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Fernández O, Aladro Y, Arroyo R, Brieva L, Calles-Hernández MC, Carrascal P, Comabella M, Costa-Frossard L, Eichau S, García-Merino JA, Ginestal R, González I, Izquierdo G, Martínez-Ginés ML, Meca-Lallana JE, Mendibe-Bilbao MM, Oterino A, Prieto JM, Río J, Ramió-Torrentà L, Romero-Pinel L, Téllez N, Rodríguez-Antigüedad A. [12th Post-ECTRIMS Meeting: review of the novelties from the 2019 ECTRIMS Congress (I)]. Rev Neurol 2021; 70:379-390. [PMID: 32390131 DOI: 10.33588/rn.7010.2020121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Like every year, after the ECTRIMS Congress, renowned Spanish neurologists who are experts in multiple sclerosis presented the main novelties in research in this field at the Post-ECTRIMS Meeting. AIM To summarise the content presented at the 12th edition of the Post-ECTRIMS Meeting, which took place in September 2019 in Sevilla and is presented in two parts. DEVELOPMENT This first part addresses the latest studies on vitamin D deficiency and the discrepancies that currently exist regarding its treatment. The advances made in epigenetics allow us to present this approach as a possible biomarker of multiple sclerosis. An account is provided to explain the growing importance of imaging techniques to detect atrophy and other phenomena that occur during the disease, such as changes in iron concentration or remyelination processes, which allow us to further our understanding of the mechanisms of cortical pathology, and the dimensionality of neurodegeneration during its course. Findings related to immunological mechanisms and advances in potential antigen-specific therapies are discussed. The contribution presents the latest studies on the assessment of cognitive impairment and its rehabilitation, which are becoming increasingly important due to the high prevalence of these disorders and the absence of their systematic assessment in clinical practice. Finally, the unmet social and health needs of multiple sclerosis patients in our country are presented, with emphasis on the current deficits in the system of social protection.
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Affiliation(s)
- O Fernández
- Instituto de Investigación Biomédica de Málaga. IBIMA, Málaga, España
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, España
| | - R Arroyo
- Hospital Quirón, Pozuelo de Alarcón, España
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, España
| | | | | | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, España
| | | | - S Eichau
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
| | - J A García-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, España
| | - R Ginestal
- Fundación Jiménez Díaz, 28040 Madrid, España
| | | | | | | | | | | | - A Oterino
- Hospital Universitario Marqués de Valdecilla, Santander, España
| | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, España
| | - J Río
- Hospitals Vall d'Hebron, 08035 Barcelona, España
| | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 Hospitalet de Ll., España
| | - N Téllez
- Hospital Clínico Universitario, 47005 Valladolid, España
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Fernández O, Montalban X, Aladro Y, Alonso A, Arroyo R, Calles C, Castillo-Triviño T, Comabella M, Costa-Frossard L, Forero L, Ginestal R, Landete L, Llaneza M, Llufriu S, Martínez-Ginés ML, Meca-Lallana J, Mendibe M, Oreja-Guevara C, Oterino A, Prieto JM, Ramió-Torrentà L, Romero-Pinel L, Téllez N, Rodríguez-Antigüedad A. 13th Post-ECTRIMS Meeting: review of the new developments presented at the 2020 ECTRIMS Congress (I). Rev Neurol 2021; 72:397-406. [PMID: 34042168 DOI: 10.33588/rn.7211.2021172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION For more than a decade, following the ECTRIMS Congress, the Post-ECTRIMS Meeting has been held in Spain, where neurologists with expertise in multiple sclerosis (MS) from all over the country meet to review the most relevant latest developments presented at the ECTRIMS congress (on this occasion held together with ACTRIMS). AIM This article, published in two parts, summarises the presentations that took place at the Post-ECTRIMS Meeting, held online on 16 and 17 October 2020. DEVELOPMENT This first part includes the latest results regarding the impact of the environment and lifestyle on risk of MS and its clinical course, and the role of epigenetics and genetic factors on these processes. Findings from preclinical and clinical research on the lymphocyte subtypes identified and the involvement of lymphoid follicles and meningeal involvement in the disease are discussed. Changes in brain structure are addressed at the microscopic and macroscopic levels, including results from high-resolution imaging techniques. The latest advances on biomarkers for the diagnosis and prognosis of MS, and on the involvement of the microbiome in these patients are also reported. Finally, results from patient registries on the impact of COVID-19 in MS patients are outlined. CONCLUSIONS There have been new data on MS risk factors, the impact of MS at the cellular and structural level, the role of the microbiome in the disease, biomarkers, and the relationship between COVID-19 and MS.
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Affiliation(s)
- O Fernández
- Hospital Regional Universitario de Málaga, Málaga, España
| | - X Montalban
- Hospital Universitario Vall d'Hebron-CEMCAT, Barcelona, España
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, España
| | - A Alonso
- Hospital Regional Universitario de Málaga, Málaga, España
| | - R Arroyo
- Hospital Universitario Quirónsalud, Madrid, España
| | - C Calles
- Hospital Universitari Son Espases, Palma de Mallorca, España
| | | | - M Comabella
- Hospital Universitario Vall d'Hebron-CEMCAT, Barcelona, España
| | | | - L Forero
- Hospital Universitario Puerta del Mar, 11009 Cádiz, España
| | - R Ginestal
- Hospital Universitario Clínico de Madrid, Madrid, España
| | - L Landete
- Hospital Universitario Doctor Peset, Valencia, España
| | - M Llaneza
- Complejo Hospitalario Universitario de Ferrol, Ferrol, España
| | - S Llufriu
- Hospital Clínic de Barcelona, 08036 Barcelona, España
| | | | - J Meca-Lallana
- Hospital Clínico Universitario Virgen de la Arrixaca. IMIB-Arrixaca, Murcia, España
| | - M Mendibe
- Hospital Universitario de Cruces, Bilbao, España
| | | | - A Oterino
- Hospital Universitario Central de Asturias, Oviedo, España
| | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, España
| | - Ll Ramió-Torrentà
- Hospital Universitari Dr. Josep Trueta, 17007 Girona, España.,Hospital de Santa Caterina-IDIBGI, Salt, España
| | - L Romero-Pinel
- Hospital Universitario de Bellvitge , Hospitalet de Ll., España
| | - N Téllez
- Hospital Clínico Universitario de Valladolid, Valladolid, España
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Fernández O, Montalban X, Aladro Y, Alonso A, Arroyo R, Calles C, Castillo-Triviño T, Comabella M, Costa-Frossard L, Forero L, Ginestal R, Landete L, Llaneza M, Llufriu S, Martínez-Ginés ML, Meca-Lallana J, Mendibe M, Oreja-Guevara C, Oterino A, Prieto JM, Ramió-Torrentà L, Romero-Pinel L, Téllez N, Rodríguez-Antigüedad A. 13th Post-ECTRIMS Meeting: review of the new developments presented at the 2020 ECTRIMS Congress (II). Rev Neurol 2021; 72:433-442. [PMID: 34109999 DOI: 10.33588/rn.7212.2021173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION For more than a decade, after the ECTRIMS Congress, Spain has hosted the Post-ECTRIMS meeting, where neurologists with expertise in multiple sclerosis (MS) meet to review the new developments presented at the ECTRIMS. AIM This article, published in two parts, summarises the presentations of the post-ECTRIMS meeting, held online on 16 and 17 October 2020. DEVELOPMENT This second part highlights the importance of gender and age in understanding the pathology of the disease and optimising its management. The advances made in paediatric MS, from a neuropsychological and neuroimaging point of view, are presented. In turn, special attention is paid to the findings that contribute to a more personalised approach to therapy and to choosing the best treatment strategy (pharmacological and non-pharmacological) for each patient. Similarly, results related to possible strategies to promote remyelination are addressed. Although there are no major advances in the treatment of progressive forms, some quantitative methods for the classification of these patients are highlighted. In addition, the study also includes results on potential tools for assessment and treatment of cognitive deficits, and some relevant aspects observed in the spectrum of neuromyelitis optica disorders. Finally, the results of the papers considered as breaking news at the ECTRIMS-ACTRIMS are detailed. CONCLUSIONS Most of the advances presented were related to the knowledge of paediatric MS, remyelination strategies and cognitive assessment in MS.
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Affiliation(s)
- O Fernández
- Hospital Regional Universitario de Málaga, Málaga, España
| | - X Montalban
- Hospital Universitario Vall d'Hebron-CEMCAT, Barcelona, España
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, España
| | - A Alonso
- Hospital Regional Universitario de Málaga, Málaga, España
| | - R Arroyo
- Hospital Universitario Quirónsalud, Madrid, España
| | - C Calles
- Hospital Universitari Son Espases, Palma de Mallorca, España
| | | | - M Comabella
- Hospital Universitario Vall d'Hebron-CEMCAT, Barcelona, España
| | | | - L Forero
- Hospital Universitario Puerta del Mar, 11009 Cádiz, España
| | - R Ginestal
- Hospital Universitario Clínico de Madrid, Madrid, España
| | - L Landete
- Hospital Universitario Doctor Peset, Valencia, España
| | - M Llaneza
- Complejo Hospitalario Universitario de Ferrol, Ferrol, España
| | - S Llufriu
- Hospital Clínic de Barcelona, 08036 Barcelona, España
| | | | - J Meca-Lallana
- Hospital Clínico Universitario Virgen de la Arrixaca. IMIB-Arrixaca, Murcia, España
| | - M Mendibe
- Hospital Universitario de Cruces, Bilbao, España
| | | | - A Oterino
- Hospital Universitario Central de Asturias, Oviedo, España
| | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, España
| | - Ll Ramió-Torrentà
- Hospital Universitari Dr. Josep Trueta, 17007 Girona, España.,Hospital de Santa Caterina-IDIBGI, Salt, España
| | - L Romero-Pinel
- Hospital Universitario de Bellvitge , Hospitalet de Ll., España
| | - N Téllez
- Hospital Clínico Universitario de Valladolid, Valladolid, España
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Beecham AH, Amezcua L, Chinea A, Manrique CP, Rubi C, Isobe N, Lund BT, Santaniello A, Beecham GW, Burchard EG, Comabella M, Patsopoulos N, Fitzgerald K, Calabresi PA, De Jager P, Conti DV, Delgado SR, Oksenberg JR, McCauley JL. The genetic diversity of multiple sclerosis risk among Hispanic and African American populations living in the United States. Mult Scler 2020; 26:1329-1339. [PMID: 31368393 PMCID: PMC6994382 DOI: 10.1177/1352458519863764] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Substantial progress has been made toward unraveling the genetic architecture of multiple sclerosis (MS) within populations of European ancestry, but few genetic studies have focused on Hispanic and African American populations within the United States. OBJECTIVE We sought to test the relevance of common European MS risk variants outside of the major histocompatibility complex (n = 200) within these populations. METHODS Genotype data were available on 2652 Hispanics (1298 with MS, 1354 controls) and 2435 African Americans (1298 with MS, 1137 controls). We conducted single variant, pathway, and cumulative genetic risk score analyses. RESULTS We found less replication than statistical power suggested, particularly among African Americans. This could be due to limited correlation between the tested and causal variants within the sample or alternatively could indicate allelic and locus heterogeneity. Differences were observed between pathways enriched among the replicating versus all 200 variants. Although these differences should be examined in larger samples, a potential role exists for gene-environment or gene-gene interactions which alter phenotype differentially across racial and ethnic groups. Cumulative genetic risk scores were associated with MS within each study sample but showed limited diagnostic capability. CONCLUSION These findings provide a framework for fine-mapping efforts in multi-ethnic populations of MS.
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Affiliation(s)
- A H Beecham
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA/The Dr. John T. Macdonald Foundation Department of Human Genetics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - L Amezcua
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A Chinea
- San Juan MS Center, Guaynabo, Puerto Rico, USA; Universidad Central del Caribe, Bayamon, Puerto Rico, USA
| | - C P Manrique
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - C Rubi
- San Juan MS Center, Guaynabo, Puerto Rico, USA; Universidad Central del Caribe, Bayamon, Puerto Rico, USA
| | - N Isobe
- Department of Neurological Therapeutics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - B T Lund
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A Santaniello
- Department of Neurology, University of California at San Francisco, San Francisco, CA, USA
| | - G W Beecham
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA/The Dr. John T. Macdonald Foundation Department of Human Genetics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - E G Burchard
- Departments of Medicine and Bioengineering and Therapeutic Sciences, University of California at San Francisco, San Francisco, CA, USA
| | - M Comabella
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Patsopoulos
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - K Fitzgerald
- Department of Neurology and The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - P A Calabresi
- Department of Neurology and The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - P De Jager
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - D V Conti
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - S R Delgado
- Multiple Sclerosis Division, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - J R Oksenberg
- Department of Neurology, University of California at San Francisco, San Francisco, CA, USA
| | - J L McCauley
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA/The Dr. John T. Macdonald Foundation Department of Human Genetics, Miller School of Medicine, University of Miami, Miami, FL, USA
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Fernández O, Aladro Y, Arroyo R, Brieva L, Calles-Hernández MC, Carrascal P, Comabella M, Costa-Frossard L, Eichau S, García-Merino JA, Ginestal R, González I, Izquierdo G, Martínez-Ginés ML, Meca-Lallana JE, Mendibe-Bilbao MM, Oterino A, Prieto JM, Río J, Ramió-Torrentà L, Romero-Pinel L, Téllez N, Rodríguez-Antigüedad A. 12th Post-ECTRIMS Meeting: review of the novelties from the 2019 ECTRIMS Congress (II). Rev Neurol 2020; 70:417-429. [PMID: 32436209 DOI: 10.33588/rn.7011.2020122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Like every year, after the ECTRIMS Congress, renowned Spanish neurologists who are experts in multiple sclerosis presented the main novelties in research in this field at the Post-ECTRIMS Meeting. AIM To summarise the content presented at the 12th edition of the Post-ECTRIMS Meeting, which took place in September 2019 in Sevilla and is presented in two parts. DEVELOPMENT In this second part, the most recent evidence on the use of disease-modifying treatments during pregnancy is presented. Details are provided concerning the results of phase 3 clinical trials conducted to evaluate the efficacy and safety of two potential disease-modifying treatments for relapsing-remitting multiple sclerosis: ponesimod and ofatumumab. For the progressive forms, both available disease modifying treatments and others still in the research phase are reviewed. In the field of stem cell therapies, the article includes the results of the only clinical trial carried out to date comparing patients with relapsing-remitting multiple sclerosis treated with autologous haematopoietic stem cell transplantation and those treated with disease-modifying therapies. There are no important developments as regards symptomatic treatments, although the European Academy of Neurology has published a guide on palliative care. The various sources of information that collect pharmacovigilance data in the post-marketing setting are reviewed. CONCLUSIONS Patients diagnosed in recent years tend to have less severe multiple sclerosis, probably due to the fact that it is diagnosed in its milder stages together with the steady increase in the number of treatments available.
