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Kania K, Pawlak MA, Forycka M, Wiłkość-Dębczyńska M, Michalak S, Łukaszewska A, Wyciszkiewicz A, Wypych A, Serafin Z, Marcinkowska J, Kozubski W, Kalinowska-Łyszczarz A. Predicting clinical progression and cognitive decline in patients with relapsing-remitting multiple sclerosis: a 6-year follow-up study. Neurol Neurochir Pol 2024; 58:176-184. [PMID: 38324117 DOI: 10.5603/pjnns.97714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 10/04/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Cognitive impairment occurs from the earliest stages of multiple sclerosis (MS) and progresses over time. The introduction of disease modifying therapies (DMTs) has changed the prognosis for MS patients, offering a potential opportunity for improvement in the cognitive arena as well. MATERIAL AND METHODS 41 patients with relapsing-remitting multiple sclerosis (MS) were recruited to the study. Thirty patients were available for final follow-up and were included in the analysis. Baseline (BL) brain MRI including volumetry and neuropsychological tests were performed. Blood samples were collected at BL and follow-up (FU) and were tested for: vascular endothelial growth factor (VEGF), soluble vascular cell adhesion molecule-1 (sVCAM1), soluble platelet-endothelial CAM-1 (sPECAM1), and soluble intercellular CAM-1 (sICAM-1). Patients were invited for a final neuropsychological follow-up after a median of 6 years. Disease activity (relapses, EDSS increase, new/active brain lesions on MRI) was analysed between BL and FU. RESULTS The study group deteriorated in the Rey-Osterrieth Complex Figure (ROCF) test (p = 0.001), but improved significantly in three other tests, i.e. semantic fluency test (p = 0.013), California Verbal Learning Test (CVLT, p = 0.016), and Word Comprehension Test (WCT, p < 0.001). EDSS increase correlated negatively with semantic fluency and WCT scores (r = -0.579, p = 0.001 and r = -0.391, p = 0.033, respectively). Improvements in semantic fluency test and WCT correlated positively with baseline deep grey matter, grey matter, and cortical volumes (p < 0.05, r > 0). Higher EDSS on FU correlated significantly negatively with baseline left and right pallidum, right caudate, right putamen, right accumbens, and cortical volume (p < 0.05, r < 0). No significant relationship was found between the number of relapses and EDSS on FU or neuropsychological deteriorations. Improvements in WCT and CVLT correlated positively with baseline sPECAM1 and sVCAM1 results, respectively (r > 0, p < 0.05). Deterioration in ROCF test correlated significantly with higher levels of baseline VEGF and sVCAM1 (p < 0.05). CONCLUSIONS Brain volume is an important predictor of future EDSS and cognitive functions outcome. MS patients have a potential for improving in neuropsychological tests over time. It remains to be established whether this is related to successful disease modification with immunotherapy. Baseline volumetric measures are stronger predictors of cognitive performance than relapse activity, which yet again highlights the importance of atrophy in MS prognosis.
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Affiliation(s)
- Karolina Kania
- Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Mikołaj A Pawlak
- Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Maria Forycka
- Chair of Palliative Medicine, Institute of Medical Sciences Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
| | - Monika Wiłkość-Dębczyńska
- Department of Health Psychology, Faculty of Psychology, Kazimierz Wielki University in Bydgoszcz, Bydgoszcz, Poland
| | - Sławomir Michalak
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Aleksandra Wyciszkiewicz
- Department of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Wypych
- Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Justyna Marcinkowska
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Wojciech Kozubski
- Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Alicja Kalinowska-Łyszczarz
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poznan, Poland
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Nowaczyk N, Kalinowska-Łyszczarz A, Paprzycki W, Michalak S, Kaźmierski R, Pawlak MA. Spatial distribution of white matter degenerative lesions and cognitive dysfunction in relapsing-remitting multiple sclerosis patients. Neurol Neurochir Pol 2019; 53:18-25. [PMID: 30742302 DOI: 10.5603/pjnns.a2018.0001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/06/2018] [Accepted: 11/06/2018] [Indexed: 11/25/2022]
Abstract
AIM The aim of this study was to assess degenerative lesion localisation in the course of relapsing-remitting multiple sclerosis (RRMS) and to identify the association between localisation and the frequency of T1-hypointense lesions (black holes) with cognitive dysfunction. We also searched for neuroradiological predictors of cognitive dysfunction in patients. The clinical rationale for the study was previous research, and our own findings suggest that lesion localisation plays an important role in cognitive performance and neurological disability of MS patients. MATERIAL AND METHODS Forty-two patients were included in the study. All subjects underwent neuropsychological examination using Raven's Coloured Progressive Matrices, a naming task from the Brief Repeatable Battery of Neuropsychological Tests, and attention to detail tests. Magnetic resonance imaging (MRI) was acquired on 1.5 Tesla scanner and black holes were manually segmented on T1-weighted volumetric images using the FMRIB Software Library. Linear regression was applied to establish a relationship between black hole volume per lobe and cognitive parameters. Bonferroni correction of voxelwise analysis was used to correct for multiple comparisons. RESULTS The following associations between black hole volume and cognition were identified: frontal lobes black hole volume was associated with phonemic verbal fluency (t = -4.013, p < 0.001), parietal black hole volume was associated with attention (t = -3.776, p < 0.001), and parietal and temporal black hole volumes were associated with nonverbal intelligence (p < 0.001). The volume of parietal black holes was the best predictor of cognitive dysfunction. CONCLUSIONS Our approach, including measurement of focal axonal loss based on T1-volumetric MRI sequence and brief neuropsychological assessment, might improve personalised diagnostic and therapeutic decisions in clinical practice.
