimmune disease of the central nervous system (CNS) mediated by activated myelin-reactive T cells. EAE is the most commonly used animal model of the human disease multiple sclerosis (MS). DAB(389)IL-2 is a recombinant fusion product made of a portion of diphtheria toxin, which contains binding and translocation components of the toxin linked to IL-2. The diphtheria toxin targets and kills cells expressing the high affinity IL-2 receptor and has been successfully used in several autoimmune and neoplastic conditions. We observed a significant suppression of guinea-pig spinal cord homogenate (gpSCH)-MBP induced active EAE in Lewis rats at 2 x 1,600 kU of DAB(389)IL-2 given on days 7 and 9 post-immunization and complete suppression with the same dose on days 7, 8 and 9 or 7, 8, 9 and 10 after immunization during the active disease period. There were reduced mononuclear cell infiltrates of CD4(+), CD8(+), CD25(+) and alphabetaTCR(+) T cells in the spinal cord of treated rats. However, treatment at day 11 or 12 post-immunization led to severe, fatal disease. The toxin added to cultures in vitro or injected in vivo suppressed antigen- and mitogen-induced T cell proliferation. DAB(389)IL-2 treatment in vivo or exposure of encephalitogenic T cells in vitro prior to transfer did have a significant inhibitory effect on adoptive transfer EAE. Our data demonstrate that DAB(389)IL-2 immunotoxin can suppress active and passive EAE if applied at specific, early time points, but can have negative consequences at later time points.
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MESH Headings
- Animals
- Antigens, CD/metabolism
- Cell Proliferation/drug effects
- Cells, Cultured
- Diphtheria Toxin/genetics
- Diphtheria Toxin/therapeutic use
- Disease Models, Animal
- Dose-Response Relationship, Drug
- Encephalomyelitis, Autoimmune, Experimental/chemically induced
- Encephalomyelitis, Autoimmune, Experimental/drug therapy
- Encephalomyelitis, Autoimmune, Experimental/immunology
- Female
- Guinea Pigs
- Immunotoxins/therapeutic use
- Interleukin-2/genetics
- Interleukin-2/therapeutic use
- Lymphocyte Activation/drug effects
- Mutation/physiology
- Myelin Basic Protein
- Rats
- Rats, Inbred Lew
- Receptors, Antigen, T-Cell, alpha-beta/metabolism
- Recombinant Fusion Proteins/genetics
- Recombinant Fusion Proteins/therapeutic use
- Severity of Illness Index
- Spinal Cord/pathology
- T-Lymphocytes, Helper-Inducer/drug effects
- Time Factors
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Affiliation(s)
- S Michael Phillips
- Department of Allergy and Immunology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
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Kleinschnitz C, Meuth SG, Kieseier BC, Wiendl H. [Update on pathophysiologic and immunotherapeutic approaches for the treatment of multiple sclerosis]. DER NERVENARZT 2007; 78:883-911. [PMID: 17551708 DOI: 10.1007/s00115-007-2261-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Multiple sclerosis (MS) is a chronic disabling disease with significant implications for patients and society. The individual disease course is difficult to predict due to the heterogeneity of clinical presentation and of radiologic and pathologic findings. Although its etiology still remains unknown, the last decade has brought considerable understanding of the underlying pathophysiology of MS. In addition to its acceptance as a prototypic inflammatory autoimmune disorder, recent data reveal the importance of primary and secondary neurodegenerative mechanisms such as oligodendrocyte death, axonal loss, and ion channel dysfunction. The deepened understanding of its immunopathogenesis and the limited effectiveness of currently approved disease-modifying therapies have led to a tremendous number of trials investigating potential new drugs. Emerging treatments take into account the different immunopathological mechanisms and strategies, to protect against axonal damage and promote remyelination. This review provides a compilation of novel immunotherapeutic strategies and recently uncovered aspects of known immunotherapeutic agents. The pathogenetic rationale of these novel drugs for the treatment of MS and accompanying preclinical and clinical data are highlighted.