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Affiliation(s)
- O Fernández
- Instituto de Investigación Biomédica de Málaga. IBIMA, Málaga, España
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, España
| | - R Arroyo
- Hospital Quirón, Pozuelo de Alarcón, España
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, España
| | | | | | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, España
| | | | - S Eichau
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
| | - J A García-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, España
| | - R Ginestal
- Fundación Jiménez Díaz, 28040 Madrid, España
| | | | | | | | | | | | - A Oterino
- Hospital Universitario Marqués de Valdecilla, Santander, España
| | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, España
| | - J Río
- Hospitals Vall d'Hebron, 08035 Barcelona, España
| | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 Hospitalet de Ll., España
| | - N Téllez
- Hospital Clínico Universitario, 47005 Valladolid, España
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Fernandez O, Tintore M, Saiz A, Calles-Hernandez MC, Comabella M, Ramio-Torrenta L, Oterino A, Izquierdo G, Tellez N, Garcia-Merino JA, Brieva L, Arnal-Garcia C, Aladro Y, Mendibe-Bilbao MM, Meca-Lallana JE, Romero-Pinel L, Martinez-Gines ML, Arroyo R, Oreja-Guevara C, Costa-Frossard L, Carrascal P, Rodriguez-Antiguedad A. Review of the novelties presented at the 2018 ECTRIMS Congress: 11th Post-ECTRIMS Meeting (II). Rev Neurol 2019; 68:468-479. [PMID: 31132136 DOI: 10.33588/rn.6811.2019121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The Post-ECTRIMS Meeting was held for the eleventh consecutive year in October 2018 in Madrid, with the aim of analysing the advances made in multiple sclerosis that were highlighted at the latest ECTRIMS annual congress. Based on the issues discussed at this meeting, attended by the nation's foremost opinion leaders on multiple sclerosis, two review articles are presented. This second part includes the growing body of evidence confirming the safety of exposure to disease-modifying treatments in women planning a pregnancy, and the beneficial effect of breastfeeding, provided that the disease is not very active. It addresses data showing how the application of the 2017 McDonald criteria in the paediatric population has significantly improved diagnosis compared to the previous criteria. With regard to progressive multiple sclerosis, the results of neuroprotective drugs are inconclusive, but biomarkers are proposed to improve the evaluation of the therapeutic response. Studies on myelin repair treatments suggest that remyelination in multiple sclerosis is possible. Likewise, there are favourable indications for haematopoietic stem cell transplantation, provided that patients are selected appropriately. On the other hand, we also conduct a review of the similarities and differences of the recommendations in the new clinical practice guidelines. Finally, the positive results of cognitive and motor rehabilitation with the use of new technologies point to the systematic incorporation of these tools in the treatment of the disease in the near future.
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Affiliation(s)
- O Fernandez
- Hospital Regional Universitario de Malaga, Malaga, Espana
| | - M Tintore
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - A Saiz
- Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana
| | | | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | | | - A Oterino
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | | | - N Tellez
- Hospital Clinico Universitario, 47005 Valladolid, Espana
| | - J A Garcia-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, Espana
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, Espana
| | - C Arnal-Garcia
- Hospital Universitario Virgen de las Nieves, 18013 Granada, Espana
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, Espana
| | | | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 Hospitalet de Ll., Espana
| | | | - R Arroyo
- Hospital Quiron, Pozuelo de Alarcon, Espana
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7
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Fernandez O, Tintore M, Saiz A, Calles-Hernandez MC, Comabella M, Ramio-Torrenta L, Oterino A, Izquierdo G, Tellez N, Garcia-Merino JA, Brieva L, Arnal-Garcia C, Aladro Y, Mendibe-Bilbao MM, Meca-Lallana JE, Romero-Pinel L, Martinez-Gines ML, Arroyo R, Oreja-Guevara C, Costa-Frossard L, Carrascal P, Rodriguez-Antiguedad A. [Review of the novelties presented at the 2018 ECTRIMS Congress: 11th Post-ECTRIMS Meeting (I)]. Rev Neurol 2019; 68:431-441. [PMID: 31070235 DOI: 10.33588/rn.6810.2019120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The Post-ECTRIMS Meeting is an emblematic event in Spain which seeks to review and disseminate the main advances in multiple sclerosis presented at the ECTRIMS annual congress. In October 2018, the eleventh Post-ECTRIMS meeting was held in Madrid and was attended by the country's leading experts in multiple sclerosis. As a result of this meeting, we present two articles which outline the most interesting novelties discussed there. This first part includes the latest results obtained regarding the influence of modifiable and non-modifiable risk factors in multiple sclerosis, with emphasis on the progress made in the field of genetics, where the discovery of genes associated with multiple sclerosis has increased exponentially. The complexity of the immune system is addressed and some contributions are made on autoimmunity mechanisms, in which bidirectional relations are observed between immune cells and cells residing in the central nervous system, such as microglial cells and astrocytes. Biomarkers, both in serum and cerebrospinal fluid as well as in imaging, are gaining more and more attention due to their current and, above all, potential role in the diagnosis and prognosis of the disease and in the evaluation of the efficacy of treatments. Finally, the observations made regarding changes in structural and functional connectivity in patients and their relationship with clinical alterations are presented.
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Affiliation(s)
- O Fernandez
- Hospital Regional Universitario de Malaga, Malaga, Espana
| | - M Tintore
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - A Saiz
- Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana
| | | | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | | | - A Oterino
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | | | - N Tellez
- Hospital Clinico Universitario, 47005 Valladolid, Espana
| | - J A Garcia-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, Espana
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, Espana
| | - C Arnal-Garcia
- Hospital Universitario Virgen de las Nieves, 18013 Granada, Espana
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, Espana
| | | | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 Hospitalet de Ll., Espana
| | | | - R Arroyo
- Hospital Quiron, Pozuelo de Alarcon, Espana
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Leurs CE, Twaalfhoven H, Lissenberg-Witte BI, van Pesch V, Dujmovic I, Drulovic J, Castellazzi M, Bellini T, Pugliatti M, Kuhle J, Villar LM, Alvarez-Cermeño JC, Alvarez-Lafuente R, Hegen H, Deisenhammer F, Walchhofer LM, Thouvenot E, Comabella M, Montalban X, Vécsei L, Rajda C, Galimberti D, Scarpini E, Altintas A, Rejdak K, Frederiksen JL, Pihl-Jensen G, Jensen P, Khalil M, Voortman MM, Fazekas F, Saiz A, La Puma D, Vercammen M, Vanopdenbosch L, Uitdehaag B, Killestein J, Bridel C, Teunissen C. Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study. Mult Scler 2019; 26:912-923. [PMID: 31066634 PMCID: PMC7350201 DOI: 10.1177/1352458519845844] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To validate kappa free light chain (KFLC) and lambda free light chain (LFLC) indices as a diagnostic biomarker in multiple sclerosis (MS). METHODS We performed a multicenter study including 745 patients from 18 centers (219 controls and 526 clinically isolated syndrome (CIS)/MS patients) with a known oligoclonal IgG band (OCB) status. KFLC and LFLC were measured in paired cerebrospinal fluid (CSF) and serum samples. Gaussian mixture modeling was used to define a cut-off for KFLC and LFLC indexes. RESULTS The cut-off for the KFLC index was 6.6 (95% confidence interval (CI) = 5.2-138.1). The cut-off for the LFLC index was 6.9 (95% CI = 4.5-22.2). For CIS/MS patients, sensitivity of the KFLC index (0.88; 95% CI = 0.85-0.90) was higher than OCB (0.82; 95%CI = 0.79-0.85; p < 0.001), but specificity (0.83; 95% CI = 0.78-0.88) was lower (OCB = 0.92; 95% CI = 0.89-0.96; p < 0.001). Both sensitivity and specificity for the LFLC index were lower than OCB. CONCLUSION Compared with OCB, the KFLC index is more sensitive but less specific for diagnosing CIS/MS. Lacking an elevated KFLC index is more powerful for excluding MS compared with OCB but the latter is more important for ruling in a diagnosis of CIS/MS.
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Affiliation(s)
- C E Leurs
- Department of Neurology, MS Center Amsterdam, VU University Medical Center, De Boelelaan 1118, Amsterdam 1081 HZ, The Netherlands
| | - Ham Twaalfhoven
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - B I Lissenberg-Witte
- Department of Epidemiology and Biostatistics, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - V van Pesch
- Department of Neurology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Sint-Lambrechts-Woluwe, Belgium
| | - I Dujmovic
- Clinic of Neurology, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - J Drulovic
- Clinic of Neurology, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - M Castellazzi
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - T Bellini
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - M Pugliatti
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - J Kuhle
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - L M Villar
- Department of Immunology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain/ Red Española de Esclerosis Múltiple (REEM), Madrid, Spain
| | - J C Alvarez-Cermeño
- Red Española de Esclerosis Múltiple (REEM), Madrid, Spain/Department of Neurology, Hospital Ramón y Cajal, IRYICIS, Madrid, Spain
| | - R Alvarez-Lafuente
- Red Española de Esclerosis Múltiple (REEM), Madrid, Spain/Grupo de Investigación de Esclerosis Múltiple, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - H Hegen
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - F Deisenhammer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - L M Walchhofer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - E Thouvenot
- Department of Neurology, CHU Nîmes, Hôpital Caremeau, Nîmes, France/Institut de Génomique Fonctionnelle, UMR5203, Université Montpellier, Montpellier, France
| | - M Comabella
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - X Montalban
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Vécsei
- Department of Neurology, University of Szeged, Szeged, Hungary/MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - C Rajda
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - D Galimberti
- Multiple Sclerosis Centre, University of Milan, Dino Ferrari Centre, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - E Scarpini
- Multiple Sclerosis Centre, University of Milan, Dino Ferrari Centre, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - A Altintas
- Koc University, School of Medicine, Neurology Department, Istanbul, Turkey
| | - K Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - J L Frederiksen
- Department of Neurology, Rigshospitalet Glostrup and University of Copenhagen, Copenhagen, Denmark
| | - G Pihl-Jensen
- Department of Neurology, Rigshospitalet Glostrup and University of Copenhagen, Copenhagen, Denmark
| | - Peh Jensen
- Danish Multiple Sclerosis Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - M Khalil
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - M M Voortman
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - F Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - A Saiz
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - D La Puma
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - M Vercammen
- Department of Laboratory Medicine, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium
| | - L Vanopdenbosch
- Department of Neurology, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium
| | - Bmj Uitdehaag
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - C Bridel
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - C Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
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9
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Fernandez O, Tintore M, Saiz A, Calles-Hernandez MC, Comabella M, Ramio-Torrenta L, Oterino A, Izquierdo G, Tellez N, Garcia-Merino JA, Brieva L, Arnal-Garcia C, Aladro Y, Mendibe-Bilbao MM, Meca-Lallana JE, Romero-Pinel L, Ginestal R, Martinez-Gines ML, Arroyo R, Rodriguez-Antiguedad A. [Review of the novelties from the 2017 ECTRIMS Congress, presented at the 10th Post-ECTRIMS Meeting (II)]. Rev Neurol 2018; 67:50-62. [PMID: 29971758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The Post-ECTRIMS Meeting is an emblematic event in the field of multiple sclerosis in Spain. Its chief aim is bring together the country's leading specialist neurologists to analyse the main advances made in multiple sclerosis and to review the most important topics addressed at the ECTRIMS Congress. The tenth Post-ECTRIMS Meeting was held in November 2017. Over the years this event has firmly established itself as an important meeting point where experts from all over the country get together to foster communication, establish synergies and promote and enhance research ultimately aimed at improving the prognosis and quality of life of patients with multiple sclerosis. This second part addresses the different strategies for the management of patients in advanced stages of the disease and the safety of therapy in multiple sclerosis. Likewise, attention is also drawn to the areas that require further scientific and clinical evidence. In this edition, particular importance is given to multiple sclerosis in the paediatric population and ageing in the disease. At the same time emphasis is placed on the need to conduct collaborative studies and to foster greater awareness among specialists regarding the detection and management of the comorbidities in multiple sclerosis.
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Affiliation(s)
- O Fernandez
- Hospital Regional Universitario de Malaga, Malaga, Espana
| | - M Tintore
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - A Saiz
- Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana
| | | | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | | | - A Oterino
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | - G Izquierdo
- Hospital Universitario Virgen Macarena, 41003 Sevilla, Espana
| | - N Tellez
- Hospital Clinico Universitario, 47005 Valladolid, Espana
| | - J A Garcia-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, Espana
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, Espana
| | - C Arnal-Garcia
- Hospital Universitario Virgen de las Nieves, 18013 Granada, Espana
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, Espana
| | | | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 L'Hospitalet de Llobregat, Espana
| | - R Ginestal
- Fundacion Jimenez Diaz, 28040 Madrid, Espana
| | | | - R Arroyo
- Hospital Quiron, Pozuelo de Alarcon, Espana
- Complejo Hospitalario Ruber, Madrid, Espana
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10
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Fernandez O, Tintore M, Saiz A, Calles-Hernandez MC, Comabella M, Ramio-Torrenta L, Oterino A, Izquierdo G, Tellez N, Garcia-Merino JA, Brieva L, Arnal-Garcia C, Aladro Y, Mendibe-Bilbao MM, Meca-Lallana JE, Romero-Pinel L, Ginestal R, Martinez-Gines ML, Arroyo R, Rodriguez-Antiguedad A. [Review of the novelties from the 2017 ECTRIMS Congress, presented at the 10th Post-ECTRIMS Meeting (I)]. Rev Neurol 2018; 67:15-27. [PMID: 29923596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The Post-ECTRIMS Meeting is an emblematic event in the field of multiple sclerosis in Spain. Its chief aim is bring together the country's leading specialist neurologists to analyse the main advances made in multiple sclerosis and to review the most important topics addressed at the ECTRIMS Congress. The tenth Post-ECTRIMS Meeting was held in November 2017. Over the years this event has firmly established itself as an important meeting point where experts from all over the country get together to foster communication, establish synergies and promote and enhance research ultimately aimed at improving the prognosis and quality of life of patients with multiple sclerosis. This first part reports on the publication of the new European and American clinical guidelines on the use of disease-modifying treatments and the new diagnostic criteria. It also discusses the strategies for following up patients treated with disease-modifying therapies, reviews cerebral atrophy and biomarkers of neurodegeneration and neuroinflammation, and analyses the role of neuroglia in pathogenesis and treatment. The study examines the natural history of the disease, with the evidence provided by registers, and we anticipate the future thanks to the progress being made in genetics and immunology.