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Affiliation(s)
- Natalia Nowaczyk
- Department of Health Psychology and Clinical Psychology Institute of Psychology, Adam Mickiewicz University in Poznan, Poland
| | - Alicja Kalinowska-Łyszczarz
- Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences (PUMS), 49 Przybyszewskiego Street, Poznan, Poland
| | | | - Sławomir Michalak
- Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences (PUMS), 49 Przybyszewskiego Street, Poznan, Poland
| | - Radosław Kaźmierski
- Department of Neurology and Cerebrovascular Disorders, Poznan University of Medical Sciences, L. Bierkowski Hospital, Poznań, Poland
| | - Mikołaj A Pawlak
- Department of Neurology and Cerebrovascular Disorders, Poznan University of Medical Sciences, L. Bierkowski Hospital, Poznań, Poland
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Kalinowska-Łyszczarz A, Pawlak MA, Wyciszkiewicz A, Osztynowicz K, Kozubski W, Michalak S. Immune-cell BDNF expression in treatment-naïve relapsing-remitting multiple sclerosis patients and following one year of immunomodulation therapy. Neurol Neurochir Pol 2018; 52:483-489. [PMID: 29643001 DOI: 10.1016/j.pjnns.2018.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 02/22/2018] [Accepted: 03/20/2018] [Indexed: 11/30/2022]
Abstract
Although neurons are the main source of neurotrophins in the healthy brain, neurotrophins can also be expressed in the immune system. We have previously shown that in relapsing-remitting multiple sclerosis (RRMS) lower immune-cell neurotrophin levels are associated with brain atrophy and cognitive impairment. The aim of the present study was to assess if immune-cell neurotrophin expression is impaired in MS as compared with the healthy controls, and to describe if these levels change in treatment-naïve RRMS patients, following one year of immunomodulation. Fifty treatment-naïve RRMS patients were assessed at baseline and after one year of immunomodulation (beta-interferons/glatiramer acetate). The control group included 39 healthy subjects matched according to age and gender. Peripheral blood mononuclear cells (PBMCs) were isolated from heparinized blood using Ficoll-Histopaque gradient. The levels of brain-derived-neurotrophic-factor (BDNF), beta-nerve-growth-factor (beta-NGF), neurotrophin-3 (NT-3) and neurotrophin-4/5 (NT-4/5) were measured in PBMC lysates with ELISA. BDNF levels were significantly lower in MS than in the healthy controls (median 613 vs. 1657pg/mg protein, p<0.001). After one year of immunomodulation, BDNF expression did not change significantly (p=0.06) on the group level. In 70% of patients there was no increase in BDNF level, and in 30% it increased. We observed no differences between treatment groups. Other neurotrophins were detected in a minority of MS samples (as opposed to the controls). To conclude, we have shown that immune-cell production of neurotrophins is impaired in MS patients. In our MS cohort standard immunomodulation failed to restore normal BDNF levels in PBMCs within one year of therapy.
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Affiliation(s)
- Alicja Kalinowska-Łyszczarz
- Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences (PUMS), 49 Przybyszewskiego Street, 60-355 Poznan, Poland.
| | - Mikołaj A Pawlak
- Department of Neurology and Cerebrovascular Disorders, Poznan University of Medical Sciences, 34 Dojazd Street, 60-631 Poznan, Poland.
| | - Aleksandra Wyciszkiewicz
- Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences (PUMS), 49 Przybyszewskiego Street, 60-355 Poznan, Poland.
| | - Krystyna Osztynowicz
- Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences (PUMS), 49 Przybyszewskiego Street, 60-355 Poznan, Poland.
| | - Wojciech Kozubski
- Department of Neurology, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355 Poznan, Poland.
| | - Sławomir Michalak
- Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences (PUMS), 49 Przybyszewskiego Street, 60-355 Poznan, Poland.
