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Koptielow J, Szyłak E, Szewczyk-Roszczenko O, Roszczenko P, Kochanowicz J, Kułakowska A, Chorąży M. Genetic Update and Treatment for Dystonia. Int J Mol Sci 2024; 25:3571. [PMID: 38612382 PMCID: PMC11011602 DOI: 10.3390/ijms25073571] [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: 02/21/2024] [Revised: 03/17/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
A neurological condition called dystonia results in abnormal, uncontrollable postures or movements because of sporadic or continuous muscular spasms. Several varieties of dystonia can impact people of all ages, leading to severe impairment and a decreased standard of living. The discovery of genes causing variations of single or mixed dystonia has improved our understanding of the disease's etiology. Genetic dystonias are linked to several genes, including pathogenic variations of VPS16, TOR1A, THAP1, GNAL, and ANO3. Diagnosis of dystonia is primarily based on clinical symptoms, which can be challenging due to overlapping symptoms with other neurological conditions, such as Parkinson's disease. This review aims to summarize recent advances in the genetic origins and management of focal dystonia.
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Affiliation(s)
- Jan Koptielow
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (E.S.); (J.K.); (A.K.); (M.C.)
| | - Emilia Szyłak
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (E.S.); (J.K.); (A.K.); (M.C.)
| | - Olga Szewczyk-Roszczenko
- Department of Synthesis and Technology of Drugs, Medical University of Bialystok, Kilinskiego 1, 15-089 Bialystok, Poland; (O.S.-R.); (P.R.)
| | - Piotr Roszczenko
- Department of Synthesis and Technology of Drugs, Medical University of Bialystok, Kilinskiego 1, 15-089 Bialystok, Poland; (O.S.-R.); (P.R.)
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (E.S.); (J.K.); (A.K.); (M.C.)
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (E.S.); (J.K.); (A.K.); (M.C.)
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (E.S.); (J.K.); (A.K.); (M.C.)
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Grunwald C, Krętowska-Grunwald A, Adamska-Patruno E, Kochanowicz J, Kułakowska A, Chorąży M. The Role of Selected Interleukins in the Development and Progression of Multiple Sclerosis-A Systematic Review. Int J Mol Sci 2024; 25:2589. [PMID: 38473835 PMCID: PMC10932438 DOI: 10.3390/ijms25052589] [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: 01/27/2024] [Revised: 02/18/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Multiple sclerosis is a disabling inflammatory disorder of the central nervous system characterized by demyelination and neurodegeneration. Given that multiple sclerosis remains an incurable disease, the management of MS predominantly focuses on reducing relapses and decelerating the progression of both physical and cognitive decline. The continuous autoimmune process modulated by cytokines seems to be a vital contributing factor to the development and relapse of multiple sclerosis. This review sought to summarize the role of selected interleukins in the pathogenesis and advancement of MS. Patients with MS in the active disease phase seem to exhibit an increased serum level of IL-2, IL-4, IL-6, IL-13, IL-17, IL-21, IL-22 and IL-33 compared to healthy controls and patients in remission, while IL-10 appears to have a beneficial impact in preventing the progression of the disease. Despite being usually associated with proinflammatory activity, several studies have additionally recognized a neuroprotective role of IL-13, IL-22 and IL-33. Moreover, selected gene polymorphisms of IL-2R, IL-4, IL-6, IL-13 and IL-22 were identified as a possible risk factor related to MS development. Treatment strategies of multiple sclerosis that either target or utilize these cytokines seem rather promising, but more comprehensive research is necessary to gain a clearer understanding of how these cytokines precisely affect MS development and progression.
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Affiliation(s)
- Cezary Grunwald
- Department of Neurology, Medical University of Bialystok, Marii Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (J.K.); (A.K.)
| | - Anna Krętowska-Grunwald
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Jerzego Waszyngtona 17, 15-274 Białystok, Poland;
| | - Edyta Adamska-Patruno
- Clinical Research Center, Medical University of Bialystok, Marii Skłodowskiej-Curie 24A, 15-276 Białystok, Poland;
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Marii Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (J.K.); (A.K.)
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Marii Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (J.K.); (A.K.)
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Marii Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (J.K.); (A.K.)
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Grunwald C, Adamska-Patruno E, Wawrusiewicz-Kurylonek N, Czarnowska A, Snarska K, Dardzińska-Głębocka A, Kapica-Topczewska K, Mirończuk A, Bazylewicz M, Kochanowicz J, Krętowski A, Kułakowska A, Chorąży M. Multiple sclerosis susceptibility may be associated with the coding rs20541 (R130Q) IL-13 gene polymorphism in the Polish population. Sci Rep 2023; 13:22083. [PMID: 38086930 PMCID: PMC10716410 DOI: 10.1038/s41598-023-49615-y] [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: 06/15/2023] [Accepted: 12/10/2023] [Indexed: 12/18/2023] Open
Abstract
Some of the multiple autoimmune diseases have been already associated with IL-13 single-nucleotide polymorphisms (SNPs). However, there are only few studies regarding multiple sclerosis (MS) risk and IL-13 rs20541 (R130Q) polymorphism, and their results are conflicting. Therefore, the aim of our study was to investigate the frequency of the IL-13 gene rs20541 (R130Q) polymorphism in MS participants and its association with MS clinical subsets in the Polish population. We conducted a case‒control study including 94 relapsing remitting MS patients and 160 healthy volunteers. We genotyped the rs20541 polymorphism in the IL-13 gene and analysed the genotype frequency, age of MS onset and clinical condition (EDSS values) of the MS participants. Fisher's exact test was used for statistical analysis, and the log-linear model was applied to test for associations. Allele A, as well as the AA and AG genotypes, was observed to be significantly more common in the MS subjects. The OR (odds ratio) for the A compared to the G allele was 1.71 (1.14-2.56), whereas OR 2.33 (0.86-6.26) and OR 1.92 (1.11-3.30) were obtained for the AA and AG genotypes, respectively. We did not identify any significant associations of the studied IL-13 SNP with the investigated clinical parameters of the MS participants. Our results suggest that the rs20541 polymorphism in the IL-13 gene may play an important role in MS predisposition but not in investigated clinical parameters in MS subjects of the Polish population.
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Affiliation(s)
- Cezary Grunwald
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland.
| | - Edyta Adamska-Patruno
- Clinical Research Support Centre, Medical University of Bialystok, Białystok, Poland.