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Affiliation(s)
- O Fernandez
- Hospital Regional Universitario de Malaga, Malaga, Espana
| | - M Tintore
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - A Saiz
- Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana
| | | | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | | | - A Oterino
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | - G Izquierdo
- Hospital Universitario Virgen Macarena, 41003 Sevilla, Espana
| | - N Tellez
- Hospital Clinico Universitario, 47005 Valladolid, Espana
| | - J A Garcia-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, Espana
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, Espana
| | - C Arnal-Garcia
- Hospital Universitario Virgen de las Nieves, 18013 Granada, Espana
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, Espana
| | | | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 L'Hospitalet de Llobregat, Espana
| | - R Ginestal
- Fundacion Jimenez Diaz, 28040 Madrid, Espana
| | | | - R Arroyo
- Hospital Quiron, Pozuelo de Alarcon, Espana
- Complejo Hospitalario Ruber, Madrid, Espana
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11
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Quintana E, Coll C, Salavedra-Pont J, Muñoz-San Martín M, Robles-Cedeño R, Tomàs-Roig J, Buxó M, Matute-Blanch C, Villar LM, Montalban X, Comabella M, Perkal H, Gich J, Ramió-Torrentà L. Cognitive impairment in early stages of multiple sclerosis is associated with high cerebrospinal fluid levels of chitinase 3-like 1 and neurofilament light chain. Eur J Neurol 2018; 25:1189-1191. [DOI: 10.1111/ene.13687] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/22/2018] [Indexed: 11/29/2022]
Affiliation(s)
- E. Quintana
- Neuroimmunology and Multiple Sclerosis Unit [Girona Biomedical Research Institute] IDIBGI; Neurology Department; Dr. Josep Trueta University Hospital; Girona Spain
- Red Española de Esclerosis Múltiple (REEM); Madrid
- Medical Sciences Department; Faculty of Medicine; University of Girona; Girona
| | - C. Coll
- Neuroimmunology and Multiple Sclerosis Unit [Girona Biomedical Research Institute] IDIBGI; Neurology Department; Dr. Josep Trueta University Hospital; Girona Spain
| | - J. Salavedra-Pont
- Neuroimmunology and Multiple Sclerosis Unit [Girona Biomedical Research Institute] IDIBGI; Neurology Department; Dr. Josep Trueta University Hospital; Girona Spain
| | - M. Muñoz-San Martín
- Neuroimmunology and Multiple Sclerosis Unit [Girona Biomedical Research Institute] IDIBGI; Neurology Department; Dr. Josep Trueta University Hospital; Girona Spain
| | - R. Robles-Cedeño
- Neuroimmunology and Multiple Sclerosis Unit [Girona Biomedical Research Institute] IDIBGI; Neurology Department; Dr. Josep Trueta University Hospital; Girona Spain
- Red Española de Esclerosis Múltiple (REEM); Madrid
- Medical Sciences Department; Faculty of Medicine; University of Girona; Girona
| | - J. Tomàs-Roig
- Neuroimmunology and Multiple Sclerosis Unit [Girona Biomedical Research Institute] IDIBGI; Neurology Department; Dr. Josep Trueta University Hospital; Girona Spain
| | - M. Buxó
- Girona Biomedical Research Institute (IDIBGI); Girona
| | - C. Matute-Blanch
- Servei de Neurologia-Neuroimmunologia; Centre d'Esclerosi Múltiple de Catalunya (Cemcat); Institut de Recerca Vall d'Hebron (VHIR); Hospital Universitari Vall d'Hebron; Universitat Autònoma de Barcelona; Barcelona
| | - L. M. Villar
- Red Española de Esclerosis Múltiple (REEM); Madrid
- Immunology Department; IRYCIS; Hospital Ramón y Cajal; Madrid Spain
| | - X. Montalban
- Red Española de Esclerosis Múltiple (REEM); Madrid
- Servei de Neurologia-Neuroimmunologia; Centre d'Esclerosi Múltiple de Catalunya (Cemcat); Institut de Recerca Vall d'Hebron (VHIR); Hospital Universitari Vall d'Hebron; Universitat Autònoma de Barcelona; Barcelona
| | - M. Comabella
- Red Española de Esclerosis Múltiple (REEM); Madrid
- Servei de Neurologia-Neuroimmunologia; Centre d'Esclerosi Múltiple de Catalunya (Cemcat); Institut de Recerca Vall d'Hebron (VHIR); Hospital Universitari Vall d'Hebron; Universitat Autònoma de Barcelona; Barcelona
| | - H. Perkal
- Neuroimmunology and Multiple Sclerosis Unit [Girona Biomedical Research Institute] IDIBGI; Neurology Department; Dr. Josep Trueta University Hospital; Girona Spain
| | - J. Gich
- Neuroimmunology and Multiple Sclerosis Unit [Girona Biomedical Research Institute] IDIBGI; Neurology Department; Dr. Josep Trueta University Hospital; Girona Spain
- Medical Sciences Department; Faculty of Medicine; University of Girona; Girona
| | - L. Ramió-Torrentà
- Neuroimmunology and Multiple Sclerosis Unit [Girona Biomedical Research Institute] IDIBGI; Neurology Department; Dr. Josep Trueta University Hospital; Girona Spain
- Red Española de Esclerosis Múltiple (REEM); Madrid
- Medical Sciences Department; Faculty of Medicine; University of Girona; Girona
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12
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Fernandez O, Oterino A, Oreja-Guevara C, Prieto JM, Mendibe-Bilbao MM, Garcia-Merino JA, Ramio-Torrenta L, Ginestal R, Meca-Lallana JE, Romero-Pinel L, Munoz D, Oliva-Nacarino P, Calles-Hernandez MC, Izquierdo G, Martinez-Gines ML, Saiz A, Comabella M, Casanova-Estruch B, Brieva L, Arroyo R, Rodriguez-Antiguedad A. Review of the novelties from the 32nd ECTRIMS Congress, 2016, presented at the 9th Post-ECTRIMS Meeting (II). Rev Neurol 2017; 65:75-84. [PMID: 28675259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
For the ninth year in a row the Post-ECTRIMS Meeting has been held in Madrid (Spain) with the aim of presenting and discussing the hottest issues debated at the ECTRIMS Congress by renowned specialists in multiple sclerosis in our country. One outcome of this scientific activity, endorsed by the Spanish Neurology Society, is this review article, which is published in two parts. This second part reflects the current controversy over the management of multiple sclerosis, especially as regards the progressive forms and their differential diagnosis. The work presents the latest advances in remyelination, where the use of the micropillar technique in laboratory stands out, and in neuroprotection, which is reviewed through a study of the optic nerve. Anti-CD20 antibodies are a very promising development and we find ourselves before a new mechanism of action and therapeutic target in cells to which little attention has been paid to date. Another notable fact is the high correlation between the levels of neurofilaments in cerebrospinal fluid and in serum, which could make it possible to avoid the use of cerebrospinal fluid as a biological sample in future studies of biomarkers. The review also provides a preview of the advances in clinical research, which will converge in clinical practice in the future, thereby conditioning the steps that should be taken in the therapeutic management of multiple sclerosis.
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Affiliation(s)
- O Fernandez
- Hospital Regional Universitario de Malaga, Malaga, Espana
| | - A Oterino
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | | | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Espana
| | | | - J A Garcia-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, Espana
| | | | - R Ginestal
- Fundacion Jimenez Diaz, 28040 Madrid, Espana
| | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 L'Hospitalet de Llobregat, Espana
| | - D Munoz
- Hospital Alvaro Cunqueiro, Vigo, Espana
| | - P Oliva-Nacarino
- Hospital Universitario Central de Asturias, 33006 Oviedo, Espana
| | | | - G Izquierdo
- Hospital Universitario Virgen Macarena, 41003 Sevilla, Espana
| | | | - A Saiz
- Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana
| | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | | | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, Espana
| | - R Arroyo
- Hospital Quiron, Pozuelo de Alarcon, Espana
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13
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Miquel-Serra L, Duarri A, Muñoz Y, Kuebler B, Aran B, Costa C, Martí M, Comabella M, Malhotra S, Montalban X, Veiga A, Raya A. Generation of six multiple sclerosis patient-derived induced pluripotent stem cell lines. Stem Cell Res 2017; 24:155-159. [PMID: 29034884 DOI: 10.1016/j.scr.2017.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 05/19/2017] [Accepted: 06/05/2017] [Indexed: 10/19/2022] Open
Abstract
Multiple sclerosis (MS) is considered a chronic autoimmune disease of the central nervous system that leads to gliosis, demyelination, axonal damage and neuronal death. The MS disease aetiology is unknown, though a polymorphism of the TNFRSF1A gene, rs1800693, is known to confer an increased risk for MS. Using retroviral delivery of reprogramming transgenes, we generated six MS patient-specific iPSC lines with two distinct genotypes, CC or TT, of the polymorphism rs1800693. iPSC lines had normal karyotype, expressed pluripotency genes and differentiated into the three germ layers. These lines offer a good tool to study MS pathomechanisms and for drug testing.
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Affiliation(s)
- L Miquel-Serra
- Center of Regenerative Medicine in Barcelona (CMRB), Barcelona, Spain
| | - A Duarri
- Center of Regenerative Medicine in Barcelona (CMRB), Barcelona, Spain; National Stem Cell Bank-Barcelona Node, Biomolecular and Bioinformatics Resources Platform PRB2, ISCIII, CMRB, Barcelona, Spain
| | - Y Muñoz
- Center of Regenerative Medicine in Barcelona (CMRB), Barcelona, Spain
| | - B Kuebler
- Center of Regenerative Medicine in Barcelona (CMRB), Barcelona, Spain
| | - B Aran
- Center of Regenerative Medicine in Barcelona (CMRB), Barcelona, Spain; National Stem Cell Bank-Barcelona Node, Biomolecular and Bioinformatics Resources Platform PRB2, ISCIII, CMRB, Barcelona, Spain
| | - C Costa
- Department of Neurology-Neuroimmunology, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - M Martí
- Center of Regenerative Medicine in Barcelona (CMRB), Barcelona, Spain
| | - M Comabella
- Department of Neurology-Neuroimmunology, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - S Malhotra
- Department of Neurology-Neuroimmunology, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - X Montalban
- Department of Neurology-Neuroimmunology, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - A Veiga
- Center of Regenerative Medicine in Barcelona (CMRB), Barcelona, Spain; National Stem Cell Bank-Barcelona Node, Biomolecular and Bioinformatics Resources Platform PRB2, ISCIII, CMRB, Barcelona, Spain; Center for Networked Biomedical Research on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - A Raya
- Center of Regenerative Medicine in Barcelona (CMRB), Barcelona, Spain; Center for Networked Biomedical Research on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain; Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain.
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14
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Rio J, Rovira A, Blanco Y, Sainz A, Perkal H, Robles R, Ramio-Torrenta L, Diaz RM, Arroyo R, Urbaneja P, Fernandez O, Garcia-Merino JA, Reyes MP, Oreja-Guevara C, Prieto JM, Izquierdo G, Olascoaga J, Alvarez-Cermeno JC, Simon E, Pujal B, Comabella M, Montalban X. [Response to treatment with interferon beta in patients with multiple sclerosis. Validation of the Rio Score]. Rev Neurol 2016; 63:145-150. [PMID: 27439483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Different criteria have been proposed for the response to treatment with interferon beta, and the Rio Score is one of the most widely used. The aim of this study was to validate the usefulness of the Rio Score in an independent cohort. PATIENTS AND METHODS A multi-centre, prospective, longitudinal study was conducted on patients with relapsing-remitting multiple sclerosis treated with interferon beta. The patients were classified according to the presence of attacks, active lesions (new in T2 or gadolinium enhancing lesions) in magnetic resonance imaging, a confirmed increase in disability or combinations of these variables (attacks, increase on the Expanded Disability Status Scale and active lesions) after one year's treatment. Regression analysis was used in order to identify the response-predicting variables after a three-year follow-up. RESULTS The sample consisted of 249 patients with relapsing-remitting multiple sclerosis. The logistic model confirmed that the presence of two (odds ratio = 6.6; CI 95% = 2.7-16.1; p < 0.0001) or three (odds ratio = 8.5; CI 95% = 1.6-46; p < 0.01) positive variables during the first year of treatment were indicative of a significant risk of activity (attacks or progression) in the next two years. CONCLUSIONS The usefulness of the Rio Score is confirmed, in an independent cohort, as a means of identifying patients with a higher risk of developing clinical activity or progression of disability during treatment with interferon beta.
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Affiliation(s)
- J Rio
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - A Rovira
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - Y Blanco
- Hospital Clinic de Barcelona, 08036 Barcelona, Espana
| | - A Sainz
- Hospital Clinic de Barcelona, 08036 Barcelona, Espana
| | - H Perkal
- Hospital Universitari Dr. Josep Trueta, 17007 Girona, Espana
| | - R Robles
- Hospital Universitari Dr. Josep Trueta, 17007 Girona, Espana
| | | | - R M Diaz
- Hospital Universitari Son Espases, Palma de Mallorca, Espana
| | - R Arroyo
- Hospital Clinico San Carlos, 28040 Madrid, Espana
| | - P Urbaneja
- Hospital Regional Universitario Carlos Haya, Malaga, Espana
| | - O Fernandez
- Hospital Regional Universitario Carlos Haya, Malaga, Espana
| | | | - M P Reyes
- Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Espana
| | - C Oreja-Guevara
- UAM. Universidad Autonoma de Madrid. Hospital Universitario La Paz, 28046 Madrid, Espana
| | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Espana
| | - G Izquierdo
- Hospital Universitario Virgen Macarena, 41003 Sevilla, Espana
| | - J Olascoaga
- Hospital Donostia, 20014 San Sebastian, Espana
| | | | - E Simon
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - B Pujal
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - X Montalban
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
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15
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López C, Comabella M, Tintoré M, Sastre-Garriga J, Montalban X. Variations in chemokine receptor and cytokine expression during pregnancy in multiple sclerosis patients. Mult Scler 2016; 12:421-7. [PMID: 16900755 DOI: 10.1191/1352458506ms1287oa] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Although several T cell-mediated autoimmune diseases have shown a reduction in their clinical disease activity during pregnancy, the underlying mechanisms by which pregnancy causes such a beneficial effect on the disease activity are not fully understood. We performed a longitudinal study of chemokine receptors (CCR3, CCR4, CCR5, CXCR3, CXCR4) by flow cytometry in different subsets of peripheral blood mononuclear cells (PBMC) during pregnancy in multiple sclerosis (MS) patients. The levels of cytokine mRNA expression (IL-10, IFN-g) were also investigated by real-time quantitative reverse transcription polymerase chain reaction. The expression of CXCR3 by CD4 and CD8 positive T cells was decreased to a statistically significant extent during the second trimester of pregnancy. CD4 and CD8 T cells showed a statistically significant increase in the expression of CXCR4 during the third trimester of pregnancy. At the mRNA expression level, an increase in the IL-10/IFN-g ratio was observed during pregnancy, especially during the third trimester. These findings indicate immunomodulatory effects of pregnancy on the expression of chemokine receptors and cytokines, which may be related to changes in the clinical disease activity of T cell-mediated autoimmune diseases, such as MS.