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Kalinowska-Lyszczarz A, Pawlak MA, Pietrzak A, Pawlak-Bus K, Leszczynski P, Puszczewicz M, Paprzycki W, Kozubski W, Michalak S. Distinct regional brain atrophy pattern in multiple sclerosis and neuropsychiatric systemic lupus erythematosus patients. Lupus 2018; 27:1624-1635. [PMID: 29950159 DOI: 10.1177/0961203318781004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Differentiation of systemic lupus erythematosus (SLE) from multiple sclerosis (MS) can be challenging, especially when neuropsychiatric (NP) symptoms are accompanied by white matter lesions in the brain. Given the lack of discriminative power of currently applied tools for their differentiation, there is an unmet need for other measures that can aid in distinguishing between the two autoimmune disorders. In this study we aimed at exploring whether brain atrophy measures could serve as markers differentiating MS and SLE. Thirty-seven relapsing-remitting MS and 38 SLE patients with nervous system manifestations, matched according to age and disease duration, underwent 1.5 Tesla magnetic resonance imaging (MRI), including volumetric sequences, and clinical assessment. Voxelwise analysis was performed using ANTS-SyN elastic registration protocol, FSL Randomise and Gamma methods. Cortical and subcortical segmentation was performed with Freesurfer 5.3 pipeline using T1-weighted MPRAGE sequence data. Using MRI volumetric markers of general and subcortical gray matter atrophy and clinical variables, we built a stepwise multivariable logistic diagnostic model to identify MRI parameters that best differentiate MS and SLE patients. We found that the best volumetric predictors to distinguish them were: fourth ventricle volume (sensitivity 0.86, specificity 0.57, area under the curve, AUC 0.77), posterior corpus callosum (sensitivity 0.81, specificity 0.57, AUC 0.68), and third ventricle to thalamus ratio (sensitivity 0.42, specificity 0.84, AUC 0.65). The same classifiers were identified in a subgroup analysis that included patients with a short disease duration. In MS brain atrophy and lesion load correlated with clinical disability, while in SLE age was the main determinant of brain volume. This study proposes new imaging parameters for differential diagnosis of MS and SLE with central nervous system involvement. We show there is a different pattern of atrophy in MS and SLE, and the key structural volumes that are differentially affected include fourth ventricle and posterior section of corpus callosum, followed by third ventricle to thalamus ratio. Different correlation patterns between volumetric and clinical data may suggest that while in MS atrophy is driven mainly by disease activity, in SLE it is mostly associated with age. However, these results need further replication in a larger cohort.
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Affiliation(s)
- A Kalinowska-Lyszczarz
- 1 Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - M A Pawlak
- 2 Department of Neurology and Cerebrovascular Disorders, Poznan University of Medical Sciences, Poznan, Poland
| | - A Pietrzak
- 3 Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - K Pawlak-Bus
- 4 Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
| | - P Leszczynski
- 4 Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
| | - M Puszczewicz
- 5 Department of Rheumatology and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - W Paprzycki
- 6 Department of Neuroradiology, Poznan University of Medical Sciences, Poznan, Poland
| | - W Kozubski
- 3 Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - S Michalak
- 1 Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
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Kalinowska-Łyszczarz A, Pawlak MA, Pietrzak A, Pawlak-Buś K, Leszczyński P, Puszczewicz M, Majewski D, Paprzycki W, Kozubski W, Michalak S. Subcortical gray matter atrophy is associated with cognitive deficit in multiple sclerosis but not in systemic lupus erythematosus patients. Lupus 2017; 27:610-620. [PMID: 28992796 DOI: 10.1177/0961203317735186] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cognitive impairment is a significant clinical problem both in multiple sclerosis (MS) and systemic lupus erythematosus (SLE) patients. In MS cognitive dysfunction has been associated with brain atrophy and total demyelinating lesion volume. In SLE cognitive impairment is much less understood, and its link to structural brain damage remains to be established. The aim of this study was to identify the relationship between subcortical gray matter volume and cognitive impairment in MS and SLE. We recruited 37 MS and 38 SLE patients matched by age, disease duration and educational level. Patients underwent magnetic resonance imaging (MRI) and a battery of psychometric tests. Severity of cognitive impairment was similar in both cohorts despite larger white matter lesion load in MS patients. Psychometric scores were associated with global and subcortical gray matter atrophy measures and lesion load in MS, but not in SLE. In SLE, the lack of a relationship between cognitive impairment and structural damage, defined either as atrophy or white matter lesions, indicates a different causal mechanism of cognitive deficit.