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Białystok, Poland.
| | - Natalia Wawrusiewicz-Kurylonek
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Białystok, Poland
- Department of Clinical Genetics, Medical University of Bialystok, Białystok, Poland
| | - Agata Czarnowska
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Katarzyna Snarska
- Department of Clinical Medicine, Medical University of Bialystok, Białystok, Poland
| | - Agnieszka Dardzińska-Głębocka
- Department of Mechanics and Computer Science, Faculty of Mechanical Engineering, Bialystok University of Technology, Białystok, Poland
| | - Katarzyna Kapica-Topczewska
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Anna Mirończuk
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland
| | - Marcin Bazylewicz
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland
| | - Jan Kochanowicz
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Adam Krętowski
- Clinical Research Support Centre, Medical University of Bialystok, Białystok, Poland
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Białystok, Poland
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Białystok, Poland
| | - Alina Kułakowska
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Monika Chorąży
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland.
- Department of Neurology, Medical University of Bialystok, Białystok, Poland.
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Stępień A, Pogoda-Wesołowska A, Tokarz-Kupczyk E, Słowik A, Puz P, Adamczyk-Sowa M, Kurkowska-Jastrzębska I, Kułakowska A, Chorąży M, Piasecka-Stryczyńska K, Jamróz-Wiśniewska A, Bartosik-Psujek H, Rejdak K. Cladribine tablets for highly active relapsing-remitting multiple sclerosis in Poland: a real-world, multi-centre, retrospective, cohort study during the COVID-19 pandemic. Neurol Neurochir Pol 2023; 57:371-378. [PMID: 37490356 DOI: 10.5603/pjnns.a2023.0050] [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: 03/01/2023] [Revised: 05/01/2023] [Accepted: 05/11/2023] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Treatment with cladribine tablets is indicated in highly active relapsing-remitting multiple sclerosis (RRMS). Cladribine tablets proved safe and effective in the pivotal CLARITY trial, but that trial included primarily treatment-naïve patients. In clinical practice however, cladribine tablets are often given to patients who have failed other treatments. Therefore, this study investigated the real-world safety and efficacy of cladribine tablets. MATERIAL AND METHODS We gathered data from nine MS clinical centres across Poland for patients with RRMS who started treatment with cladribine tablets from December 2019 to June 2022. RESULTS We enrolled 140 patients, with follow-up data available for 136 in year 1 and for 66 in year 2. At baseline, the mean age was 35.6 years, mean disease duration was 7.3 years, median EDSS score was 2.5, and 94% of patients were treatment- -experienced. Thirty-nine patients (27.9%) had undergone COVID-19, and 94 (67.1%) were vaccinated against COVID-19. The annualised relapse rate (ARR) decreased from 1.49 at baseline to 0.33 in year 1 (p < 0.001) and to 0.25 in year 2 (p < 0.001). The percentage of relapse-free patients increased from 11.5% at baseline to 70.2% in year 1 and 82.1% in year 2. The percentage of patients with active lesions decreased from 91.4% at baseline to 36.2% in year 1 and 18.2% in year 2. EDSS score remained stable or improved in 83.7% of patients in year 1 and 89.6% in year 2. No evidence of disease activity (NEDA-3) was achieved in 42.7% of patients in year 1 and 66.7% in year 2. Only one patient (0.72%) had grade 4 lymphopenia and 21 (15.1%) had grade 3 lymphopenia. Varicella zoster virus infections occurred in three patients. Eight patients discontinued treatment with cladribine: five due to inefficacy, one due to lymphopenia, and two due to a personal decision. CONCLUSIONS Cladribine tablets proved safe and effective in a real-world cohort of treatment-experienced patients. However, the efficacy measures improved to a lesser extent in our cohort than in the pivotal clinical trial, which is probably due to a higher proportion of treatment-experienced patients in our cohort.
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Affiliation(s)
- Adam Stępień
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland.
| | | | | | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Przemysław Puz
- Department of Neurology, Upper-Silesian Medical Center of the Silesian Medical University, Katowice, Poland
| | | | | | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Karolina Piasecka-Stryczyńska
- Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
- Department of Neurology, SPZOZ MSWiA, Poznan, Poland
| | | | | | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
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Czarnowska A, Kapica-Topczewska K, Tarasów E, Tarasiuk J, Chorąży M, Kochanowicz J, Kułakowska A. Case report: First manifestation of multiple sclerosis temporally correlated with COVID-19 vaccination. Front Neurol 2023; 14:1097799. [PMID: 36873437 PMCID: PMC9975751 DOI: 10.3389/fneur.2023.1097799] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 01/24/2023] [Indexed: 02/17/2023] Open
Abstract
There are several case reports describing a temporal correlation between the first clinical manifestation of multiple sclerosis (MS) and the occurrence of relapses with vaccination against SARS-CoV-2. Here we report a case of a 33-year-old male who developed partial right upper and lower extremities numbness 2 weeks after receiving Johnson & Johnson's Janssen COVID-19 vaccine. The brain MRI performed during diagnostics in the Department of Neurology detected several demyelinating lesions, one with enhancement. Oligoclonal bands were present in the cerebrospinal fluid. The patient was treated with high-dose glucocorticoid therapy with improvement and the diagnosis of MS was made. It seems plausible that the vaccination revealed the underlying autoimmune condition. Cases like the one we reported here are rare, and-based on current knowledge-the benefits of vaccination against SARS-CoV-2 far outweigh the potential risks.
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Affiliation(s)
- Agata Czarnowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | | | - Eugeniusz Tarasów
- Department of Radiology, Medical University of Białystok, Białystok, Poland
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
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Kulikowska J, Czarnowska A, Gudowska-Sawczuk M, Kulczyńska-Przybik A, Bazylewicz M, Collins F, Chorąży M, Mroczko B, Kochanowicz J, Kapica-Topczewska K, Kułakowska A. Antibodies against SARS-CoV-2 S and N proteins in relapsing-remitting multiple sclerosis patients treated with disease-modifying therapies. Neurol Neurochir Pol 2022; 57:121-130. [PMID: 36421067 DOI: 10.5603/pjnns.a2022.0067] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/10/2022] [Accepted: 10/19/2022] [Indexed: 11/25/2022]
Abstract
CLINICAL RATIONALE FOR THE STUDY The course of COVID-19 in people with multiple sclerosis (PwMS) has been described, while the serological status after SARS-CoV-2 infection or vaccination, especially in patients treated with disease-modifying therapies (DMT), is still under investigation. This is a significant clinical problem, as certain DMTs may predispose to a severe course of viral infections. AIM OF THE STUDY We analyzed the presence of antibodies against spike (S) and nucleocapsid (N) proteins of SARS-CoV-2 in relapsing-remitting PwMS treated with DMT, especially dimethyl fumarate, interferon beta, and glatiramer acetate, in a single multiple sclerosis (MS) centre in north-eastern Poland (the Department of Neurology, Medical University of Bialystok). MATERIAL AND METHODS The presence of antibodies against S and N proteins in PwMS was assessed twice: on visit one (between May and June 2020) (n = 186) and on visit two (between May and June 2021) (n = 88). Samples were taken from 68 individuals on both visits. Demographic and clinical data was collected: duration of MS, Expanded Disability Status Scale Score (EDSS), type of DMT, history of COVID-19 (positive PCR or antigen test in the past), vaccination status, and the type of vaccine. RESULTS It was shown that on visit one: 3.7% (n = 7) PwMS were positive for IgA against S protein (IgA-S), 3.2% (n = 6) for IgG against S (IgG-S) protein, and none of those examined was positive for IgG against N protein (IgG-N). On visit two, the most common detected antibodies were IgG-S (71.3%; n = 62), then IgA-S (65.1%; n = 55), and the least common was IgG-N (18.2%; n = 16). On visit two: 20.45% of PwMS had a history of a positive SARS-CoV-2 PCR or antigen test during the last year. By the time of visit two, 42.05% (n = 37) of patients who participated in visit two had been full-course vaccinated against COVID-19. It was demonstrated that vaccination against SARS-CoV-2 significantly induces the production of IgG-S and IgA-S (p < 0.0001), while no difference between vaccinated and unvaccinated patients was shown in the detection of IgG-N. There was no correlation between COVID-19 infection and antibodies against proteins S and N in the study group. Moreover, the presented study did not show any relationship between the ability to produce antibodies against the S protein with any of the used DMTs. CONCLUSIONS AND CLINICAL IMPLICATIONS According to our study, PwMS treated with dimethyl fumarate, interferon beta, or glatiramer acetate can efficiently produce antibodies against SARS-CoV-2 both after infection and after vaccination.