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MESH Headings
- Adult
- B-Lymphocytes/metabolism
- B-Lymphocytes/physiology
- CD4-Positive T-Lymphocytes/metabolism
- CD4-Positive T-Lymphocytes/physiology
- CD8-Positive T-Lymphocytes/metabolism
- CD8-Positive T-Lymphocytes/physiology
- Female
- Gene Expression/immunology
- Humans
- Interferon-gamma/genetics
- Interleukin-10/genetics
- Killer Cells, Natural/metabolism
- Killer Cells, Natural/physiology
- Monocytes/metabolism
- Monocytes/physiology
- Multiple Sclerosis/immunology
- Pregnancy
- Pregnancy Complications/immunology
- RNA, Messenger/metabolism
- Receptors, CCR3
- Receptors, CCR4
- Receptors, CCR5/genetics
- Receptors, CCR5/metabolism
- Receptors, CXCR3
- Receptors, CXCR4/genetics
- Receptors, CXCR4/metabolism
- Receptors, Chemokine/genetics
- Receptors, Chemokine/metabolism
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Affiliation(s)
- C López
- Unitat de Neuroimmunologia Clinica, Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
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16
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Fernandez O, Rodriguez-Antiguedad A, Olascoaga J, Oreja-Guevara C, Prieto JM, Mendibe-Bilbao MM, Garcia-Merino JA, Ramio-Torrenta L, Ginestal R, Meca-Lallana JE, Romero-Pinel L, Munoz D, Saiz A, Calles-Hernandez MC, Izquierdo G, Villar LM, Oliva-Nacarino P, Arnal-Garcia C, Comabella M, Brieva L, Arroyo R, Montalban X. Review of the novelties from the 31st ECTRIMS Congress, 2015, presented at the 8th Post-ECTRIMS meeting. Rev Neurol 2016; 62:559-569. [PMID: 27270678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Renowned national specialists in multiple sclerosis (MS) met, for the eighth year in a row, to give details of the latest novelties presented at the last ECTRIMS Congress 2015, which are included in this review. One of the highlights at this Congress was the new classification of the phenotypes of MS. Both the diagnostic criteria of the neuromyelitis optica spectrum and the problems involved in the differential diagnosis derived from the lack of definition of the radiological spectrum were reviewed. The microbiota comes to the fore as a possible factor determining the disease, together with extrinsic factors such as tobacco, salt ingestion or vitamin D deficiency. Advances made in immunomodulation are driving the progress being made in the treatment of MS. Ocrelizumab is the first treatment with positive results in the primarily progressive forms and tocilizumab, a drug product for rheumatoid arthritis, stands out as a potential candidate for the treatment of neuromyelitis optica. Certain antibiotics and vitamins could also play a role in the treatment of MS. In this edition of the Congress special attention was paid to personalised therapy. To date, 11 drugs have been approved for use in Europe. There is a need for therapeutic algorithms that help us to choose the best treatment for each patient. Likewise, we need to be able to identify, in the early stages of the disease, the risk of developing disability, so as to be able to design therapeutic strategies. To do so, molecular biomarkers and other predictive tools are required. The problems that still exist in software technology in magnetic resonance hinder its application in daily clinical practice.
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Affiliation(s)
- O Fernandez
- Fundacion IMABIS, Hospital Universitario Carlos Haya, 29190 Malaga, Espana
| | | | - J Olascoaga
- Hospital Donostia, 20014 San Sebastian, Espana
| | | | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Espana
| | | | - J A Garcia-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, Espana
| | | | - R Ginestal
- Fundacion Jimenez Diaz, 28040 Madrid, Espana
| | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 L'Hospitalet de Llobregat, Espana
| | - D Munoz
- Hospital Alvaro Cunqueiro, Vigo, Espana
| | - A Saiz
- Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana
| | | | - G Izquierdo
- Hospital Universitario Virgen Macarena, 41003 Sevilla, Espana
| | | | - P Oliva-Nacarino
- Hospital Universitario Central de Asturias, 33006 Oviedo, Espana
| | - C Arnal-Garcia
- Hospital Universitario Virgen de las Nieves, 18013 Granada, Espana
| | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, Espana
| | - R Arroyo
- Hospital Quiron, Pozuelo de Alarcon, Espana
| | - X Montalban
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
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17
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Mahurkar S, Moldovan M, Suppiah V, Sorosina M, Clarelli F, Liberatore G, Malhotra S, Montalban X, Antigüedad A, Krupa M, Jokubaitis VG, McKay FC, Gatt PN, Fabis-Pedrini MJ, Martinelli V, Comi G, Lechner-Scott J, Kermode AG, Slee M, Taylor BV, Vandenbroeck K, Comabella M, Boneschi FM, King C. Response to interferon-beta treatment in multiple sclerosis patients: a genome-wide association study. Pharmacogenomics J 2016; 17:312-318. [PMID: 27001119 DOI: 10.1038/tpj.2016.20] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 11/04/2015] [Accepted: 02/12/2016] [Indexed: 01/23/2023]
Abstract
Up to 50% of multiple sclerosis (MS) patients do not respond to interferon-beta (IFN-β) treatment and determination of response requires lengthy clinical follow-up of up to 2 years. Response predictive genetic markers would significantly improve disease management. We aimed to identify IFN-β treatment response genetic marker(s) by performing a two-stage genome-wide association study (GWAS). The GWAS was carried out using data from 151 Australian MS patients from the ANZgene/WTCCC2 MS susceptibility GWAS (responder (R)=51, intermediate responders=24 and non-responders (NR)=76). Of the single-nucleotide polymorphisms (SNP) that were validated in an independent group of 479 IFN-β-treated MS patients from Australia, Spain and Italy (R=273 and NR=206), eight showed evidence of association with treatment response. Among the replicated associations, the strongest was observed for FHIT (Fragile Histidine Triad; combined P-value 6.74 × 10-6) and followed by variants in GAPVD1 (GTPase activating protein and VPS9 domains 1; combined P-value 5.83 × 10-5) and near ZNF697 (combined P-value 8.15 × 10-5).
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Affiliation(s)
- S Mahurkar
- School of Pharmacy and Medical Sciences and Sansom Institute for Health Research, University of South Australia, Frome Road, Adelaide, South Australia, Australia
| | - M Moldovan
- South Australian Health &Medical Research Institute and Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia.,Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia
| | - V Suppiah
- School of Pharmacy and Medical Sciences and Sansom Institute for Health Research, University of South Australia, Frome Road, Adelaide, South Australia, Australia
| | - M Sorosina
- Laboratory of Genetics of Complex Neurological Disorders, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - F Clarelli
- Laboratory of Genetics of Complex Neurological Disorders, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - G Liberatore
- Laboratory of Genetics of Complex Neurological Disorders, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.,Department of Neurology and Neurorehabilitation, San Raffaele Scientific Institute, Milan, Italy
| | - S Malhotra
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - X Montalban
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Antigüedad
- Servicio de Neurología, Basurto Hospital, Bilbao, Spain
| | - M Krupa
- Flinders University and Medical Centre, Adelaide, South Australia, Australia
| | - V G Jokubaitis
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Victoria, Australia
| | - F C McKay
- Centre for Immunology and Allergy Research, Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
| | - P N Gatt
- Centre for Immunology and Allergy Research, Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
| | - M J Fabis-Pedrini
- Western Australian Neuroscience Research Institute, Centre for Neuromuscular and Neurological Disorders, University of WA, Nedlands, Western Australia, Australia
| | - V Martinelli
- Laboratory of Genetics of Complex Neurological Disorders, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - G Comi
- Laboratory of Genetics of Complex Neurological Disorders, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.,Department of Neurology and Neurorehabilitation, San Raffaele Scientific Institute, Milan, Italy
| | - J Lechner-Scott
- Hunter Medical Research Institute, The University of Newcastle, Newcastle, New South Wales, Australia
| | - A G Kermode
- Western Australian Neuroscience Research Institute, Centre for Neuromuscular and Neurological Disorders, University of WA, Nedlands, Western Australia, Australia.,Institute of Immunology and Infectious Diseases, Murdoch University, Western Australia, Australia
| | - M Slee
- Flinders University and Medical Centre, Adelaide, South Australia, Australia
| | - B V Taylor
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - K Vandenbroeck
- Neurogenomiks Group, Universidad del País Vasco (UPV/EHU), Leioa, Spain.,Achucarro Basque Center for Neuroscience, Zamudio, Spain.,Ikerbasque, Basque Foundation of Science, Bilbao, Spain
| | - M Comabella
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F M Boneschi
- Laboratory of Genetics of Complex Neurological Disorders, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.,Department of Neurology and Neurorehabilitation, San Raffaele Scientific Institute, Milan, Italy
| | | | - C King
- School of Pharmacy and Medical Sciences and Sansom Institute for Health Research, University of South Australia, Frome Road, Adelaide, South Australia, Australia
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18
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Fernandez O, Alvarez-Cermeno JC, Arroyo R, Brieva L, Calles-Hernandez MC, Casanova-Estruch B, Comabella M, Garcia-Merino JA, Ginestal R, Izquierdo G, Meca-Lallana JE, Mendibe-Bilbao MM, Montalban X, Munoz-Garcia D, Olascoaga J, Oliva-Nacarino P, Oreja-Guevara C, Ramio-Torrenta L, Romero-Pinel L, Rodriguez-Antiguedad A, Saiz A, Tintore M, Grupo Post-Ectrims GPE. Review of the novelties from the 2014 ECTRIMS-ACTRIMS Joint Congress, presented at the 7th Post-ECTRIMS Meeting (II). Rev Neurol 2015; 61:271-283. [PMID: 26350778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
For the seventh year in a row the Post-ECTRIMS Meeting has been held in Madrid (Spain). Renowned specialists in multiple sclerosis and national leaders in this area have gathered once again to discuss the novelties presented at the 2014 ECTRIM-ACTRIMS World Congress. That meeting gave rise to this review, which is published in two parts. This second part shows that immunological phenomena are increasingly more present in the pathogenesis of the disease, and that the interaction between inflammation and neurodegeneration is becoming more apparent. Metabolic, mitochondrial dysfunction and oxidative stress phenomena are also involved in axonal degeneration and the experimental models open up the way to promising new therapeutic approaches for regenerative strategies. Although ambitious, inducible neural progenitor cells have become a promising alternative to the conventional treatments with stem cells, and the identification of new genetic variants of susceptibility to multiple sclerosis opens up the way to the discovery of new drugs. Reconsidering the value of old drugs and procedures would be another alternative therapeutic development.
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Affiliation(s)
- O Fernandez
- Fundacion IMABIS, Hospital Universitario Carlos Haya, 29190 Malaga, Espana
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19
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Fernandez O, Alvarez-Cermeno JC, Arroyo R, Brieva L, Calles-Hernandez MC, Casanova-Estruch B, Comabella M, Garcia-Merino JA, Ginestal R, Izquierdo G, Meca-Lallana JE, Mendibe-Bilbao MM, Montalban X, Munoz-Garcia D, Olascoaga J, Oliva-Nacarino P, Oreja-Guevara C, Ramio-Torrenta L, Romero-Pinel L, Rodriguez-Antiguedad A, Saiz A, Tintore M, Grupo Post-Ectrims GPE. [Review of the novelties from the 2014 ECTRIMS-ACTRIMS Joint Congress, presented at the 7th Post-ECTRIMS meeting (I)]. Rev Neurol 2015; 61:215-224. [PMID: 26308843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
For the seventh year in a row the Post-ECTRIMS Meeting has been held in Madrid (Spain). Renowned specialists in multiple sclerosis and national leaders in this area have gathered once again to discuss the novelties presented at the 2014 ECTRIM-ACTRIMS World Congress. That meeting gave rise to this review, which will be published in two parts. One of the main conclusions in this first part is the deeper understanding of the genetic component of multiple sclerosis that we are acquiring, although it is still insufficient unless we bear in mind its interaction with the environmental risk factors of the disease or the impact of comorbidity and healthy habits on the patients' susceptibility and prognosis. In this respect, the authors insist on the fact that, in clinical practice, the cognitive and psychiatric disorders remain under-diagnosed and are rarely taken into account in clinical research. Yet, although scarce, the evidence we have points to the possible benefits of disease-modifying drugs and alternatives to treatment with selective serotonin reuptake inhibitors. Addressing the sub-populations in multiple sclerosis and variants of the disease enhances the importance of an early accurate diagnosis in order to offer patients a safer and more personalised prognosis and treatment. Paediatric multiple sclerosis is ideal for studying the risk factors of the disease but, given its low prevalence, the use of prospective studies raises a number of doubts and there is a preference for conducting collaborative studies.