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Affiliation(s)
- A Kalinowska-Łyszczarz
- 1 Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences (PUMS), Poznan, Poland
| | - M A Pawlak
- 2 Department of Neurology and Cerebrovascular Disorders, PUMS, Poznan, Poland
| | - A Pietrzak
- 3 Department of Neurology, PUMS, Poznan, Poland
| | - K Pawlak-Buś
- 4 Department of Rheumatology and Rehabilitation, PUMS, Poznan, Poland
| | - P Leszczyński
- 4 Department of Rheumatology and Rehabilitation, PUMS, Poznan, Poland
| | - M Puszczewicz
- 5 Department of Rheumatology and Internal Diseases, PUMS, Poznan, Poland
| | - D Majewski
- 5 Department of Rheumatology and Internal Diseases, PUMS, Poznan, Poland
| | - W Paprzycki
- 6 Department of Neuroradiology, PUMS, Poznan, Poland
| | - W Kozubski
- 3 Department of Neurology, PUMS, Poznan, Poland
| | - S Michalak
- 1 Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences (PUMS), Poznan, Poland
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Biduła SP, Przybylski Ł, Pawlak MA, Króliczak G. Unique Neural Characteristics of Atypical Lateralization of Language in Healthy Individuals. Front Neurosci 2017; 11:525. [PMID: 28983238 PMCID: PMC5613132 DOI: 10.3389/fnins.2017.00525] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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] [Received: 04/07/2017] [Accepted: 09/07/2017] [Indexed: 12/15/2022] Open
Abstract
Using functional magnetic resonance imaging (fMRI) in 63 healthy participants, including left-handed and ambidextrous individuals, we tested how atypical lateralization of language—i. e., bilateral or right hemispheric language representation—differs from the typical left-hemisphere dominance. Although regardless of their handedness, all 11 participants from the atypical group engaged classical language centers, i.e., Broca's and Wernicke's areas, the right-hemisphere components of the default mode network (DMN), including the angular gyrus and middle temporal gyrus, were also critically involved during the verbal fluency task. Importantly, activity in these regions could not be explained in terms of mirroring the typical language pattern because left-hemisphere dominant individuals did not exhibit similar significant signal modulations. Moreover, when spatial extent of language-related activity across whole brain was considered, the bilateral language organization entailed more diffuse functional processing. Finally, we detected significant differences between the typical and atypical group in the resting-state connectivity at the global and local level. These findings suggest that the atypical lateralization of language has unique features, and is not a simple mirror image of the typical left hemispheric language representation.
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Affiliation(s)
- Szymon P Biduła
- Action and Cognition Laboratory, Institute of Psychology, Adam Mickiewicz University in PoznańPoznan, Poland
| | - Łukasz Przybylski
- Action and Cognition Laboratory, Institute of Psychology, Adam Mickiewicz University in PoznańPoznan, Poland
| | - Mikołaj A Pawlak
- Department of Neurology and Cerebrovascular Disorders, Poznań University of Medical SciencesPoznan, Poland
| | - Gregory Króliczak
- Action and Cognition Laboratory, Institute of Psychology, Adam Mickiewicz University in PoznańPoznan, Poland
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7
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Kalinowska-Łyszczarz A, Pawlak MA, Wyciszkiewicz A, Pawlak-Buś K, Leszczyński P, Puszczewicz M, Paprzycki W, Kozubski W, Michalak S. Immune Cell Neurotrophin Production Is Associated with Subcortical Brain Atrophy in Neuropsychiatric Systemic Lupus Erythematosus Patients. Neuroimmunomodulation 2017. [PMID: 29539621 DOI: 10.1159/000487139] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Central nervous system (CNS) involvement in systemic lupus erythematosus (SLE) remains poorly understood. Damage within the CNS is driven by the autoimmune response; however, immunopathophysiology of neuropsychiatric (NP) SLE is multifactorial. Immune cell neurotrophin production could be neuroprotective against autoimmunity-driven CNS damage, as has been shown in multiple sclerosis. The aim of this study was to establish whether immune cell neurotrophin production is associated with damage severity in NPSLE. METHODS Selected neurotrophins (BDNF, NGF, NT-3, and NT-4/5) were measured with ELISA within peripheral blood mononuclear cells (PBMCs) isolated from 38 NPSLE patients matched with 39 healthy controls. Subcortical and cortical structure volumes were segmented with the Freesurfer 5.3 pipeline on T1-weighted isotropic images acquired on a 1.5-T MRI scanner. RESULTS BDNF and NGF levels in PBMCs were reduced in NPSLE compared to the healthy population. The PBMC BDNF level was associated with reduced thalamus, caudate, and putamen volumes. The NGF level correlated with lateral ventricles enlargement and thalamic volume loss. CONCLUSIONS In NPSLE, immune cell BDNF and NGF levels are linked with subcortical atrophy. Higher BDNF levels are associated with higher midsagittal atrophy, which may reflect compensatory mechanisms, upregulating BDNF when neuroprotection is needed. These data require further confirmation.