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Affiliation(s)
- Joanna Kulikowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland.
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Monika Gudowska-Sawczuk
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | | | - Marcin Bazylewicz
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | | | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Jan Kochanowicz
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | | | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
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7
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Czarnowska A, Tarasiuk J, Zajkowska O, Wnuk M, Marona M, Nowak K, Słowik A, Jamroz-Wiśniewska A, Rejdak K, Lech B, Popiel M, Rościszewska-Żukowska I, Perenc A, Bartosik-Psujek H, Świderek-Matysiak M, Siger M, Ciach A, Walczak A, Jurewicz A, Stasiołek M, Kania K, Dyczkowska K, Kalinowska-Łyszczarz A, Galus W, Walawska-Hrycek A, Krzystanek E, Chojdak-Łukasiewicz J, Ubysz J, Pokryszko-Dragan A, Kapica-Topczewska K, Chorąży M, Bazylewicz M, Mirończuk A, Kulikowska J, Kochanowicz J, Białek M, Stolarz M, Kubicka-Bączyk K, Niedziela N, Warmus P, Adamczyk-Sowa M, Podlecka-Piçtowska A, Nojszewska M, Zakrzewska-Pniewska B, Jasińska E, Zaborski J, Milewska-Jȩdrzejczak M, Zwiernik J, Zwiernik B, Potemkowski A, Brola W, Kułakowska A. Analysis of Side Effects Following Vaccination Against COVID-19 Among Individuals With Multiple Sclerosis Treated With DMTs in Poland. Front Neurol 2022; 13:913283. [PMID: 35775049 PMCID: PMC9237390 DOI: 10.3389/fneur.2022.913283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives Since vaccination against COVID-19 is available for over a year and the population of immunized individuals with autoimmune disorders is higher than several months before, an evaluation of safety and registered adverse events can be made. We conducted a large study of side effects following the COVID-19 vaccine among patients with multiple (MS) sclerosis treated with disease-modifying therapies (DMTs) and analyzed factors predisposing for particular adverse events. Methods We gathered data of individuals with MS treated with DMTs from 19 Polish MS Centers, who reported at least one adverse event following COVID-19 vaccination. The information was obtained by neurologists using a questionnaire. The same questionnaire was used at all MS Centers. To assess the relevance of reported adverse events, we used Fisher's exact test, t-test, and U-Menn-Whutney test. Results A total of 1,668 patients with MS and reports of adverse events after COVID-19 vaccination were finally included in the study. Besides one case marked as “red flag”, all adverse events were classified as mild. Pain at the injection site was the most common adverse event, with a greater frequency after the first dose. Pain at the injection site was significantly more frequent after the first dose among individuals with a lower disability (EDSS ≤2). The reported adverse events following immunization did not differ over sex. According to age, pain at the injection site was more common among individuals between 30 and 40 years old, only after the first vaccination dose. None of the DMTs predisposed for particular side effects. Conclusions According to our findings, vaccination against COVID-19 among patients with MS treated with DMTs is safe. Our study can contribute to reducing hesitancy toward vaccination among patients with MS.
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Affiliation(s)
- Agata Czarnowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
- *Correspondence: Agata Czarnowska
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Olga Zajkowska
- Faculty of Economic Sciences, University of Warsaw, Warsaw, Poland
| | - Marcin Wnuk
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Monika Marona
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Klaudia Nowak
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Beata Lech
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska, Poland
| | - Małgorzata Popiel
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska, Poland
| | - Iwona Rościszewska-Żukowska
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | - Adam Perenc
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska, Poland
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | | | - Małgorzata Siger
- Department of Neurology, Medical University of Lodz, Łódz, Poland
| | - Agnieszka Ciach
- Department of Neurology, Medical University of Lodz, Łódz, Poland
| | - Agata Walczak
- Department of Neurology, Medical University of Lodz, Łódz, Poland
| | - Anna Jurewicz
- Department of Neurology, Medical University of Lodz, Łódz, Poland
| | | | - Karolina Kania
- Department of Neurology, Poznan University of Medical Sciences, Poznań, Poland
| | - Klara Dyczkowska
- Department of Neurology, Poznan University of Medical Sciences, Poznań, Poland
| | | | - Weronika Galus
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Anna Walawska-Hrycek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Ewa Krzystanek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | | | - Jakub Ubysz
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | | | | | - Monika Chorąży
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Marcin Bazylewicz
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Anna Mirończuk
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Joanna Kulikowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Marta Białek
- Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, Bytom, Poland
| | - Małgorzata Stolarz
- Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, Bytom, Poland
| | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Natalia Niedziela
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Paweł Warmus
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | | | - Monika Nojszewska
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | | | - Elżbieta Jasińska
- Jan Kochanowski University, Collegium Medicum, Kielce, Poland
- Clinical Center, Resmedica, Kielce, Poland
| | - Jacek Zaborski
- Department of Neurology and Neurorehabilitation, Miedzyleski Szpital Specjalistyczny, Warsaw, Poland
| | | | - Jacek Zwiernik
- Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland
- Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland
| | - Beata Zwiernik
- Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland
- Clinic of Neurology, University of Warmia and Mazury, Olsztyn, Poland
| | - Andrzej Potemkowski
- Department of Clinical Psychology and Psychoprophylaxis, University of Szczecin, Szczecin, Poland
| | - Waldemar Brola
- Department of Neurology, Specialist Hospital in Końskie, Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