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Affiliation(s)
- O Fernandez
- Fundacion IMABIS, Hospital Universitario Carlos Haya, 29190 Malaga, Espana
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20
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Dujmovic I, Jancic J, Dobricic V, Jankovic M, Novakovic I, Comabella M, Drulovic J. Are Leber's mitochondial DNA mutations associated with aquaporin-4 autoimmunity? Mult Scler 2015. [PMID: 26209590 DOI: 10.1177/1352458515590649] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- I Dujmovic
- Clinic of Neurology, Clinical Centre of Serbia, University of Belgrade School of Medicine, Belgrade, Serbia
| | - J Jancic
- Clinic of Neurology and Psychiatry for Children and Youth, University of Belgrade School of Medicine, Belgrade, Serbia
| | - V Dobricic
- Clinic of Neurology, Clinical Centre of Serbia, Belgrade, Serbia
| | - M Jankovic
- Clinic of Neurology, Clinical Centre of Serbia, Belgrade, Serbia
| | - I Novakovic
- Institute for Human Genetics, University of Belgrade School of Medicine, Belgrade, Serbia
| | - M Comabella
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Drulovic
- Clinic of Neurology, Clinical Centre of Serbia, University of Belgrade School of Medicine, Belgrade, Serbia
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21
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Kuhle J, Disanto G, Dobson R, Adiutori R, Bianchi L, Topping J, Bestwick JP, Meier UC, Marta M, Costa GD, Runia T, Evdoshenko E, Lazareva N, Thouvenot E, Iaffaldano P, Direnzo V, Khademi M, Piehl F, Comabella M, Sombekke M, Killestein J, Hegen H, Rauch S, D’Alfonso S, Alvarez-Cermeño JC, Kleinová P, Horáková D, Roesler R, Lauda F, Llufriu S, Avsar T, Uygunoglu U, Altintas A, Saip S, Menge T, Rajda C, Bergamaschi R, Moll N, Khalil M, Marignier R, Dujmovic I, Larsson H, Malmestrom C, Scarpini E, Fenoglio C, Wergeland S, Laroni A, Annibali V, Romano S, Martínez AD, Carra A, Salvetti M, Uccelli A, Torkildsen Ø, Myhr KM, Galimberti D, Rejdak K, Lycke J, Frederiksen JL, Drulovic J, Confavreux C, Brassat D, Enzinger C, Fuchs S, Bosca I, Pelletier J, Picard C, Colombo E, Franciotta D, Derfuss T, Lindberg RLP, Yaldizli Ö, Vécsei L, Kieseier BC, Hartung HP, Villoslada P, Siva A, Saiz A, Tumani H, Havrdová E, Villar LM, Leone M, Barizzone N, Deisenhammer F, Teunissen C, Montalban X, Tintoré M, Olsson T, Trojano M, Lehmann S, Castelnovo G, Lapin S, Hintzen R, Kappos L, Furlan R, Martinelli V, Comi G, Ramagopalan SV, Giovannoni G. Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study. Mult Scler 2015; 21:1013-24. [DOI: 10.1177/1352458514568827] [Citation(s) in RCA: 196] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 11/19/2014] [Indexed: 11/15/2022]
Abstract
Background and objective: We explored which clinical and biochemical variables predict conversion from clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS) in a large international cohort. Methods: Thirty-three centres provided serum samples from 1047 CIS cases with at least two years’ follow-up. Age, sex, clinical presentation, T2-hyperintense lesions, cerebrospinal fluid (CSF) oligoclonal bands (OCBs), CSF IgG index, CSF cell count, serum 25-hydroxyvitamin D3 (25-OH-D), cotinine and IgG titres against Epstein-Barr nuclear antigen 1 (EBNA-1) and cytomegalovirus were tested for association with risk of CDMS. Results: At median follow-up of 4.31 years, 623 CIS cases converted to CDMS. Predictors of conversion in multivariable analyses were OCB (HR = 2.18, 95% CI = 1.71–2.77, p < 0.001), number of T2 lesions (two to nine lesions vs 0/1 lesions: HR = 1.97, 95% CI = 1.52–2.55, p < 0.001; >9 lesions vs 0/1 lesions: HR = 2.74, 95% CI = 2.04–3.68, p < 0.001) and age at CIS (HR per year inversely increase = 0.98, 95% CI = 0.98–0.99, p < 0.001). Lower 25-OH-D levels were associated with CDMS in univariable analysis, but this was attenuated in the multivariable model. OCB positivity was associated with higher EBNA-1 IgG titres. Conclusions: We validated MRI lesion load, OCB and age at CIS as the strongest independent predictors of conversion to CDMS in this multicentre setting. A role for vitamin D is suggested but requires further investigation.
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Affiliation(s)
- J Kuhle
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK/ Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - G Disanto
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - R Dobson
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - R Adiutori
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - L Bianchi
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - J Topping
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - JP Bestwick
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, Barts and the London School for Medicine and Dentistry, UK
| | - U-C Meier
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - M Marta
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - G Dalla Costa
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - T Runia
- Department of Neurology, Erasmus MC University Medical Center, The Netherlands
| | - E Evdoshenko
- Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia
| | - N Lazareva
- Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia
| | - E Thouvenot
- Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France
| | - P Iaffaldano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - V Direnzo
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - M Khademi
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - F Piehl
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - M Comabella
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d’Hebron (VHIR), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - M Sombekke
- Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network
| | - J Killestein
- Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network
| | - H Hegen
- Department of Neurology, Innsbruck Medical University, Austria
| | - S Rauch
- Department of Radiology, Innsbruck Medical University, Austria
| | - S D’Alfonso
- Department of Health Sciences and IRCAD, Eastern Piedmont University, Italy
| | | | - P Kleinová
- Department of Neurology, Charles University in Prague, Czech Republic
| | - D Horáková
- Department of Neurology, Charles University in Prague, Czech Republic
| | - R Roesler
- Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany
| | - F Lauda
- Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany
| | - S Llufriu
- Center for Neuroimmunology and Department of Neurology. Institut d’investigacions Biomèdiques August Pi Sunyer (IDIBAPS) – Hospital Clinic of Barcelona, Spain
| | - T Avsar
- Dr Orhan Öcalgiray Molecular Biology-Biotechnology and Genetics Research Centre, Istanbul Technical University, Turkey
| | - U Uygunoglu
- Department of Neurology, Istanbul University, Turkey
| | - A Altintas
- Department of Neurology, Istanbul University, Turkey
| | - S Saip
- Department of Neurology, Istanbul University, Turkey
| | - T Menge
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany
| | - C Rajda
- Department of Neurology, University of Szeged, Hungary
| | | | - N Moll
- Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d’histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France
| | - M Khalil
- Department of Neurology, Medical University of Graz, Austria
| | - R Marignier
- Department of Neurology, Université de Lyon, Université Claude Bernard-Lyon 1, France
| | - I Dujmovic
- Clinic of Neurology, Belgrade University School of Medicine, Serbia
| | - H Larsson
- Unit of Functional Imaging, Glostrup Hospital, University of Copenhagen, Denmark
| | - C Malmestrom
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - E Scarpini
- Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico
| | - C Fenoglio
- Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico
| | - S Wergeland
- KG Jebsen Centre for MS-Research, Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Norway
| | - A Laroni
- Department of Neurology, University of Genoa, Italy
| | - V Annibali
- Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy
| | - S Romano
- Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy
| | - AD Martínez
- Department of Neurology of Hospital Británico of Buenos Aires, Argentina
| | - A Carra
- Department of Neurology of Hospital Británico of Buenos Aires, Argentina
| | - M Salvetti
- Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy
| | - A Uccelli
- Department of Neurology, University of Genoa, Italy
| | - Ø Torkildsen
- KG Jebsen Centre for MS-Research, Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Norway
| | - KM Myhr
- Department of Neurology, University of Genoa, Italy
| | - D Galimberti
- Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico
| | - K Rejdak
- Department of Neurology, Medical University of Lublin, Poland
| | - J Lycke
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - JL Frederiksen
- Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark
| | - J Drulovic
- Clinic of Neurology, Belgrade University School of Medicine, Serbia
| | - C Confavreux
- Department of Neurology, Université de Lyon, Université Claude Bernard-Lyon 1, France
| | - D Brassat
- Department of Neurology, University of Toulouse, France
| | - C Enzinger
- Department of Neurology, Medical University of Graz, Austria
| | - S Fuchs
- Department of Neurology, Medical University of Graz, Austria
| | - I Bosca
- MS Unit, Neurology Department, La Fe University and Polytechnic Hospital, Instituto de investigación Sanitaria La Fe, Spain
| | - J Pelletier
- Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d’histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France
| | - C Picard
- Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d’histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France
| | - E Colombo
- C. Mondino National Neurological Institute, Italy
| | - D Franciotta
- C. Mondino National Neurological Institute, Italy
| | - T Derfuss
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - RLP Lindberg
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - Ö Yaldizli
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - L Vécsei
- Department of Neurology, University of Szeged, Hungary
| | - BC Kieseier
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany
| | - HP Hartung
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany
| | - P Villoslada
- Center for Neuroimmunology and Department of Neurology. Institut d’investigacions Biomèdiques August Pi Sunyer (IDIBAPS) – Hospital Clinic of Barcelona, Spain
| | - A Siva
- Department of Neurology, Istanbul University, Turkey
| | - A Saiz
- Center for Neuroimmunology and Department of Neurology. Institut d’investigacions Biomèdiques August Pi Sunyer (IDIBAPS) – Hospital Clinic of Barcelona, Spain
| | - H Tumani
- Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany
| | - E Havrdová
- Department of Neurology, Charles University in Prague, Czech Republic
| | - LM Villar
- Department of Neurology and Immunology, Hospital Ramón y Cajal, Spain
| | - M Leone
- MS Centre, SCDU Neurology, Head and Neck Department, AOU Maggiore della Carità, Italy
| | - N Barizzone
- Department of Health Sciences and IRCAD, Eastern Piedmont University, Italy
| | - F Deisenhammer
- Department of Neurology, Innsbruck Medical University, Austria
| | - C Teunissen
- Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network
| | - X Montalban
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d’Hebron (VHIR), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - M Tintoré
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d’Hebron (VHIR), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - T Olsson
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - M Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - S Lehmann
- Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France
| | - G Castelnovo
- Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France
| | - S Lapin
- Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia
| | - R Hintzen
- Department of Neurology, Erasmus MC University Medical Center, The Netherlands
| | - L Kappos
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - R Furlan
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - V Martinelli
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - G Comi
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - SV Ramagopalan
- Department of Physiology, Anatomy and Genetics and Medical Research Council Functional Genomics Unit, University of Oxford, UK
| | - G Giovannoni
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
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22
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Vidal-Jordana A, Tintoré M, Tur C, Pérez-Miralles F, Auger C, Río J, Nos C, Arrambide G, Comabella M, Galán I, Castilló J, Sastre-Garriga J, Rovira A, Montalban X. Significant clinical worsening after natalizumab withdrawal: Predictive factors. Mult Scler 2014; 21:780-5. [PMID: 25392320 DOI: 10.1177/1352458514549401] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 07/25/2014] [Indexed: 12/14/2022]
Abstract
We aimed to single out multiple sclerosis (MS) cases with poor outcome after natalizumab withdrawal and to identify predictive variables. We ascertained 47 withdrawals, and compared their pre- and post-natalizumab periods. We objectively defined significant clinical worsening after natalizumab withdrawal as a 2-step increase in Expanded Disability Status Scale (EDSS). We performed regression models. As a group, post-natalizumab annualized relapse rate (ARR) was lower in the post-natalizumab period, and there were no differences in the mean number of gadolinium (Gd)-enhancing lesions between pre- and post-natalizumab magnetic resonance imaging (MRI). Corticosteroid treatment did not change the outcomes. Eight patients (19%) presented significant clinical worsening after natalizumab withdrawal, which was predicted by a higher baseline EDSS and a 1-step EDSS increase while on natalizumab.
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Affiliation(s)
- A Vidal-Jordana
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Tintoré
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Tur
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F Pérez-Miralles
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Auger
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Río
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Nos
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Arrambide
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Comabella
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Galán
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Castilló
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Sastre-Garriga
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Rovira
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - X Montalban
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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23
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Fernandez O, Alvarez-Cermeno JC, Arnal-Garcia C, Arroyo-Gonzalez R, Brieva L, Calles-Hernandez MC, Casanova-Estruch B, Comabella M, Garcia-Merino JA, Izquierdo G, Meca-Lallana JE, Mendibe-Bilbao MM, Munoz-Garcia D, Olascoaga J, Oliva-Nacarino P, Oreja-Guevara C, Prieto JM, Ramio-Torrenta L, Romero-Pinel L, Saiz A, Rodriguez-Antiguedad A, Grupo Post-Ectrims GPE. Review of the novelties presented at the 29th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) (I). Rev Neurol 2014; 59:269-280. [PMID: 25190340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The most relevant data presented at the 29th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), held in October 2013 in Denmark, were summarised at the sixth edition of the Post-ECTRIMS Expert Meeting, held in Madrid in October 2013, resulting in this review, to be published in three parts. This first part of the Post-ECTRIMS review presents an update on gender differences in multiple sclerosis (MS) as well as new evidence on the impact of sex hormones on the disease. We should consider that there is still much to discover with regard to the genetic components of the disease. Similarly, possible infections and lifestyle habits are added as triggers of the known environmental risk factors for MS. The interaction between genetics and the environment has been increasingly implicated as a cause of susceptibility to MS. With regard to the mechanisms of inflammation, axo-glial proteins, instead of myelin proteins, may be the early antigenic targets, and B cells have been implicated in the production of cytokines toxic to oligodendrocytes. Chitinase 3-like 1 (CHI3L1) is validated as a prognostic marker of conversion to MS, and immunoglobulin M oligoclonal bands and L-selectin could be incorporated as possible measures of the risk stratification strategy in patients treated with natalizumab.
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Affiliation(s)
- O Fernandez
- Fundacion IMABIS, Hospital Universitario Carlos Haya, 29190 Malaga, Espana
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24
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Fernandez O, Arnal-Garcia C, Arroyo-Gonzalez R, Brieva L, Calles-Hernandez MC, Casanova-Estruch B, Comabella M, de Las Heras V, Garcia-Merino JA, Hernandez-Perez MA, Izquierdo G, Matas E, Meca-Lallana JE, Mendibe-Bilbao MM, Munoz-Garcia D, Olascoaga J, Oreja-Guevara C, Prieto JM, Ramio-Torrenta L, Rodriguez-Antiguedad A, Saiz A, Tellez N, Villar LM, Tintore M, Grupo Post-Ectrims GPE. Review of the novelties presented at the 28th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) (II). Rev Neurol 2013; 57:269-281. [PMID: 24008938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The most relevant data presented at the 28th edition of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) held in October 2012 in France have been summarised in the fifth edition of the Post-ECTRIMS Expert Meeting held in Madrid in October 2012. This review is the result of the meeting, which is being published in three parts. This second part of the Post-ECTRIMS review discusses the biology of recovery and remyelination in multiple sclerosis (MS) as well as the different repair and endogenous and exogenous remyelination strategies currently being evaluated based on the fact that resident microglia and oligodendroglial progenitor cells have been implicated in the remyelination process. This review also discusses the current state and future use of biomarkers in MS and proposes as markers of neurodegeneration the following: T2 lesion volume and brain atrophy using MRI and the loss of the ganglion cell layer as assessed by optical coherence tomography. A greater future utility for double inversion recovery (DIR) sequences is proposed to correlate cognitive impairment with MS impairment, given its higher diagnostic yield in locating and defining cortical lesions. The availability of novel biomarkers in the future requires strict validation. In this context, this paper proposes possible areas of action to improve the current situation and also presents the latest research results in identifying potential candidates with useful diagnostic characteristics, prognostic characteristics, treatment responses, and safety procedures.