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Affiliation(s)
- Alicja Kalinowska-Łyszczarz
- Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences (PUMS), Poznan, Poland
| | - Mikołaj A Pawlak
- Department of Neurology and Cerebrovascular Disorders, PUMS, Poznan, Poland
| | - Aleksandra Wyciszkiewicz
- Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences (PUMS), Poznan, Poland
| | | | | | | | | | - Wojciech Kozubski
- Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Sławomir Michalak
- Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences (PUMS), Poznan, Poland
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8
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Kalinowska-Łyszczarz A, Michalak S, Pawlak MA, Losy J, Kozubski W. Serum sPECAM-1 and sVCAM-1 levels are associated with conversion to multiple sclerosis in patients with optic neuritis. J Neuroimmunol 2016; 300:11-14. [PMID: 27806869 DOI: 10.1016/j.jneuroim.2016.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 07/14/2016] [Revised: 09/30/2016] [Accepted: 10/04/2016] [Indexed: 12/13/2022]
Abstract
Platelet-Endothelial-Cell-Adhesion-Molecule-1 (PECAM-1) and Human-Vascular-CAM-1 (VCAM-1) are adhesion molecules involved in leukocyte-endothelial interaction. In our study serum levels of sPECAM-1 and sVCAM-1 were measured (ELISA) in twenty-nine patients during their first monosymptomatic optic neuritis (ON) episode. Anti-aquaporin-4-antibodies (AQP4-IgG) were detected with the cell-based assay. Patients were followed for seven years, during which 16/24 AQP4-IgG (-) patients developed MS and 2/5 AQP4-IgG (+) patients developed NMO. Patients who developed MS had significantly lower sPECAM-1 and sVCAM-1 than those who did not. Serum sPECAM-1 and sVCAM-1 may turn out to be useful biomarkers correlated with the risk of progression to MS after first ON incident.
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Affiliation(s)
- Alicja Kalinowska-Łyszczarz
- Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences, 49, Przybyszewskiego st., 60-355 Poznan, Poland.
| | - Sławomir Michalak
- Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences, 49, Przybyszewskiego st., 60-355 Poznan, Poland; Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - Mikołaj A Pawlak
- Department of Neurology and Cerebrovascular Disorders, Poznan University of Medical Sciences, 34, Dojazd st., 60-631 Poznan, Poland
| | - Jacek Losy
- Division of Neuroimmunology, Department of Neurology, Poznan University of Medical Sciences, 49, Przybyszewskiego st., 60-355 Poznan, Poland; Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.
| | - Wojciech Kozubski
- Department of Neurology, Poznan University of Medical Sciences, 49, Przybyszewskiego st., 60-355 Poznan, Poland.
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Kalinowska-Łyszczarz A, Pawlak MA, Michalak S, Losy J. Cognitive deficit is related to immune-cell beta-NGF in multiple sclerosis patients. J Neurol Sci 2012; 321:43-8. [PMID: 22877509 DOI: 10.1016/j.jns.2012.07.044] [Citation(s) in RCA: 4] [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] [Received: 03/01/2012] [Revised: 05/29/2012] [Accepted: 07/19/2012] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Multiple sclerosis (MS) is a chronic inflammatory demyelinating and neurodegenerative disease of the central nervous system (CNS), causing cognitive impairment in 45-65% of patients. Beta-NGF facilitates proper cholinergic transmission in the healthy CNS. In MS-damaged tissue there is a relative deficit of neurotrophins that might be compensated by peripheral blood mononuclear cells (PBMCs) synthesis. Our aim was to evaluate the relationship between PBMCs neurotrophins' expression and cognitive performance in relapsing-remitting MS (RRMS) patients. PATIENTS AND METHODS Beta-NGF, NT-3 and NT-4/5 levels were measured in sera and in PBMCs by ELISA method in 41 RRMS patients in remission. All patients underwent neuropsychological assessment with a battery of 10 tests evaluating a wide range of cognitive functions. RESULTS PBMCs beta-NGF concentration correlated significantly with spontaneous word list generation test (Pearson R=0.37, p=0.02) and 15-Word List Recall Test results (Pearson R=0.40, p<0.00). Both tests assessing semantic memory correlated significantly with the cognitive composite score, defined as a number of tests in which patients performed below group median for the given test. CONCLUSIONS In RRMS beta-NGF is strongly linked to cognitive performance, which makes it an attractive therapeutic target. It might play a neuroprotective role in MS, especially in the cognitive domain.