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Affiliation(s)
- C Kleinschnitz
- Neurologische Klinik und Poliklinik, Universitätsklinikum, Josef-Schneider-Strasse 11, 97080, Würzburg, Germany
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Forte M, Gold BG, Marracci G, Chaudhary P, Basso E, Johnsen D, Yu X, Fowlkes J, Rahder M, Stem K, Bernardi P, Bourdette D. Cyclophilin D inactivation protects axons in experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis. Proc Natl Acad Sci U S A 2007; 104:7558-63. [PMID: 17463082 PMCID: PMC1857227 DOI: 10.1073/pnas.0702228104] [Citation(s) in RCA: 166] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Indexed: 11/18/2022] Open
Abstract
Multiple sclerosis (MS) is the leading cause of neurological disability in young adults, affecting some two million people worldwide. Traditionally, MS has been considered a chronic, inflammatory disorder of the central white matter in which ensuing demyelination results in physical disability [Frohman EM, Racke MK, Raine CS (2006) N Engl J Med 354:942-955]. More recently, MS has become increasingly viewed as a neurodegenerative disorder in which neuronal loss, axonal injury, and atrophy of the CNS lead to permanent neurological and clinical disability. Although axonal pathology and loss in MS has been recognized for >100 years, very little is known about the underlying molecular mechanisms. Progressive axonal loss in MS may stem from a cascade of ionic imbalances initiated by inflammation, leading to mitochondrial dysfunction and energetic deficits that result in mitochondrial and cellular Ca2+ overload. In a murine disease model, experimental autoimmune encephalomyelitis (EAE) mice lacking cyclophilin D (CyPD), a key regulator of the mitochondrial permeability transition pore (PTP), developed EAE, but unlike WT mice, they partially recovered. Examination of the spinal cords of CyPD-knockout mice revealed a striking preservation of axons, despite a similar extent of inflammation. Furthermore, neurons prepared from CyPD-knockout animals were resistant to reactive oxygen and nitrogen species thought to mediate axonal damage in EAE and MS, and brain mitochondria lacking CyPD sequestered substantially higher levels of Ca2+. Our results directly implicate pathological activation of the mitochondrial PTP in the axonal damage occurring during MS and identify CyPD, as well as the PTP, as a potential target for MS neuroprotective therapies.
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MESH Headings
- Animals
- Axons/enzymology
- Axons/pathology
- Brain/metabolism
- Cells, Cultured
- Peptidyl-Prolyl Isomerase F
- Cyclophilins/deficiency
- Cyclophilins/genetics
- Cyclophilins/metabolism
- Disease Models, Animal
- Encephalomyelitis, Autoimmune, Experimental/enzymology
- Encephalomyelitis, Autoimmune, Experimental/genetics
- Encephalomyelitis, Autoimmune, Experimental/pathology
- Enzyme Activation
- Inflammation/enzymology
- Inflammation/genetics
- Inflammation/pathology
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Mitochondria/genetics
- Mitochondria/metabolism
- Multiple Sclerosis/enzymology
- Multiple Sclerosis/genetics
- Multiple Sclerosis/pathology
- Nitrogen/metabolism
- Phosphorylation
- Reactive Oxygen Species/metabolism
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Affiliation(s)
| | - Bruce G. Gold
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239
| | - Gail Marracci
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239
- Department of Veterans Affairs, Portland, OR 97239
| | - Priya Chaudhary
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239
| | - Emy Basso
- Department of Biomedical Sciences, University of Padova, I-35121 Padova, Italy; and
| | | | - Xiaolin Yu
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239
| | | | - Micha Rahder
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239
| | - Katie Stem
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239
| | - Paolo Bernardi
- Department of Biomedical Sciences, University of Padova, I-35121 Padova, Italy; and
| | - Dennis Bourdette
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239
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Lopatinskaya L, Zwemmer J, Uitdehaag B, Lucas K, Polman C, Nagelkerken L. Mediators of apoptosis Fas and FasL predict disability progression in multiple sclerosis over a period of 10 years. Mult Scler 2007; 12:704-9. [PMID: 17262997 DOI: 10.1177/1352458506070826] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
TNF-alpha, IL-12p35, IL-12p40, IL-4, IL-10, TGF-beta1, CCR3, CXCR3, CCR5, Fas and FasL mRNA levels in PBMC of 25 multiple sclerosis (MS) patients were quantified at baseline by real-time PCR according to a post-hoc study design. The baseline values of the different markers were analysed with respect to their correlation with the increase in disability over a period of 10 years. High levels of Fas mRNA were associated with a favourable disease course in relapsing-remitting (RR) MS (R2 = 0.74, P = 0.0001, n = 13), as measured by the Expanded Disability Status Scale (EDSS); high levels of FasL mRNA were associated with relatively mild disease progression (R2 = 0.86, P = 0.0001, n =12) in secondary progressive (SP) MS. These findings suggest that Fas-mediated apoptosis plays a major role in the mechanism underlying long-term disease progression in MS.:
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Affiliation(s)
- L Lopatinskaya
- Division of Biomedical Research, TNO Quality of Life, P.O. Box 2215, 2301 CE, Leiden, The Netherlands
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