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Tarasiuk J, Kapica-Topczewska K, Czarnowska A, Chorąży M, Kochanowicz J, Kułakowska A. Co-occurrence of Fatigue and Depression in People With Multiple Sclerosis: A Mini-Review. Front Neurol 2022; 12:817256. [PMID: 35242093 PMCID: PMC8886154 DOI: 10.3389/fneur.2021.817256] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 11/17/2021] [Accepted: 12/20/2021] [Indexed: 12/11/2022] Open
Abstract
Fatigue and depression are common conditions diagnosed in people with multiple sclerosis (MS). Fatigue defined as subjective lack of physical and/or mental energy is present in 35–97% of people with MS, who classify it as one of the most serious symptoms interfering with daily activities and influencing the quality of life. Depression is diagnosed in about 50% of people with MS. Since fatigue and depression frequently coexists, it may be quite hard to differentiate them. Primary fatigue and primary depression in MS are caused by inflammatory, oxidative/nitrosative, and neurodegenerative processes leading to demyelination, axonal damage, and brain atrophy. In people with MS and comorbid fatigue and/or depression there is reported increased serum and cerebrospinal fluid concentration of inflammatory mediators such as tumor necrosis factor, interleukins (IL-1a, IL-1b, IL-6), interferon γ and neopterin. Moreover, the brain atrophy of prefrontal, frontal, parietotemporal regions, thalamus, and basal ganglia was observed in people with MS with fatigue and/or depression. The secondary fatigue and secondary depression in people with MS may be caused by emotional factors, sleep disorders, pain, the coexistence of other diseases, and the use of medications. In some studies, the use of disease-modifying therapies positively influenced fatigue, probably by reducing the inflammatory response, which proves that fatigue and depression are closely related to immunological factors. In this mini-review, the pathogenesis, methods of evaluation and differentiation, and possible therapies for fatigue and depression in MS are discussed.
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Affiliation(s)
- Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | | | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
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Brola W, Steinborn B, Niewada M, Mazurkiewicz-Bełdzińska M, Jóźwiak S, Sobolewski P, Żak M, Wilski M, Bilska M, Siedlarska M, Puzio-Bochen I, Wencel-Warot A, Lemka M, Kroczka S, Czyżyk E, Bocheńska M, Emich-Widera E, Pietruszewski J, Boćkowski L, Kapica-Topczewska K, Chorąży M, Kułakowska A, Ujma-Czapska B, Przysło Ł, Połatyńska K, Dudzińska M, Mitosek-Szewczyk K, Melnyk A, Knap M, Kotulska K. Pediatric-onset multiple sclerosis in Poland: A registry-based retrospective cohort study. Mult Scler Relat Disord 2022; 57:103344. [DOI: 10.1016/j.msard.2021.103344] [Citation(s) in RCA: 2] [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: 08/26/2021] [Revised: 10/14/2021] [Accepted: 10/21/2021] [Indexed: 11/28/2022]
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10
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Czarnowska A, Kapica-Topczewska K, Zajkowska O, Adamczyk-Sowa M, Kubicka-Bączyk K, Niedziela N, Warmus P, Kalinowska-Łyszczarz A, Kania K, Słowik A, Wnuk M, Marona M, Nowak K, Bartosik-Psujek H, Lech B, Perenc A, Popiel M, Kucharska-Lipowska M, Chorąży M, Tarasiuk J, Mirończuk A, Kochanowicz J, Lasek-Bal A, Puz P, Maciejowska K, Wawrzyniak S, Niezgodzińska-Maciejek A, Pokryszko-Dragan A, Gruszka E, Budrewicz S, Białek M, Zwiernik J, Michałowska A, Nosek K, Zwiernik B, Lewańczyk B, Brola W, Kułakowska A. Symptoms after COVID-19 Infection in Individuals with Multiple Sclerosis in Poland. J Clin Med 2021; 10:jcm10225225. [PMID: 34830507 PMCID: PMC8618380 DOI: 10.3390/jcm10225225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 09/15/2021] [Revised: 10/14/2021] [Accepted: 11/04/2021] [Indexed: 12/13/2022] Open
Abstract
(1) Background: To report and analyze the presence of residual symptoms after SARS-CoV-2 infection among Polish patients with multiple sclerosis (MS) treated with different disease-modifying therapies (DMTs). (2) Methods: The study included 426 individuals with MS treated with DMTs and confirmed SARS-CoV-2 infection from 12 Polish MS centers. The data were collected through to 31 May 2021. The information included demographics, specific MS characteristics, course of SARS-CoV-2 infection, and residual (general and neurological) symptoms lasting more than four and 12 weeks after the initial infection. The results were obtained using maximum likelihood estimates for odds ratio and logistic regression. (3) Results: A total of 44.84% patients with MS reported symptoms lasting between four and 12 weeks after the initial infection; 24.41% people had symptoms that resolved up to 12 weeks, and 20.42% patients had symptoms that lasted over 12 weeks. The most common symptoms were: fatigue, disturbance of concentration, attention, and memory, cognitive complaints, and headache. None of the DMTs were predisposed to the development of residual symptoms after the initial infection. A total of 11.97% of patients had relapse three months prior or after SARS-CoV-2 infection. (4) Conclusion: Almost half of individuals with MS treated with different DMTs had residual symptoms after SARS-CoV-2 infection. None of the DMTs raised the probability of developing post-acute COVID symptoms.
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Affiliation(s)
- Agata Czarnowska
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
- Correspondence: ; Tel.: +48-85-746-83-26; Fax: +48-85-746-86-08
| | - Katarzyna Kapica-Topczewska
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
| | - Olga Zajkowska
- Faculty of Economic Sciences, University of Warsaw, 00-241 Warszawa, Poland;
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (M.A.-S.); (K.K.-B.); (N.N.); (P.W.)
| | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (M.A.-S.); (K.K.-B.); (N.N.); (P.W.)
| | - Natalia Niedziela
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (M.A.-S.); (K.K.-B.); (N.N.); (P.W.)
| | - Paweł Warmus
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (M.A.-S.); (K.K.-B.); (N.N.); (P.W.)
| | - Alicja Kalinowska-Łyszczarz
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, 61-701 Poznań, Poland; (A.K.-Ł.); (K.K.)
| | - Karolina Kania
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, 61-701 Poznań, Poland; (A.K.-Ł.); (K.K.)
| | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University Medical College, University Hospital, 30-688 Krakow, Poland; (A.S.); (M.W.); (M.M.); (K.N.)
| | - Marcin Wnuk
- Department of Neurology, Jagiellonian University Medical College, University Hospital, 30-688 Krakow, Poland; (A.S.); (M.W.); (M.M.); (K.N.)
| | - Monika Marona
- Department of Neurology, Jagiellonian University Medical College, University Hospital, 30-688 Krakow, Poland; (A.S.); (M.W.); (M.M.); (K.N.)
| | - Klaudia Nowak
- Department of Neurology, Jagiellonian University Medical College, University Hospital, 30-688 Krakow, Poland; (A.S.); (M.W.); (M.M.); (K.N.)