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Affiliation(s)
- O Fernandez
- Fundacion IMABIS, Hospital Universitario Carlos Haya, 29190 Malaga, Espana.
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25
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Hegen H, Millonig A, Bertolotto A, Comabella M, Giovanonni G, Guger M, Hoelzl M, Khalil M, Killestein J, Lindberg R, Malucchi S, Mehling M, Montalban X, Polman CH, Rudzki D, Schautzer F, Sellebjerg F, Sørensen PS, Deisenhammer F. Early detection of neutralizing antibodies to interferon-beta in multiple sclerosis patients: binding antibodies predict neutralizing antibody development. Mult Scler 2013; 20:577-87. [PMID: 24009164 DOI: 10.1177/1352458513503597] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Neutralizing antibodies (NAb) affect efficacy of interferon-beta (IFN-b) treatment in multiple sclerosis (MS) patients. NAbs evolve in up to 44% of treated patients, usually between 6-18 months on therapy. OBJECTIVES To investigate whether early binding antibody (BAb) titers or different IFN-b biomarkers predict NAb evolution. METHODS We included patients with MS or clinically isolated syndrome (CIS) receiving de novo IFN-b treatment in this prospective European multicenter study. Blood samples were collected at baseline, before and after the first IFN-b administration, and again after 3, 12 and 24 months on that therapy; for determination of NAbs, BAbs, gene expression of MxA and protein concentrations of MMP-9, TIMP-1, sTRAIL, CXCL-10 and CCL-2. RESULTS We found that 22 of 164 (13.4%) patients developed NAbs during a median time of 23.8 months on IFN-b treatment. Of these patients, 78.9% were BAb-positive after 3 months. BAb titers ≥ 1:2400 predicted NAb evolution with a sensitivity of 74.7% and a specificity of 98.5%. Cross-sectionally, MxA levels were significantly diminished in the BAb/NAb-positive samples; similarly, CXCL-10 and sTRAIL concentrations in BAb/NAb-positive and BAb-positive/NAb-negative samples, respectively, were also diminished compared to BAb/NAb-negative samples. CONCLUSIONS BAb titers reliably predict NAbs. CXCL-10 is a promising sensitive biomarker for IFN-b response and its abrogation by anti-IFN-b antibodies.
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Affiliation(s)
- H Hegen
- Department of Neurology, Innsbruck Medical University, Austria
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26
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Malhotra S, Castilló J, Negrotto L, Merino-Zamorano C, Montaner J, Vidal-Jordana A, Montalban X, Comabella M. TRPM4 mRNA expression levels in peripheral blood mononuclear cells from multiple sclerosis patients. J Neuroimmunol 2013; 261:146-8. [PMID: 23796873 DOI: 10.1016/j.jneuroim.2013.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 05/23/2013] [Accepted: 05/28/2013] [Indexed: 11/28/2022]
Abstract
Recent studies have suggested a role of the cation channel TRPM4 in mediating neurodegeneration in experimental autoimmune encephalomyelitis and multiple sclerosis (MS). We aimed to extrapolate central nervous system findings to the blood compartment by determining TRPM4 expression in peripheral blood mononuclear cells from 12 healthy controls (HC) and 64 untreated MS patients. TRPM4 mRNA expression levels were comparable between HC and MS patients with primary progressive MS (n=17), secondary progressive MS (n=19), and relapsing-remitting MS during clinical remission (n=21) and relapses (n=7). These findings do not support a role of TRPM4 in the peripheral blood compartment of MS patients.
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Affiliation(s)
- S Malhotra
- Department of Neurology-Neuroimmunology, Centre d'Esclerosi Múltiple de Catalunya, Cemcat, Hospital Universitari Vall d´Hebron (HUVH), Barcelona, Spain
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27
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Malhotra S, Morcillo-Suárez C, Nurtdinov R, Rio J, Sarro E, Moreno M, Castilló J, Navarro A, Montalban X, Comabella M. Roles of the ubiquitin peptidase USP18 in multiple sclerosis and the response to interferon-β treatment. Eur J Neurol 2013; 20:1390-7. [PMID: 23700969 DOI: 10.1111/ene.12193] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 04/16/2013] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE Ubiquitin specific peptidase 18 (USP18) is a deubiquitinating enzyme that functions as a negative regulator of the type I interferon (IFN) signalling pathway and is specifically induced by type I IFNs. In the present study, previous observations by our group were expanded suggesting an implication of USP18 in multiple sclerosis (MS) based on the finding of a deficient expression of the gene in peripheral blood mononuclear cells from MS patients compared with healthy controls. METHODS Two polymorphisms, rs2542109 (intronic) and rs9618216 (promoter), were genotyped in a cohort of 691 relapse-onset MS patients and 1028 healthy controls and in 225 MS patients treated with IFNβ and classified into responders and non-responders after 2 years of treatment according to clinical criteria. Correlations between genotypes and expression levels for USP18 and its target ISG15 were performed by real-time polymerase chain reaction. RESULTS Two USP18 haplotypes were significantly associated with MS, TG and CG. Additional experiments revealed that CG carriers were characterized by lower USP18 gene expression levels in peripheral blood mononuclear cells and higher clinical disease activity. Finally, AA homozygosis for the intronic polymorphism rs2542109 was associated with the responder phenotype; however, USP18 expression levels induced by IFNβ did not differ amongst MS patients carrying different rs2542109 genotypes. CONCLUSIONS Altogether, these results point to a role of USP18 in MS pathogenesis and the therapeutic response to IFNβ.
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Affiliation(s)
- S Malhotra
- Servei de Neurologia/Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (CEM-Cat), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
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28
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Bustamante MF, Rio J, Castro Z, Sánchez A, Montalban X, Comabella M. Cellular immune responses in multiple sclerosis patients treated with interferon-beta. Clin Exp Immunol 2013; 171:243-6. [PMID: 23379429 DOI: 10.1111/cei.12016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2012] [Indexed: 11/29/2022] Open
Abstract
We investigated cellular immune responses at baseline in peripheral blood mononuclear cells (PBMC) of patients with multiple sclerosis (MS) treated with interferon (IFN)-β and classified into responders and non-responders according to clinical response criteria. Levels for IFN-γ, interleukin (IL)-17A, IL-17F, IL-10 and IL-4 were determined in activated PBMC of 10 responders, 10 non-responders and 10 healthy controls by cytometric bead arrays. Cytokine levels in cell culture supernatants were similar between responders and non-responders, and comparable to those obtained in healthy controls. These findings do not support differential cellular immune responses in PBMC at baseline between IFN-β responders and non-responders.
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Affiliation(s)
- M F Bustamante
- Centre d'Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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29
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Comabella M, Rentzsch K, Río J, Bustamante M, Borowski K, Stoecker W, Montalban X. Treatment with interferon-beta does not induce anti-nuclear and anti-neuronal serum autoantibodies in multiple sclerosis patients. J Neuroimmunol 2013. [DOI: 10.1016/j.jneuroim.2012.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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30
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Malhotra S, Castilló J, Bustamante MF, Vidal-Jordana A, Castro Z, Montalban X, Comabella M. SIGLEC1 and SIGLEC7 expression in circulating monocytes of patients with multiple sclerosis. Mult Scler 2012; 19:524-31. [DOI: 10.1177/1352458512458718] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Sialic acid binding immunoglobulin-like lectins (Siglecs) are cell surface receptors that recognize sialic acids and may attenuate immune responses and reduce inflammation. Objective: The purpose of this study was to investigate the role of two members of the Siglec family, SIGLEC1 and SIGLEC7, in the clinical course and disease activity of patients with multiple sclerosis (MS). Methods: SIGLEC1 and SIGLEC7 expression was determined by flow cytometry in the blood monocytes of 16 healthy controls and 55 untreated MS patients (13 primary progressive MS (PPMS) patients, 13 secondary progressive MS (SPMS) patients and 29 relapsing–remitting MS (RRMS) patients (18 during clinical remission and 11 during relapse)). Results: SIGLEC1 expression by CD14+ monocytes was significantly increased in MS patients compared with controls ( p=0.025 for percentage of positive cells; p=0.007 for mean fluorescence intensity (MFI)). Stratification of patients into different clinical forms revealed increased SIGLEC1 expression in patients with progressive forms of the disease, particularly in those with PPMS ( p=0.003 for percentage of positive cells and p=0.001 for MFI when compared with controls; p=0.031 for percentage of positive cells when compared with RRMS patients). Both inflammatory and resident monocytes contributed to the increase in SIGLEC1 expression observed in PPMS patients. SIGLEC7 expression was significantly up-regulated in blood monocytes from RRMS during relapse compared with patients during clinical remission ( p=0.001 for MFI). Conclusions: These findings suggest roles for SIGLEC1 in the chronic progressive phases of MS and for SIGLEC7 in acute disease activity.
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Affiliation(s)
- S Malhotra
- Centre d’Esclerosi Múltiple de Catalunya, Hospital Universitari Vall d’Hebron, Spain
| | - J Castilló
- Centre d’Esclerosi Múltiple de Catalunya, Hospital Universitari Vall d’Hebron, Spain
| | - MF Bustamante
- Centre d’Esclerosi Múltiple de Catalunya, Hospital Universitari Vall d’Hebron, Spain
| | - A Vidal-Jordana
- Centre d’Esclerosi Múltiple de Catalunya, Hospital Universitari Vall d’Hebron, Spain
| | - Z Castro
- Centre d’Esclerosi Múltiple de Catalunya, Hospital Universitari Vall d’Hebron, Spain
| | - X Montalban
- Centre d’Esclerosi Múltiple de Catalunya, Hospital Universitari Vall d’Hebron, Spain
| | - M Comabella
- Centre d’Esclerosi Múltiple de Catalunya, Hospital Universitari Vall d’Hebron, Spain
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31
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Costa C, Arrambide G, Tintore M, Castillo J, Sastre-Garriga J, Tur C, Rio J, Saiz A, Vidal-Jordana A, Auger C, Nos C, Rovira A, Comabella M, Horga A, Montalban X. Value of NMO-IgG determination at the time of presentation as CIS. Neurology 2012; 78:1608-11. [DOI: 10.1212/wnl.0b013e3182563b32] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Lopez de Lapuente A, Alloza I, Goertsches R, Zettl UK, Urcelay E, Arroyo R, Comabella M, Montalban X, Antigüedad A, Vandenbroeck K. Analysis of the IL28RA locus as genetic risk factor for multiple sclerosis. J Neuroimmunol 2012; 245:98-101. [PMID: 22386267 DOI: 10.1016/j.jneuroim.2012.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 01/24/2012] [Accepted: 02/06/2012] [Indexed: 01/07/2023]
Abstract
Recently, we reported an association between a SNP in IL28RA and MS. Here, we performed a fine-mapping of the IL28RA locus by genotyping 10 haplotype-tagging SNPs in a Basque-Spanish population. In addition, based on shared genetic risk loci between autoimmune diseases, a psoriasis-associated SNP located at this locus, rs4649203, was genotyped in four independent populations, comprising a total of 2582 cases and 2614 controls. We did not find any consistent association between IL28RA and MS in these populations, suggesting that, although it may play a role in other autoimmune diseases, this gene is unlikely of general relevance to MS pathogenesis.
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Río J, Tintoré M, Sastre-Garriga J, Nos C, Castilló J, Tur C, Comabella M, Montalban X. Change in the clinical activity of multiple sclerosis after treatment switch for suboptimal response. Eur J Neurol 2012; 19:899-904. [PMID: 22289050 DOI: 10.1111/j.1468-1331.2011.03648.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Therapy for multiple sclerosis (MS) has a partial efficacy, and a significant proportion of treated patients will develop a suboptimal response with first-line disease-modifying drugs (DMD). Therapy switch in patients with MS can be a strategy after a treatment failure. We studied the change in clinical activity after switching of first-line DMD because of a treatment failure. METHODS Relapsing-remitting multiple sclerosis (RRMS) patients treated with interferon-beta (IFNB) or glatiramer acetate (GA) were divided into (i) patients without change in DMD, (ii) patients with a change in DMD because of a poor response, and (iii) those with a change in DMD without relation with response. Annualized relapse rate (ARR) and relapse-free proportions were analyzed. RESULTS We identified 923 patients with RRMS. Of the 180 who experienced a change because of suboptimal response, 90 switched to another first-line DMT, 38 to mitoxantrone, and 52 to natalizumab. Median ARR in the pre-DMD period on first DMD and second DMD was the following: 1, 1, and 0 for switchers from IFNB to another IFNB (P = 0.0001); 0.67, 1, and 0 for switchers from GA to IFNB (P = 0.01); 1, 1, and 0 for switchers from an IFNB to GA (P = 0.02); 1.1, 1.5, 0.2 for switchers from IFNB or GA to mitoxantrone (P = 0.0001); 0.9, 1, 0 for switchers from IFNB or GA to natalizumab (P = 0.0001). CONCLUSIONS In patients with RRMS who have a poor response, switch to another DMD may reduce the clinical activity of the disease.
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Affiliation(s)
- J Río
- Hospital Universitari Vall d'Hebron. Barcelona. Spain.
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Cantó E, Reverter F, Morcillo-Suárez C, Matesanz F, Fernández O, Izquierdo G, Vandenbroeck K, Rodríguez-Antigüedad A, Urcelay E, Arroyo R, Otaegui D, Olascoaga J, Saiz A, Navarro A, Sanchez A, Domínguez C, Caminero A, Horga A, Tintoré M, Montalban X, Comabella M. Chitinase 3-like 1 plasma levels are increased in patients with progressive forms of multiple sclerosis. Mult Scler 2011; 18:983-90. [DOI: 10.1177/1352458511433063] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Chitinase 3-like 1 (CHI3L1) is upregulated in a wide variety of inflammatory conditions. Recent studies have pointed to a role of CHI3L1 in multiple sclerosis (MS) pathogenesis. Objective: The objective of this study was to investigate the role of plasma CHI3L1 in MS clinical course and disease activity and to evaluate the effect of interferon-beta (IFNβ) treatment on protein levels. Methods: Plasma CHI3L1 levels were determined by ELISA in 57 healthy controls (HC), 220 untreated MS patients [66 primary progressive MS patients (PPMS), 30 secondary progressive MS patients (SPMS), and 124 relapsing–remitting MS patients (RRMS), 94 during clinical remission and 30 during relapse], and 32 MS patients receiving IFNβ treatment. A polymorphism of the CHI3L1 gene, rs4950928, was genotyped in 3274 MS patients and 3483 HC. Results: Plasma CHI3L1 levels were significantly increased in patients with progressive forms of MS compared with RRMS patients and HC. CHI3L1 levels were similar between RRMS patients in relapse and remission. A trend towards decreased CHI3L1 levels was observed in IFNβ-treated patients. Allele C of rs4950928 was significantly associated with PPMS patients and with higher plasma CHI3L1 levels. Conclusions: These findings point to a role of CHI3L1 in patients with progressive forms of MS, particularly in those with PPMS.