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Affiliation(s)
- Alicja Kalinowska-Łyszczarz
- Department of Neurochemistry and Neuropathology, Chair of Neurology, Poznan University of Medical Sciences, Poland.
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Kalinowska-Łyszczarz A, Pawlak MA, Michalak S, Paprzycki W, Losy J. Immune cell NT-3 expression is associated with brain atrophy in multiple sclerosis patients. J Neuroimmunol 2011; 240-241:109-13. [PMID: 22036954 DOI: 10.1016/j.jneuroim.2011.10.002] [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: 08/09/2011] [Revised: 09/17/2011] [Accepted: 10/07/2011] [Indexed: 01/03/2023]
Abstract
While neurotrophins mediate cell survival and proliferation in the nervous system, they are also expressed within peripheral blood mononuclear cells (PBMCs) of the immunological system. In multiple sclerosis (MS) neurotrophins released from PBMCs might play a neuroprotective role, delaying neurodegeneration within central nervous system. We aimed for identifying the link between neurotrophins' PBMCs expression and brain atrophy markers in relapsing-remitting MS (RRMS) patients. We have found that neurotrophin-3 PBMCs concentration is strongly correlated with brain-parenchymal fraction and corpus callosum cross-sectional area, which are well-established brain atrophy measures. Thus, PBMC-derived neurotrophin-3 might exert a direct or indirect neuroprotective effect in MS.
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Affiliation(s)
- Alicja Kalinowska-Łyszczarz
- Department of Clinical Neuroimmunology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland.
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11
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Kalinowska-Łyszczarz A, Szczuciński A, Pawlak MA, Losy J. Clinical study on CXCL13, CCL17, CCL20 and IL-17 as immune cell migration navigators in relapsing-remitting multiple sclerosis patients. J Neurol Sci 2010; 300:81-5. [PMID: 20947098 DOI: 10.1016/j.jns.2010.09.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [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: 02/12/2010] [Revised: 09/15/2010] [Accepted: 09/20/2010] [Indexed: 12/18/2022]
Abstract
BACKGROUND There has been a growing evidence for the role of chemokines in the pathology of multiple sclerosis. Recently, there has been great emphasis placed on humoral immunity and the T(H)-17 response, which has not yet been thoroughly described in MS. The aim of this study was to investigate the role of specific chemokines involved in B-cell migration (CXCL13) and in the T(H)-17 immune response (IL-17, CCL17, CCL20). METHODS Using ELISA, the chosen chemokine concentrations were measured in the serum and cerebrospinal fluid of relapsing-remitting MS patients with both active and stable disease, and the relapse prediction rate was calculated. RESULTS We found that the CSF concentrations of CXCL13 in patients with RRMS both, during relapse and remission, were significantly higher than in controls. CCL17 and CCL20 were not detected in CSF in either of the groups, whereas serum CCL20 level was significantly higher in remission than during relapse. Intravenous methylprednisolone treatment of patients with relapse did not influence serum CXCL13 and CCL20 levels. However, it did lower CCL17 and IL-17 concentrations. CONCLUSIONS CXCL13 is an important mediator in MS that is strongly linked to the neuroinflammatory activity of the disease. However, more studies are needed for elucidating the roles of CCL17, CCL20 and IL-17 in MS pathology.