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszów, Poland;
| | - Beata Lech
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, 35-301 Rzeszów, Poland; (B.L.); (A.P.); (M.P.)
| | - Adam Perenc
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, 35-301 Rzeszów, Poland; (B.L.); (A.P.); (M.P.)
| | - Małgorzata Popiel
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, 35-301 Rzeszów, Poland; (B.L.); (A.P.); (M.P.)
| | | | - Monika Chorąży
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
| | - Anna Mirończuk
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
| | - Anetta Lasek-Bal
- Department of Neurology, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland; (A.L.-B.); (P.P.); (K.M.)
| | - Przemysław Puz
- Department of Neurology, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland; (A.L.-B.); (P.P.); (K.M.)
| | - Katarzyna Maciejowska
- Department of Neurology, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland; (A.L.-B.); (P.P.); (K.M.)
| | - Sławomir Wawrzyniak
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Independent Public Healthcare Centre, 85-681 Bydgoszcz, Poland; (S.W.); (A.N.-M.)
| | - Anna Niezgodzińska-Maciejek
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Independent Public Healthcare Centre, 85-681 Bydgoszcz, Poland; (S.W.); (A.N.-M.)
| | - Anna Pokryszko-Dragan
- Department of Neurology, Wroclaw Medical University, 50-367 Wroclaw, Poland; (A.P.-D.); (E.G.); (S.B.)
| | - Ewa Gruszka
- Department of Neurology, Wroclaw Medical University, 50-367 Wroclaw, Poland; (A.P.-D.); (E.G.); (S.B.)
| | - Sławomir Budrewicz
- Department of Neurology, Wroclaw Medical University, 50-367 Wroclaw, Poland; (A.P.-D.); (E.G.); (S.B.)
| | - Marta Białek
- Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, 41-902 Bytom, Poland;
| | - Jacek Zwiernik
- Neurology Ward, Provincial Specialist Hospital, 10-561 Olsztyn, Poland; (J.Z.); (A.M.)
- Department of Neurology, University of Warmia and Mazury, 10-719 Olsztyn, Poland;
| | - Anna Michałowska
- Neurology Ward, Provincial Specialist Hospital, 10-561 Olsztyn, Poland; (J.Z.); (A.M.)
| | - Krzysztof Nosek
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, 10-719 Olsztyn, Poland;
| | - Beata Zwiernik
- Department of Neurology, University of Warmia and Mazury, 10-719 Olsztyn, Poland;
- Clinic of Neurology, University of Warmia and Mazury, 10-719 Olsztyn, Poland
| | - Bożena Lewańczyk
- Neurology Ward, Provincial Integrated Hospital, 82-300 Elbląg, Poland;
| | - Waldemar Brola
- Department of Neurology, Specialist Hospital in Końskie, Collegium Medicum, Jan Kochanowski University Kielce, 26-200 Końskie, Poland;
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
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Czarnowska A, Brola W, Zajkowska O, Rusek S, Adamczyk-Sowa M, Kubicka-Bączyk K, Kalinowska-Łyszczarz A, Kania K, Słowik A, Wnuk M, Marona M, Podlecka-Piętowska A, Nojszewska M, Zakrzewska-Pniewska B, Jasińska E, Gołuch K, Lech B, Noga M, Perenc A, Popiel M, Lasek-Bal A, Puz P, Maciejowska K, Kucharska-Lipowska M, Lipowski M, Kapica-Topczewska K, Chorąży M, Tarasiuk J, Kochanowicz J, Kulikowska J, Wawrzyniak S, Niezgodzińska-Maciejek A, Pokryszko-Dragan A, Gruszka E, Budrewicz S, Białek M, Kurkowska-Jastrzębska I, Kurowska K, Stępień A, Włodek A, Ptasznik V, Pawełczyk M, Sobolewski P, Lejmel H, Strzalińska K, Maciejowski M, Tutaj A, Zwiernik J, Litwin A, Lewańczyk B, Paprocka I, Zwiernik B, Pawlos A, Borysowicz A, Narożnik A, Michałowska A, Nosek K, Fudala M, Milewska-Jędrzejczak M, Kułakowska A, Bartosik-Psujek H. Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease-modifying therapies - the Polish experience. Neurol Neurochir Pol 2021; 55:212-222. [PMID: 33856686 DOI: 10.5603/pjnns.a2021.0031] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The aim of this study was to report the course and outcome of SARS-CoV-2 infection in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs) in Poland. A major concern for neurologists worldwide is the course and outcome of SARS-CoV-2 infection in patients with MS treated with different DMTs. Although initial studies do not suggest an unfavourable course of infection in this group of patients, the data is limited. MATERIALS AND METHODS This study included 396 MS patients treated with DMTs and confirmed SARS-CoV-2 infection from 28 Polish MS centres. Information concerning patient demographics, comorbidities, clinical course of MS, current DMT use, as well as symptoms of SARS-CoV-2 infection, need for pharmacotherapy, oxygen therapy, and/or hospitalisation, and short-term outcomes was collected up to 30 January 2021. Additional data about COVID-19 cases in the general population in Poland was obtained from official reports of the Polish Ministry of Health. RESULTS There were 114 males (28.8%) and 282 females (71.2%). The median age was 39 years (IQR 13). The great majority of patients with MS exhibited relapsing-remitting course (372 patients; 93.9%). The median EDSS was 2 (SD 1.38), and the mean disease duration was 8.95 (IQR 8) years. Most of the MS patients were treated with dimethyl fumarate (164; 41.41%). Other DMTs were less frequently used: interferon beta (82; 20.70%), glatiramer acetate (42; 10.60%), natalizumab (35;8.84%), teriflunomide (25; 6.31%), ocrelizumab (20; 5.05%), fingolimod (16; 4.04), cladribine (5; 1.26%), mitoxantrone (3; 0.76%), ozanimod (3; 0.76%), and alemtuzumab (1; 0.25%). The overall hospitalisation rate due to COVID-19 in the cohort was 6.81% (27 patients). Only one patient (0.3%) died due to SARS-CoV-2 infection, and three (0.76%) patients were treated with mechanical ventilation; 106 (26.8%) patients had at least one comorbid condition. There were no significant differences in the severity of SARS-CoV-2 infection regarding patient age, duration of the disease, degree of disability (EDSS), lymphocyte count, or type of DMT used. CONCLUSIONS AND CLINICAL IMPLICATIONS Most MS patients included in this study had a favourable course of SARS-CoV-2 infection. The hospitalisation rate and the mortality rate were not higher in the MS cohort compared to the general Polish population. Continued multicentre data collection is needed to increase the understanding of SARS-CoV-2 infection impact on the course of MS in patients treated with DMTs.