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Affiliation(s)
- E Cantó
- Centre d’Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d’Hebron (HUVH), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F Reverter
- Departament d’Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - C Morcillo-Suárez
- Institute of Evolutionary Biology (UPF-CSIC), PRBB, Barcelona, Spain
- National Institute for Bioinformatics, Universitat Pompeu Fabra, Barcelona, Spain
| | - F Matesanz
- Instituto de Parasitología y Biomedicina López Neyra, Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - O Fernández
- Servicio de Neurología, Instituto de Neurociencias Clínicas, Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - G Izquierdo
- Unidad de Esclerosis Múltiple, Hospital Virgen Macarena, Sevilla, Spain
| | - K Vandenbroeck
- Neurogenomiks Group, Universidad del País Vasco (UPV/EHU), Leioa, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | | | - E Urcelay
- Servicio de Inmunología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - R Arroyo
- Unidad de Esclerosis Múltiple. Servicio de Neurología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - D Otaegui
- Multiple Sclerosis Unit, Biodonostia Institute, San Sebastián, Spain
| | - J Olascoaga
- Multiple Sclerosis Unit, Biodonostia Institute, San Sebastián, Spain
| | - A Saiz
- Service of Neurology, Hospital Clinic and Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
| | - A Navarro
- National Institute for Bioinformatics, Universitat Pompeu Fabra, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - A Sanchez
- Unitat d’Estadística i Bioinformàtica, Institut de Recerca, HUVH, Barcelona, Spain
| | - C Domínguez
- Molecular Biology and Biochemistry Research Center for Nanomedicine, Hospital Universitari Vall d’Hebron (HUVH), Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - A Caminero
- Centre d’Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d’Hebron (HUVH), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Horga
- Centre d’Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d’Hebron (HUVH), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Tintoré
- Centre d’Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d’Hebron (HUVH), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - X Montalban
- Centre d’Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d’Hebron (HUVH), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Comabella
- Centre d’Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d’Hebron (HUVH), Universitat Autònoma de Barcelona, Barcelona, Spain
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Caminero A, Comabella M, Montalban X. Role of tumour necrosis factor (TNF)-α and TNFRSF1A R92Q mutation in the pathogenesis of TNF receptor-associated periodic syndrome and multiple sclerosis. Clin Exp Immunol 2011; 166:338-45. [PMID: 22059991 PMCID: PMC3232381 DOI: 10.1111/j.1365-2249.2011.04484.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2011] [Indexed: 12/31/2022] Open
Abstract
It has long been known that tumour necrosis factor (TNF)/TNFRSF1A signalling is involved in the pathophysiology of multiple sclerosis (MS). Different genetic and clinical findings over the last few years have generated renewed interest in this relationship. This paper provides an update on these recent findings. Genome-wide association studies have identified the R92Q mutation in the TNFRSF1A gene as a genetic risk factor for MS (odds ratio 1·6). This allele, which is also common in the general population and in other inflammatory conditions, therefore only implies a modest risk for MS and provides yet another piece of the puzzle that defines the multiple genetic risk factors for this disease. TNFRSF1A mutations have been associated with an autoinflammatory disease known as TNF receptor-associated periodic syndrome (TRAPS). Clinical observations have identified a group of MS patients carrying the R92Q mutation who have additional TRAPS symptoms. Hypothetically, the co-existence of MS and TRAPS or a co-morbidity relationship between the two could be mediated by this mutation. The TNFRSF1A R92Q mutation behaves as a genetic risk factor for MS and other inflammatory diseases, including TRAPS. Nevertheless, this mutation does not appear to be a severity marker of the disease, neither modifying the clinical progression of MS nor its therapeutic response. An alteration in TNF/TNFRS1A signalling may increase proinflammatory signals; the final clinical phenotype may possibly be determined by other genetic or environmental modifying factors that have not yet been identified.
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Affiliation(s)
- A Caminero
- Centre d'Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
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Malhotra S, Morcillo-Suárez C, Brassat D, Goertsches R, Lechner-Scott J, Urcelay E, Fernández O, Drulovic J, García-Merino A, Martinelli Boneschi F, Chan A, Vandenbroeck K, Navarro A, Bustamante MF, Río J, Akkad DA, Giacalone G, Sánchez AJ, Leyva L, Alvarez-Lafuente R, Zettl UK, Oksenberg J, Montalban X, Comabella M. IL28B polymorphisms are not associated with the response to interferon-β in multiple sclerosis. J Neuroimmunol 2011; 239:101-4. [PMID: 21889215 DOI: 10.1016/j.jneuroim.2011.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2011] [Revised: 08/04/2011] [Accepted: 08/05/2011] [Indexed: 01/09/2023]
Abstract
Recent studies have revealed an association between interleukin 28B (IL28B) and response to IFN-alpha treatment in hepatitis C patients. Here we investigated the influence of IL28B polymorphisms in the response to interferon-beta (IFNβ) in multiple sclerosis (MS) patients. We genotyped two SNPs of the IL28B gene (rs8099917 and rs12979860) in 588 MS patients classified into responders (n=281) and non-responders (n=307) to IFNβ. Combined analysis of the study cohorts showed no significant associations between SNPs rs8099917 and rs12979860 and the response to treatment. These findings do not support a role of IL28B polymorphisms in the response to IFNβ in MS patients.
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Affiliation(s)
- S Malhotra
- Centre d'Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain
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Martínez-Rodríguez JE, López-Botet M, Munteis E, Rio J, Roquer J, Montalban X, Comabella M. Natural killer cell phenotype and clinical response to interferon-beta therapy in multiple sclerosis. Clin Immunol 2011; 141:348-56. [PMID: 21992960 DOI: 10.1016/j.clim.2011.09.006] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 09/05/2011] [Accepted: 09/06/2011] [Indexed: 01/09/2023]
Abstract
CD56(bright) NK cells, which may play a role in immunoregulation, are expanded in multiple sclerosis (MS) patients treated with immunomodulatory therapies such as daclizumab and interferon-beta (IFNβ). Yet, whether this NK cell subset is directly involved in the therapeutic effect is unknown. As NK receptor (NKR) expression by subsets of NK cells and CD8+ T lymphocytes is related to MS clinical course, we addressed whether CD56(bright) NK cells and NKR in IFNβ-treated MS patients differ according to the clinical response. IFNβ was associated to lower LILRB1+ and KIR+NK cells, and higher NKG2A+NK cell proportions, an immunophenotypic pattern mainly found in responders. After IFNβ treatment, a CD56(bright) NK cell expansion was significantly related to a positive clinical response. Our results reveal that IFNβ may promote in responders changes in the NK cell immunophenotype, corresponding to the profile found at early maturation stages of this lymphocyte lineage.
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Affiliation(s)
- J E Martínez-Rodríguez
- Neurology Service, Parc de Salut Mar, IMIM (Hospital del Mar Research Institute), Barcelona, Spain.
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Raguer N, Serrano I, Garcia B, Gratacos M, Seoane J, Comabella M, Gamez J. W1.2 Multifocal motor neuropathy. Clinical and electrophysiological long term evolution in a group of patients. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60019-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vosslamber S, van der Voort LF, van den Elskamp IJ, Heijmans R, Aubin C, Uitdehaag BMJ, Crusius JBA, van der Pouw Kraan TCTM, van der PouwKraan TCTM, Comabella M, Montalban X, Hafler DA, De Jager PL, Killestein J, Polman CH, Verweij CL. Interferon regulatory factor 5 gene variants and pharmacological and clinical outcome of Interferonβ therapy in multiple sclerosis. Genes Immun 2011; 12:466-72. [PMID: 21471993 DOI: 10.1038/gene.2011.18] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Interferon-β (IFNβ) therapy is effective in approximately half of the patients with relapsing-remitting multiple sclerosis (RRMS). Clinical non-responders were characterized by an increased expression of IFN response genes before the start of therapy, and a lack of a pharmacologically induced increase in IFN response gene activity. Because Interferon Regulatory Factor 5 (IRF5) is a master regulator of IFN-activity, we carried out a candidate gene study of IRF5 gene variants in relation to the pharmacological and clinical response upon IFNβ treatment. We found that patients with the IRF5 rs2004640-TT and rs47281420-AA genotype exerted a poor pharmacological response to IFNβ compared with patients carrying the respective G-alleles (P=0.0006 and P=0.0023, respectively). Moreover, patients with the rs2004640-TT genotype developed more magnetic resonance imaging (MRI)-based T2 lesions during IFNβ treatment (P=0.003). Accordingly, an association between MRI-based non-responder status and rs2004640-TT genotype was observed (P=0.010). For the rs4728142-AA genotype a trend of an association with more T2 lesions during IFNβ treatment and MRI-based non-responder status was observed (P=0.103 and P=0.154, respectively). The clinical relevance of the rs2004640-TT genotype was validated in an independent cohort wherein a shorter time to first relapse was found (P=0.037). These findings suggest a role for IRF5 gene variation in the pharmacological and clinical outcome of IFNβ therapy that might have relevance as biomarker to predict the response to IFNβ in multiple sclerosis.
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Affiliation(s)
- S Vosslamber
- VU University Medical Center, Department of Pathology, Amsterdam, The Netherlands.
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Horga A, Castillo J, Rio J, Tintore M, Auger C, Sastre-Garriga J, Edo MC, Perez-Miralles F, Tur C, Nos C, Huerga E, Comabella M, Rovira A, Montalban X. An observational study of the effectiveness and safety of natalizumab in the treatment of multiple sclerosis. Rev Neurol 2011; 52:321-330. [PMID: 21387248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM To analyse the safety and effectiveness of natalizumab in the treatment of multiple sclerosis in a real clinical practice setting and according to the approved indications. PATIENTS AND METHODS All patients with multiple sclerosis treated with natalizumab in our centre were evaluated. The clinical and radiological disease activity during the first year of treatment was analyzed in patients who received at least 12 doses of the drug. The data regarding moderate and severe adverse events in the entire study sample was also evaluated. RESULTS A total of 112 patients were included in the study, of which 110 had been previously treated with other drugs and 76 had received at least 12 doses of natalizumab. In this group, the annualized relapse rate was reduced by 89% compared to the preceding year and 80% of patients were free from relapses after one year of treatment. Nine percent of patients exhibited 3-month confirmed disability progression. At month 12, the mean number of gadolinium-enhancing lesions on brain MRI was decreased by 99% compared to the pre-treatment MRI. During the first year of treatment, 76% of patients remained free from clinical activity and 33% remained free from both clinical and radiological disease activity. Twenty-nine percent of patients had at least one moderate or severe adverse event, which led to treatment discontinuation in 6%. Four percent of patients experienced immediate hypersensitivity reactions. CONCLUSION This study suggests that natalizumab is effective in reducing disease activity in patients with relapsing multiple sclerosis and inadequate response to other therapies, with a favorable risk-benefit ratio.
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Affiliation(s)
- A Horga
- Centre d'esclerosi multiple de Catalunya, Barcelona, Espana.
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Fernandez-Fernandez O, Alvarez-Cermeno JC, Arbizu-Urdiain T, Arroyo-Gonzalez R, Arnal-Garcia C, Casanova-Estruch B, Calles-Hernandez MC, Coret-Ferrer F, Comabella M, Garcia-Merino JA, de Las Heras V, Izquierdo G, Meca-Lallana JE, Munoz-Garcia D, Olascoaga J, Oreja-Guevara C, Prieto JM, Rodriguez-Antiguedad A, Tintore M, Montalban X. [Review of the novelties presented at the 26th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) (II)]. Rev Neurol 2011; 52:289-299. [PMID: 21341224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The new insights presented at European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), held in the city of Gothenburg, Sweden, in October 2010, have been summarized at the third edition of Post-ECTRIMS meeting held in Madrid in November 2010. Encouraging findings from the 5-years follow up extension from PreCISe study confirm the benefit of early treatment with glatiramer acetate in patients with clinically isolated syndromes (CIS) against the conversion to clinically definitive multiple sclerosis and cerebral atrophy with an adequate safety and tolerability. Regarding treatment decision with escalation or induction therapy, different strategies have been proposed depending on to the characteristics of the individual patient with CIS. Findings from several of the reported studies have revealed the favorable role of combined therapy on relapse rate but not on magnetic resonance parameters in patients with recurrent-remittent multiple sclerosis. Novel therapies such as alemtuzumab, daclizumab ofatutumab or ocrelizumab have shown promising findings regarding efficacy. Nevertheless, safety findings for these emerging therapies have detected some severe adverse events, the main ones being potentially fatal opportunistic infections such as progressive multifocal leukoencephalopathy (PML) caused by JC virus, mainly linked to natalizumab treatment. In this regard, clinicians will face the assessment of he benefit-risk ratio when deciding on the adequate treatment for each patient in the clinical setting. In this regard, determination of antibodies to JC virus by a novel two-step enzyme-linked immunosorbent assay (ELISA) could provide clinicians with a useful tool to stratify PML risk in patients. Regarding non pharmacologic therapies, behavioral intervention has emerged as an effective therapy in the treatment of depression in multiple sclerosis, showing additional benefits on fatigue, disability and adherence to treatment.