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12
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Krejza J, Rudzinski W, Pawlak MA, Tomaszewski M, Ichord R, Kwiatkowski J, Gor D, Melhem ER. Angle-corrected imaging transcranial doppler sonography versus imaging and nonimaging transcranial doppler sonography in children with sickle cell disease. AJNR Am J Neuroradiol 2007; 28:1613-8. [PMID: 17846223 PMCID: PMC8134377 DOI: 10.3174/ajnr.a0591] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Nonimaging transcranial Doppler sonography (TCD) and imaging TCD (TCDI) are used for determination of the risk of stroke in children with sickle cell disease (SCD). The purpose was to compare angle-corrected, uncorrected TCDI, and TCD blood flow velocities in children with SCD. MATERIALS AND METHODS A total of 37 children (mean age, 7.8 +/- 3.0 years) without intracranial arterial narrowing determined with MR angiography, were studied with use of TCD and TCDI at the same session. Depth of insonation and TCDI mean velocities with and without correction for the angle of insonation in the terminal internal carotid artery (ICA) and middle (MCA), anterior (ACA), and posterior (PCA) cerebral arteries were compared with TCD velocities with use of a paired t test. RESULTS Two arteries were not found on TCDI compared with 15 not found on TCD. Average angle of insonation in the MCA, ACA, ICA, and PCA was 31 degrees , 44 degrees , 25 degrees , and 29 degrees , respectively. TCDI and TCD mean depth of insonation for all arteries did not differ significantly; however, individual differences varied substantially. TCDI velocities were significantly lower than TCD velocities, respectively, for the right and left sides (mean +/- SD): MCA, 106 +/- 22 cm/s and 111 +/- 33 cm/s versus 130 +/- 19 cm/s and 134 +/- 26 cm/s; ICA, 90 +/- 14 cm/s and 98 +/- 27 cm/s versus 117 +/- 18 cm/s and 119 +/- 23 cm/s; ACA, 74 +/- 24 cm/s and 88 +/- 25 cm/s versus 105 +/- 23 cm/s and 105 +/- 31 cm/s; and PCA, 84 +/- 27 cm/s and 82 +/- 21 cm/s versus 95 +/- 23 cm/s and 94 +/- 20 cm/s. TCD and angle-corrected TCDI velocities were not statistically different except for higher angle-corrected TCDI values in the left ACA and right PCA. CONCLUSION TCD velocities are significantly higher than TCDI velocities but are not different from the angle-corrected TCDI velocities. TCDI identifies the major intracranial arteries more effectively than TCD.
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Affiliation(s)
- J Krejza
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA.
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13
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Yang Y, Jones DM, Pawlak MA, Macdonald GJ, Duggan KA. Accuracy of single concentration estimations of platelet angiotensin II receptor number. Its usefulness in screening for pregnancy-induced hypertension. Am J Hypertens 1994; 7:989-95. [PMID: 7848626 DOI: 10.1093/ajh/7.11.989] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Platelet angiotensin II (AngII) receptor number has been suggested as a screening test for pregnancy-induced hypertension. However, markedly different false-positive rates have been reported, perhaps the result of differing methods used. We sought therefore to compare the two methods. Platelet AngII receptor number was determined by saturation analysis with computerized curve fitting and specific binding at a single radioligand concentration. The two methods were compared by correlation and by plotting their differences v their means, to determine their limits of agreement. There were significant correlations between the value obtained by saturation analysis and each of the three single ligand concentrations studied (1 nmol/L, P < .001; 500 pmol/L, P < .001; and 250 pmol/L, P < .01). However, for none of the three did the regression line approach the line of equality. Assessment of agreement by comparing differences and means for each subject showed increasing scatter with increasing receptor number and 95% confidence intervals too large to be clinically relevant. We conclude that the receptor number estimated from specific binding at one ligand concentration differs significantly from that obtained by saturation analysis. The limits of agreement of the two methods are wide and we urge caution in the use of single ligand concentration methods for estimating binding site densities.
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Affiliation(s)
- Y Yang
- University Department of Medicine, Prince Henry Hospital, Sydney, Australia
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14
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Yang Y, Pawlak MA, Macdonald GJ, Duggan KA. Single point estimation of platelet angiotensin II receptor number may not be valid screening test for pregnancy-induced hypertension. Clin Exp Pharmacol Physiol 1993; 20:339-42. [PMID: 8324921 DOI: 10.1111/j.1440-1681.1993.tb01699.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 01/29/2023]
Abstract
1. Quantification of platelet angiotensin II (AII) receptors has been suggested as a screening test for pregnancy-induced hypertension (PIH). Saturation analysis is too technically demanding to screen the requisite numbers and although a simplified method has been proposed, it has not been validated against saturation. This study sought to compare the two methods. 2. Platelet AII receptor number was determined by saturation analysis and from the specific binding at each of three radioligand concentrations. The two methods were compared by correlation and by plotting their differences against their means to determine limits of agreement. 3. Significant correlations were observed at all three radioligand concentrations; however, none of the regression lines approached the line of equality. There was increasing scatter as receptor number increased and 95% confidence intervals were too large to be clinically useful. 4. From this study it is concluded that the simplified method for estimating platelet AII receptor number is inaccurate and caution is urged in its use as a screening test for PIH.