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Affiliation(s)
| | - Waldemar Brola
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Olga Zajkowska
- Faculty of Economic Sciences, University of Warsaw, Poland
| | - Stanisław Rusek
- Department of Neurology, Specialist Hospital Ludwika Rydygiera in Krakow, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Alicja Kalinowska-Łyszczarz
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poland
| | - Karolina Kania
- Department of Neurology, Poznan University of Medical Sciences, Poland
| | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Marcin Wnuk
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Monika Marona
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | | | | | | | - Elżbieta Jasińska
- Collegium Medicum UJK, and Clinical Center, RESMEDICA, Kielce, Poland
| | | | - Beata Lech
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland
| | - Magdalena Noga
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland
| | - Adam Perenc
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland
| | - Małgorzata Popiel
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland
| | - Anetta Lasek-Bal
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Przemysław Puz
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Katarzyna Maciejowska
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | | | - Michał Lipowski
- Department of Urology, Specialist Hospital in Końskie, Poland
| | | | | | | | | | | | - Sławomir Wawrzyniak
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Independent Public Healthcare Centre, Bydgoszcz, Poland
| | - Anna Niezgodzińska-Maciejek
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Independent Public Healthcare Centre, Bydgoszcz, Poland
| | | | - Ewa Gruszka
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Marta Białek
- Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, Poland
| | | | - Katarzyna Kurowska
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland
| | - Agata Włodek
- Department of Neurology, Masovian Voivodeship Hospital in Siedlce, Poland
| | | | | | - Piotr Sobolewski
- Department of Neurology and Stroke Unit in Sandomierz, Collegium Medicum, Jan Kochanowski University in Kielce
| | - Henryka Lejmel
- Department of Neurology, The Regional Hospital in Suwalki, Poland
| | | | | | - Andrzej Tutaj
- Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland
| | - Jacek Zwiernik
- Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland; Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland
| | - Anna Litwin
- Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland
| | | | | | - Beata Zwiernik
- Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland; Clinic of Neurology, University of Warmia and Mazury, Olsztyn, Poland
| | - Aleksandra Pawlos
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | - Andrzej Borysowicz
- Department of Neurology, Specialist Hospital Dr Tytus Chałubiński Radom, Poland
| | - Anna Narożnik
- Department of Neurology, Specialist Hospital Dr Tytus Chałubiński Radom, Poland
| | | | - Krzysztof Nosek
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | - Małgorzata Fudala
- Department of Neurology, Regional Hospital in Skarżysko-Kamienna, Poland
| | | | | | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Poland
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Kapica-Topczewska K, Collin F, Tarasiuk J, Czarnowska A, Chorąży M, Mirończuk A, Kochanowicz J, Kułakowska A. Assessment of Disability Progression Independent of Relapse and Brain MRI Activity in Patients with Multiple Sclerosis in Poland. J Clin Med 2021; 10:jcm10040868. [PMID: 33669799 PMCID: PMC7923173 DOI: 10.3390/jcm10040868] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/29/2020] [Revised: 02/10/2021] [Accepted: 02/14/2021] [Indexed: 12/16/2022] Open
Abstract
The aim of the study was to verify the association of clinical relapses and brain activity with disability progression in relapsing/remitting multiple sclerosis patients receiving disease-modifying treatments in Poland. Disability progression was defined as relapse-associated worsening (RAW), progression independent of relapse activity (PIRA), and progression independent of relapses and brain MRI Activity (PIRMA). Data from the Therapeutic Program Monitoring System were analyzed. Three panels of patients were identified: R0, no relapse during treatment, and R1 and R2 with the occurrence of relapse during the first and the second year of treatment, respectively. In the R0 panel, we detected 4.6% PIRA patients at 24 months (p < 0.001, 5.0% at 36 months, 5.6% at 48 months, 6.1% at 60 months). When restricting this panel to patients without brain MRI activity, we detected 3.0% PIRMA patients at 12 months, 4.5% at 24 months, and varying from 5.3% to 6.2% between 36 and 60 months of treatment, respectively. In the R1 panel, RAW was detected in 15.6% patients at 12 months and, in the absence of further relapses, 9.7% at 24 months and 6.8% at 36 months of treatment. The R2 group was associated with RAW significantly more frequently at 24 months compared to the R1 at 12 months (20.7%; p < 0.05), but without a statistical difference later on. In our work, we confirmed that disability progression was independent of relapses and brain MRI activity.
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Affiliation(s)
- Katarzyna Kapica-Topczewska
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
- Correspondence: ; Tel.: +48-85-7468326
| | - François Collin
- Independent Statistical Consultant, 40-668 Katowice, Poland;
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
| | - Anna Mirończuk
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
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Kapica-Topczewska K, Collin F, Tarasiuk J, Czarnowska A, Chorąży M, Mirończuk A, Kochanowicz J, Kułakowska A. John Cunningham Virus Status, Seroconversion Rate, and the Risk of Progressive Multifocal Leukoencephalopathy in Polish John Cunningham Virus-Seronegative Patients with Relapsing-Remitting Multiple Sclerosis. Eur Neurol 2020; 83:487-492. [PMID: 33027785 DOI: 10.1159/000510849] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 08/07/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Presence of anti-JC-virus antibodies (JCVAbs) is associated with the increased risk of natalizumab (NAT)-related progressive multifocal leukoencephalopathy (PML). Little is known about seroconversion rate and time to seroconversion in relapsing-remitting multiple sclerosis (RRMS) patients treated with NAT in Poland. The aim of the study was to assess the true risk of PML, seroconversion rate, and time to seroconversion in all JCVAb-negative RRMS patients treated with NAT in Poland. METHODS Demographic and clinical data of all Polish RRMS patients treated with NAT reimbursed by National Health Fund (NFZ) were prospectively collected in electronic files using the Therapeutic Programme Monitoring System provided by NFZ. The assessment of JCVAb presence (without collection of JCVAb index value) in serum (Unilabs, STRATIFY JCV: anti-JCV antibody ELISA) was done at the beginning of therapy and then repeated every 6 months. The maximum follow-up time was 4 years. In Poland, since 2013, according to the NFZ drug program guidance, only patients with negative JCVAb test have started treatment with NAT. RESULTS In all Polish multiple sclerosis centers, 210 negative JCVAb RRMS patients with at least 9 (±3) months of observation (146 females, 64 males, and the median age at baseline: 33 years) were included in the study. During the follow-up period, JCVAb status changed from negative to positive in 34 patients (16.2%). For half of the patients, the seroconversion was diagnosed 1 year after starting NAT treatment. In 4 patients (1.9%) during follow-up, JCVAb status changed again from positive to negative. In Poland, before establishment of NFZ drug program, 4 cases of PML in patients treated with NAT in clinical trials were diagnosed. In the NFZ drug program, since 2013, no patient treated with NAT has been diagnosed with PML. CONCLUSIONS NAT therapy in JCV-seronegative RRMS patients is safe and results in the absence of PML cases. In Poland, JCV seroconversion rate is similar to that observed in other European countries.