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Tintore M, Rovira A, Arrambide G, Mitjana R, Río J, Auger C, Nos C, Edo MC, Castilló J, Horga A, Perez-Miralles F, Huerga E, Comabella M, Sastre-Garriga J, Montalban X. Brainstem lesions in clinically isolated syndromes. Neurology 2011; 75:1933-8. [PMID: 21098409 DOI: 10.1212/wnl.0b013e3181feb26f] [Citation(s) in RCA: 138] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Number of baseline lesions has been shown to predict future attacks and disability in clinically isolated syndromes (CIS). OBJECTIVE To investigate the role of baseline infratentorial lesions in long-term prognosis. METHODS Subjects were included in a prospective cohort of patients with CIS. Patients underwent brain MRI within 3 months after CIS onset. Number and location of lesions at baseline were prospectively studied. Retrospective scan analysis was conducted to specifically look at number and location of infratentorial lesions. We analyzed the time to a second attack and to reach EDSS 3.0. RESULTS We included 246 patients with CIS followed for a median of 7.7 years. Patients with infratentorial lesions had both a higher risk of conversion (71.4% vs 29.6%; hazard ratio [HR] 3.3; 95% confidence interval [CI] 2.2-4.8; p < 0.001) and of developing disability (32.5% vs 12.4%; HR 2.4; 95% CI 1.3-4.3; p = 0.003). Presence of at least one cerebellar lesion was associated with an increased risk of conversion (HR 2.4; 95% CI 1.3-4.5; p = 0.007). Presence of at least one brainstem lesion increased both the risk of conversion (HR 2.9; 95% CI 1.7-5.0; p < 0.001) and disability (HR 2.5; 95% CI 1.1-5.4; p = 0.026). Broken down into number of lesions, the presence of infratentorial lesions increased both the risk of conversion (83% vs 61%) (HR 22.3; 95% CI 9.7-51.1; p < 0.001) and of reaching EDSS 3.0 (40% vs 19%) (HR 3.2; 95% CI 1.3-7.4; p = 0.008) only in patients with 9 or more lesions. CONCLUSIONS Presence of infratentorial lesions increases the risk for disability. Brainstem rather than cerebellar lesions may be responsible for poor prognosis.
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Affiliation(s)
- M Tintore
- Unitat de Neuroimmunologia Clinica (UNIC), Edif. Escola d'infermeria planta 2, Hospital Universitari Vall d'Hebron, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain.
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Comabella M, Montalban X, Horga A, Messmer B, Kakalacheva K, Strowig T, Caballero E, Münz C, Lünemann J. Antiviral immune response in patients with multiple sclerosis and healthy siblings. Mult Scler 2010; 16:355-8. [PMID: 20203149 DOI: 10.1177/1352458509357066] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this study was to determine the immune responses to candidate viral triggers of multiple sclerosis in patients and healthy siblings raised in the same family household. Virus antigen-specific IgG responses to Epstein-Barr virus-derived gene products as well as to human herpersvirus-6, human cytomegalovirus, and measles virus were evaluated in 25 multiple sclerosis patients and compared with 49 healthy full-siblings. IgG responses to the latent Epstein-Barr virus-encoded nuclear antigen-1 (EBNA1) were selectively increased in individuals with multiple sclerosis compared with their unaffected siblings. We conclude that elevated IgG responses towards EBNA1 are associated with the development of multiple sclerosis.
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Affiliation(s)
- M Comabella
- Centre d'Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
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Camiña-Tato M, Fernández M, Morcillo-Suárez C, Navarro A, Julià E, Edo MC, Montalban X, Comabella M. Genetic association of CASP8 polymorphisms with primary progressive multiple sclerosis. J Neuroimmunol 2010; 222:70-5. [PMID: 20363033 DOI: 10.1016/j.jneuroim.2010.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Revised: 02/01/2010] [Accepted: 03/05/2010] [Indexed: 10/19/2022]
Abstract
We investigated caspase 8 (CASP8) as a candidate gene for multiple sclerosis (MS) susceptibility. Three SNPs (rs2037815, rs12990906 and rs1035140) were genotyped in 546 MS patients and 547 controls. For SNP rs2037815, GG homozygosity was associated with primary progressive multiple sclerosis (PPMS) when compared with relapse-onset MS and controls. We identified risk (GCA) and protective (ACT) haplotypes associated with PPMS when compared with relapse-onset MS and controls. GG homozygosity for SNP rs2037815 in PPMS patients was associated with a trend towards faster disease progression. These findings point to a role of CASP8 polymorphisms in the MS genetic risk in PPMS patients.
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Affiliation(s)
- M Camiña-Tato
- Centre d'Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d Hebron (HUVH), Departament de Medicina de la Universitat Autònoma de Barcelona, Barcelona, Spain
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Comabella M, Lünemann JD, Río J, Sánchez A, López C, Julià E, Fernández M, Nonell L, Camiña-Tato M, Deisenhammer F, Caballero E, Tortola MT, Prinz M, Montalban X, Martin R. A type I interferon signature in monocytes is associated with poor response to interferon-beta in multiple sclerosis. ACTA ACUST UNITED AC 2010; 132:3353-65. [PMID: 19741051 DOI: 10.1093/brain/awp228] [Citation(s) in RCA: 164] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The effect of interferon-beta in multiple sclerosis is modest and many patients do not respond to treatment. To date, no single biomarker reliably correlates with responsiveness to interferon-beta in multiple sclerosis. In the present study, genome-wide expression profiling was performed in peripheral blood mononuclear cells from 47 multiple sclerosis patients treated with interferon-beta for a minimum of 2 years and classified as responders and non-responders based on clinical criteria. A validation cohort of 30 multiple sclerosis patients was included in the study to replicate gene-expression findings. Before treatment, interferon-beta responders and non-responders were characterized by differential expression of type I interferon-induced genes with overexpression of the type interferon-induced genes in non-responders. Upon treatment the expression of these genes remained unaltered in non-responders, but was strongly upregulated in responders. Functional experiments showed a selective increase in phosphorylated STAT1 levels and interferon receptor 1 expression in monocytes of non-responders at baseline. When dissecting this type I interferon signature further, interferon-beta non-responders were characterized by increased monocyte type I interferon secretion upon innate immune stimuli via toll-like receptor 4, by increased endogenous production of type I interferon, and by an elevated activation status of myeloid dendritic cells. These findings indicate that perturbations of the type I interferon signalling pathway in monocytes are related to lack of response to interferon-beta, and type I interferon-regulated genes may be used as response markers in interferon-beta treatment.
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Affiliation(s)
- M Comabella
- Unitat de Neuroimmunologia Clínica, CEM-Cat. Edif. EUI 2 feminine planta, Hospital Universitari Vall d'Hebron, Pg. Vall d'Hebron 119-129, 08035 Barcelona, Spain.
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46
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Teunissen CE, Tumani HT, Bennett JL, Berven FS, Brundin L, Comabella M, Franciotta D, Federiksen JL, Fleming JO, Furlan R, Hintzen RQ, Hughes SG, Johnson MH, Krasulova E, Kuhle J, Magnone MC, Petzold A, Rajda C, Rejdak K, Schmidt HK, van Pesch V, Waubant E, Wolf C, Hemmer B, Deisenhammer F, Giovannoni G. Short commentary on ‘a consensus protocol for the standardization of cerebrospinal fluid collection and biobanking’. Mult Scler 2009; 16:129-32. [DOI: 10.1177/1352458509356368] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- CE Teunissen
- Molecular Cell Biology and Immunology, VU University Medical Center, Amsterdam, The Netherlands,
| | - HT Tumani
- Department of Neurology, University Hospital of Ulm, Ulm, Germany
| | - JL Bennett
- Departments of Neurology & Ophthalmology, University of Colorado, Denver, Aurora, CO, USA
| | - FS Berven
- Institute of Medicine, University of Bergen, Bergen, Norway
| | - L. Brundin
- Department Clinical Neuroscience, div Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - M. Comabella
- Neurology, Centre d'Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - D. Franciotta
- Laboratory of Neuroimmunology, IRCCS, 'C. Mondino Neurological Institute' , Pavia, Italy
| | - JL Federiksen
- Neurology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark
| | - JO Fleming
- Department of Neurology, University of Wisconsin, Madison, WI, USA
| | - R. Furlan
- Neuroimmunology Unit, Institute of Experimental Neurology 'San Raffaele Scientific Institute, Milan, Italy
| | - RQ Hintzen
- Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - SG Hughes
- Medical Research, Biogen Idec, Maidenhead, UK
| | - MH Johnson
- Department of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - E. Krasulova
- Department of Neurology, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic
| | - J. Kuhle
- Neurology and Clinical Neuroimmunology, University Hospital, University of Basel, Basel, Switzerland
| | - Maria-Chiara Magnone
- Clinical Research and Exploratory Development, F. Hoffmann - La Roche Pharma, Basel, Switzerland
| | - A. Petzold
- Department of Neuroimmunology, Institute of Neurology, UCL, London, UK
| | - C. Rajda
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - K. Rejdak
- Neurology, Medical University of Lublin, Poland/Experimental Pharmacology, Medical Research Center, Warsaw, Poland
| | - HK Schmidt
- Accelerated Cure Project for Multiple Sclerosis, Waltham, MA, USA
| | - V. van Pesch
- Neurology Department UCL, Université Catholique de Louvain, Louvain, Belgium
| | - E. Waubant
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - C. Wolf
- Clinical Development, UCB Pharma SA, Braine l'Alleud, Belgium
| | - B. Hemmer
- Department of Neurology, Klinikum rechts der Isar, Technische Universität, Munich, Germany
| | - F. Deisenhammer
- Department of Clinical Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - G. Giovannoni
- Queen Mary University of London, Neuroimmunology Unit, Neuroscience & Trauma Centre, Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry, London, UK
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47
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Teunissen CE, Petzold A, Bennett JL, Berven FS, Brundin L, Comabella M, Franciotta D, Frederiksen JL, Fleming JO, Furlan R, Hintzen RQ, Hughes SG, Johnson MH, Krasulova E, Kuhle J, Magnone MC, Rajda C, Rejdak K, Schmidt HK, van Pesch V, Waubant E, Wolf C, Giovannoni G, Hemmer B, Tumani H, Deisenhammer F. A consensus protocol for the standardization of cerebrospinal fluid collection and biobanking. Neurology 2009; 73:1914-22. [PMID: 19949037 DOI: 10.1212/wnl.0b013e3181c47cc2] [Citation(s) in RCA: 553] [Impact Index Per Article: 36.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
There is a long history of research into body fluid biomarkers in neurodegenerative and neuroinflammatory diseases. However, only a few biomarkers in CSF are being used in clinical practice. One of the most critical factors in CSF biomarker research is the inadequate powering of studies because of the lack of sufficient samples that can be obtained in single-center studies. Therefore, collaboration between investigators is needed to establish large biobanks of well-defined samples. Standardized protocols for biobanking are a prerequisite to ensure that the statistical power gained by increasing the numbers of CSF samples is not compromised by preanalytical factors. Here, a consensus report on recommendations for CSF collection and biobanking is presented, formed by the BioMS-eu network for CSF biomarker research in multiple sclerosis. We focus on CSF collection procedures, preanalytical factors, and high-quality clinical and paraclinical information. The biobanking protocols are applicable for CSF biobanks for research targeting any neurologic disease.
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Affiliation(s)
- C E Teunissen
- Department of Molecular Cell Biology and Immunology, VU University Medical Center, Amsterdam, The Netherlands.
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48
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Pelayo R, Montalban X, Minoves T, Moncho D, Rio J, Nos C, Tur C, Castillo J, Horga A, Comabella M, Perkal H, Rovira A, Tintoré M. Do multimodal evoked potentials add information to MRI in clinically isolated syndromes? Mult Scler 2009; 16:55-61. [DOI: 10.1177/1352458509352666] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The role of multimodal evoked potentials (MMEPs) in establishing multiple sclerosis (MS) diagnosis and prognosis has diminished nowadays. The objective of this article is to evaluate whether MMEPs add information to MRI in identifying patients with higher risk of relapse or development of disability after a clinically isolated syndrome (CIS). Patients who underwent visual, somato-sensory and brainstem auditory evoked potentials (EPs) were identified from a cohort of consecutive CIS. Patients also underwent brain MRI within 3 months of first attack. We analysed time to second attack and to Expanded Disability Status Scale (EDSS) score of 3.0 according to number of Barkhof criteria and number of abnormal MMEPs. A complete study was performed in 245 patients who were followed for a mean of 76.4 months (interquartile range: 61 to 96). Seventy-one patients (29%) had the three EPs normal, 115 patients (47%) had one abnormal EP; 40 patients (16%) had two; and 19 patients (8%) had three abnormal EPs. Baseline MRI determined the risk for converting to clinically definite MS and correlated with disability according to previous studies. EPs individually did not modify the risk of conversion or disability. However, the presence of three abnormal EPs increased the risk of reaching moderate disability (hazard ratio 7.0; 1.4—34.9) independently of baseline MRI. In conclusion, in the presence of three abnormal EPs could help identify CIS patients with a higher risk of developing disability, independently of MRI findings. However, the utility of MMEPs is limited by the low percentage of CIS patients having the three abnormal at baseline.
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Affiliation(s)
- R. Pelayo
- Multiple Sclerosis Center of Catalonia, Clinical Neuroimmunology Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain, Institut Guttmann, Badalona, Universitat Autònoma de Barcelona, Spain
| | - X. Montalban
- Multiple Sclerosis Center of Catalonia, Clinical Neuroimmunology Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - T. Minoves
- Department of Neurophysiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - D. Moncho
- Department of Neurophysiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - J. Rio
- Multiple Sclerosis Center of Catalonia, Clinical Neuroimmunology Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C. Nos
- Multiple Sclerosis Center of Catalonia, Clinical Neuroimmunology Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C. Tur
- Multiple Sclerosis Center of Catalonia, Clinical Neuroimmunology Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J. Castillo
- Multiple Sclerosis Center of Catalonia, Clinical Neuroimmunology Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A. Horga
- Multiple Sclerosis Center of Catalonia, Clinical Neuroimmunology Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M. Comabella
- Multiple Sclerosis Center of Catalonia, Clinical Neuroimmunology Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - H. Perkal
- Multiple Sclerosis Center of Catalonia, Clinical Neuroimmunology Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A. Rovira
- Magnetic Resonance Unit (Department of Radiology), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - M. Tintoré
- Multiple Sclerosis Center of Catalonia, Clinical Neuroimmunology Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain,
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49
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Sastre-Garriga J, Tintoré M, Nos C, Tur C, Río J, Téllez N, Castilló J, Horga A, Perkal H, Comabella M, Rovira A, Montalban X. Clinical features of CIS of the brainstem/cerebellum of the kind seen in MS. J Neurol 2009; 257:742-6. [DOI: 10.1007/s00415-009-5403-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Revised: 10/23/2009] [Accepted: 11/16/2009] [Indexed: 10/20/2022]
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50
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Comabella M, Pradillo JM, Fernández M, Río J, Lizasoain I, Julià E, Moro MA, Sastre-Garriga J, Montalban X. Plasma levels of 15d-PGJ2are not altered in multiple sclerosis. Eur J Neurol 2009; 16:1197-201. [DOI: 10.1111/j.1468-1331.2009.02696.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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