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Affiliation(s)
- Y Yang
- Hypertension Laboratory, Prince Henry Hospital, Sydney, New South Wales, Australia
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15
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Pawlak MA, Macdonald GJ. Altered number of platelet angiotensin II receptors in relation to plasma agonist concentrations in normal and hypertensive pregnancy. J Hypertens 1992; 10:813-9. [PMID: 1325514] [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: 12/26/2022]
Abstract
OBJECTIVE The relation between plasma angiotensin II concentrations and the platelet angiotensin II receptor was examined in four different groups of subjects. Platelet receptors were used as representative of physiologically significant sites such as in vascular smooth muscle. SUBJECTS A control group consisting of non-pregnant females was studied together with three pregnant groups: normal pregnant women in both early and then late gestation and women with diagnosed pregnancy-induced hypertension (PIH). METHODS Blood was collected from each subject for estimation of plasma angiotensin II concentration and isolation of platelets, which were then used in non-competitive binding studies. Both receptor capacity and affinity for the ligand were calculated for each subject. RESULTS In the control group, a significant negative correlation between angiotensin II and receptor capacity was established. This was in marked contrast to the first trimester group which showed no such correlation and where there was a significant reduction or nil receptor capacity but only a slight elevation in mean plasma angiotensin II concentration. This phenomenon of reduced or absent binding persisted into the third trimester when plasma angiotensin II was significantly elevated compared with all other groups. PIH subjects had the lowest plasma angiotensin levels and 90% had clearly measurable binding to the platelet receptor, which was not however as high as that in the control group. Two normotensive subjects who demonstrated significant potentiation of receptor binding in the third trimester subsequently developed PIH. CONCLUSIONS The inverse relation between plasma angiotensin II and its platelet receptor, found in non-pregnant subjects, is significantly altered in normal pregnancy. Reduced receptor capacity and lack of relation with circulating ligand observed in early gestation reflects an alteration at the receptor level which is independent of plasma angiotensin II concentration. This alteration appears to persist throughout pregnancy except in subjects predisposed to PIH when receptor binding is closer to non-pregnant values. Changes in receptor binding found in people who ultimately developed PIH but who were still clinically normal at the time suggest that binding to the platelet receptor could be used as a screening test for all primiparae to identify those predisposed to PIH later on in pregnancy.
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Affiliation(s)
- M A Pawlak
- University of New South Wales School of Medicine, Prince Henry Hospital, Little Bay, Australia
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Timmermans V, Peake PW, Charlesworth JA, Macdonald GJ, Pawlak MA. Angiotensin II receptor regulation in anti-glomerular basement membrane nephritis. Kidney Int 1990; 38:518-24. [PMID: 2232495 DOI: 10.1038/ki.1990.234] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [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: 12/30/2022]
Abstract
The expression of the glomerular receptor for angiotensin II (Ang II-R) was examined longitudinally following the induction of anti-glomerular basement membrane (GBM) nephritis in the rat. The specific aim of the project was to determine whether immunologically-induced glomerular injury led to significant abnormalities of the relationship between glomerular Ang II-R and its circulating ligand, Ang II. Scatchard analysis was used to measure Ang II-R on purified glomeruli at selected time intervals over two months following a single dose of sheep anti-rat GBM antibody. Corresponding values for plasma Ang II were determined. Receptor density fell to approximately 50% by 16 hours following the injection of antibody (control 96.4 +/- 9.3 x 10(6); nephritic 52.6 +/- 5.6 x 10(6) receptors/glomerulus; P less than 0.001) and there was a corresponding threefold increase in plasma Ang II (control 21.0 +/- 2.5; nephritic 66.6 +/- 20.6 pg/ml; P less than 0.01). However, this reduction in receptor binding could not be explained by the rise in plasma Ang II concentration, as effective blockade of the RAS by enalapril did not alter receptor expression (56.1 +/- 4.6 x 10(6) receptors/glomerulus). Subsequently, a rise in receptor density and a corresponding fall in plasma Ang II were observed: three days after antibody administration, receptor concentration had increased significantly above control values (150.5 +/- 11.9 x 10(6] while plasma Ang II was undetectable (that is, less than 5 pg/ml). Ang II-R remained elevated for the next two weeks but returned to normal four to eight weeks after the administration of nephrotoxic antibody.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- V Timmermans
- Department of Medicine, Prince Henry Hospital, Sydney, Australia
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