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Affiliation(s)
| | - Francois Collin
- Independent Statistical Consultant, François COLLIN, Katowice, Poland
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Anna Mirończuk
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
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Kapica-Topczewska K, Tarasiuk J, Chorąży M, Czarnowska A, Brola W, Szczepański M, Kochanowicz J, Kułakowska A. The epidemiology of comorbidities among multiple sclerosis patients in northeastern Poland. Mult Scler Relat Disord 2020; 41:102051. [DOI: 10.1016/j.msard.2020.102051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 11/30/2022]
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Kapica-Topczewska K, Collin F, Tarasiuk J, Chorąży M, Czarnowska A, Kwaśniewski M, Brola W, Bartosik-Psujek H, Adamczyk-Sowa M, Kochanowicz J, Kułakowska A. Clinical and epidemiological characteristics of multiple sclerosis patients receiving disease-modifying treatment in Poland. Neurol Neurochir Pol 2020; 54:161-168. [PMID: 32219813 DOI: 10.5603/pjnns.a2020.0020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 10/04/2019] [Revised: 11/19/2019] [Accepted: 11/24/2019] [Indexed: 11/25/2022]
Abstract
AIM OF STUDY The aim of this study was to collect and analyse data on relapsing-remitting multiple sclerosis (RRMS) patients receiving disease-modifying therapies (DMTs) in Poland. MATERIAL AND METHODS This observational, multicentre study with prospective data collection included RRMS patients receiving DMTs reimbursed by the National Health Fund (NFZ) in Poland, monitored by the Therapeutic Programme Monitoring System (SMPT). Demographic profiles, disability status, and treatment modalities were analysed. RESULTS Data from 11,632 RRMS patients was collected (from 15,368 new prescriptions), including 10,649 patients in the first-line and 983 in the second-line therapeutic programme of DMTs. The proportion of females to males was 2.39 in the first-line and 1.91 in the second-line. The mean age at DMTs start was 36.6 years in the first-line and 35.1 in the second-line. The median time from the first symptoms to MS diagnosis was 7.4 months, and from MS diagnosis to treatment it was 18.48 months. A total of 43.4% of MS patients started DMT during the 12 months following diagnosis. There was a positive correlation between the duration from MS diagnosis to the start of DMT and a higher initial EDSS value [correlation 0.296 (p < 0.001)]. About 10% of patients stopped DMTs. In Poland, about one third of all MS patients are treated in both lines, and the choice of first-line treatment depends on the region of the country. CONCLUSIONS In Poland there is a need to increase MS patient access to DMTs by improving the organisation of drug programmes.
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Affiliation(s)
- Katarzyna Kapica-Topczewska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland, Skłodowskiej-Curie 24 A, 15-275 Białystok, Poland.
| | - Francois Collin
- Centre for Bioinformatics and Data Analysis, Medical University of Bialystok, Bialystok, Poland, Ul.J. Waszyngtona 13 A, 15-269 Białystok, Poland
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland, Skłodowskiej-Curie 24 A, 15-275 Białystok, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland, Skłodowskiej-Curie 24 A, 15-275 Białystok, Poland
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland, Skłodowskiej-Curie 24 A, 15-275 Białystok, Poland
| | - Mirosław Kwaśniewski
- Centre for Bioinformatics and Data Analysis, Medical University of Bialystok, Bialystok, Poland, Ul.J. Waszyngtona 13 A, 15-269 Białystok, Poland
| | - Waldemar Brola
- The Faculty of Medicine and Health Sciences, Institute of Physiotherapy, Jan Kochanowski University, Kielce, Poland, Al. IX Wieków Kielc 19A, 25-317 Kielce, Poland
| | - Halina Bartosik-Psujek
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Medical Faculty, University of Rzeszow, Rzeszów, Poland, Lwowska 60, 35-301 Rzeszów, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology in Zabrze, Medical University of Silesia, Zabrze, Poland, 3-go Maja St. 13-15,, 41-800 Zabrze, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland, Skłodowskiej-Curie 24 A, 15-275 Białystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland, Skłodowskiej-Curie 24 A, 15-275 Białystok, Poland
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Wawrusiewicz-Kurylonek N, Gościk J, Chorąży M, Siewko K, Posmyk R, Zajkowska A, Citko A, Maciulewski R, Szelachowska M, Myśliwiec J, Jastrzębska I, Kułakowska A, Kochanowicz J, Krętowski AJ. The interferon-induced helicase C domain-containing protein 1 gene variant (rs1990760) as an autoimmune-based pathology susceptibility factor. Immunobiology 2020; 225:151864. [DOI: 10.1016/j.imbio.2019.10.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 10/17/2019] [Accepted: 10/29/2019] [Indexed: 12/18/2022]
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Kapica-Topczewska K, Tarasiuk J, Collin F, Brola W, Chorąży M, Czarnowska A, Kwaśniewski M, Bartosik-Psujek H, Adamczyk-Sowa M, Kochanowicz J, Kułakowska A. The effectiveness of interferon beta versus glatiramer acetate and natalizumab versus fingolimod in a Polish real-world population. PLoS One 2019; 14:e0223863. [PMID: 31647829 PMCID: PMC6812766 DOI: 10.1371/journal.pone.0223863] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 09/30/2019] [Indexed: 12/22/2022] Open
Abstract
Objective The aim of the study was to assess the effectiveness of disease-modifying therapies (DMTs) in relapsing-remitting multiple sclerosis (RRMS) patients treated in MS centres in Poland. Methods Demographic and clinical data of all Polish RRMS patients receiving DMTs were prospectively collected from 2014 to 2018 in electronic files using the Therapeutic Program Monitoring System (SMPT). Results The study included 10,764 RRMS patients treated with DMTs in first-line and 1,042 in second-line programmes. IFNβ more effectively lengthened the times to the first relapse, disability progression, and brain MRI activity than GA. After 2 and 4 years of follow-up, more patients on IFNβ showed no evidence of disease activity (NEDA-3) in comparison to GA (66.3% and 44.3% vs 55.2% and 33.2%, respectively; p<0.001). NAT more effectively reduced brain MRI activity than FTY (p = 0.001). More patients under NAT had NEDA-3 after 2 and 4 years of follow-up compared to FTY (66.2% and 42.1% vs 52.1% and 29.5%, respectively; p = 0.03). In adjusted analysis, a higher baseline Expanded Disability Status Score (EDSS) was a predictor of relapse (p<0.001) and NEDA-3 failure (p = 0.003). Conclusion IFNβ compared to GA and NAT compared to FTY more effectively reduced disease activity in a Polish population of RRMS patients.
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Affiliation(s)
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Francois Collin
- Centre for Bioinformatics and Data Analysis, Medical University of Bialystok, Bialystok, Poland
| | - Waldemar Brola
- The Faculty of Medicine and Health Sciences, Institute of Physiotherapy, Jan Kochanowski University, Kielce, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Mirosław Kwaśniewski
- Centre for Bioinformatics and Data Analysis, Medical University of Bialystok, Bialystok, Poland
| | - Halina Bartosik-Psujek
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Medical Faculty, University of Rzeszow, Rzeszów, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
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Tarasiuk J, Kapica-Topczewska K, Chorąży M, Mroczko B, Kochanowicz J, Kułakowska A. Is vitamin D deficiency a reliable risk factor for multiple sclerosis development? Neurol Neurochir Pol 2019; 53:388-389. [PMID: 31538658 DOI: 10.5603/pjnns.a2019.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 08/01/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland.
| | | | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Barbara Mroczko
- Department of Neurodegenerative Diseases Diagnostic, Medical University of Bialystok, Bialystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
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Chorąży M, Wawrusiewicz-Kurylonek N, Posmyk R, Zajkowska A, Kapica-Topczewska K, Krętowski AJ, Kochanowicz J, Kułakowska A. Analysis of chosen SNVs in GPC5, CD58 and IRF8 genes in multiple sclerosis patients. Adv Med Sci 2019; 64:230-234. [PMID: 30818222 DOI: 10.1016/j.advms.2018.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/06/2018] [Accepted: 12/07/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Multiple sclerosis (MS) is an autoimmune disease of the central nervous system with a neurodegenerative compound. Heterogenetic background of autoimmunity pathway components has been suggested in the MS pathogenesis. The main aim of our study was to evaluate the association between selected polymorphisms of theCD58, IRF8 and GPC5 genes and treatment effectiveness in a group of relapsing-remitting MS patients. This is the first study of MS patients from Podlaskie Region in the Polish population. MATERIALS AND METHODS The study group comprised 174 relapsing-remitting MS patients diagnosed under 40 years of age. Genotyping was performed using ready to use TaqMan assays. RESULTS We demonstrate a strong association of the polymorphisms with sex, age of onset and response to the treatment applied. A significant correlation was observed in the presence of allele T of rs10492503 polymorphism inGPC5 gene with sex and age of MS onset. Logistic regression analysis revealed an increased risk of the interaction of rs17445836 in IRF8 gene with male sex and the type of treatment (OR = 3.80, p < 0.05), and a decreased risk in the interaction of female sex with disease progress according to the EDSS scale (OR=-2.33, p < 0.05). CONCLUSIONS The analysis of the correlation between different alleles, genotypes and clinical status confirmed the interaction between the genetic factors of age of onset and response to therapy. The study suggests that genetic variants inGPC5, CD58 and IRF8 genes may be of clinical interest in MS as predictors of age of onset and response to therapy.
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Chorąży M, Wawrusiewicz-Kurylonek N, Gościk J, Posmyk R, Czarnowska A, Więsik M, Kapica-Topczewska K, Krętowski AJ, Kochanowicz J, Kułakowska A. Association between polymorphisms of a folate - homocysteine - methionine - SAM metabolising enzyme gene and multiple sclerosis in a Polish population. Neurol Neurochir Pol 2019; 53:194-198. [PMID: 31145465 DOI: 10.5603/pjnns.a2019.0019] [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: 01/29/2019] [Revised: 04/30/2019] [Accepted: 05/06/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Multiple sclerosis (MS) is a chronic inflammatory, autoimmune disease with a still unknown aetiology. The main initial mechanism of demyelination and injury to the central nervous system (CNS) appears to be inflammation. Neurotoxicity induced by homocysteine (Hcy) may be a factor affecting this process. 5,10-methylenetetrahydrofolate reductase (MTHFR) is an essential enzyme involved in Hcy metabolism. It leads to Hcy remethylation to methionine. In the present study, we aimed to investigate a possible association between two variants of MTHFR gene in patients with MS in Poland and healthy individuals. METHODS In this study, we genotyped 174 relapsing-remitting MS patients and 186 healthy controls using the TaqMan technique. RESULTS AND CONCLUSIONS It was found that, regardless of the presence of a specific allele, the gender of MS patients affects age at the time of the clinical onset of the disease: in rs1801133 for the C allele and T, the average age was 35 years for women and 29 for men (p = 0.0004; p = 0.034 respectively). Similarly for the second polymorphism rs1801131 for the A allele and C, the average age was 35 years for women and 29 for men (p = 0.001; p = 0.01 respectively). No significant allelic / genotypic frequency differences have been observed between the studied groups (c.677C > T, CT/TT p = 0.719, p = 0.262; c.1298A > C, AC/CC of p = 0.686; p = 0.66). We found no association between polymorphisms of a folate-homocysteine-methionine-SAM metabolising gene enzyme and multiple sclerosis in a Polish population.
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Affiliation(s)
- Monika Chorąży
- Department of Neurology, Medical University in Bialystok, Bialystok, Poland, Sklodowska-Curie 24a, 15-276 Bialystok, Poland.
| | - Natalia Wawrusiewicz-Kurylonek
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok Clinical Hospital, Marii Skłodowskiej-Curie 24a, 15-276 Bialystok, Poland
| | - Joanna Gościk
- Faculty of Computer Science Bialystok University of Technology, Bialystok, Poland
| | - Renata Posmyk
- Department of Perinatology, Medical University in Bialystok, Bialystok, Poland
| | - Agata Czarnowska
- Department of Neurology, Medical University in Bialystok, Bialystok, Poland, Sklodowska-Curie 24a, 15-276 Bialystok, Poland
| | - Marta Więsik
- Alab Diagnostic Laboratory Company, Warsaw, Poland
| | - Katarzyna Kapica-Topczewska
- Department of Neurology, Medical University in Bialystok, Bialystok, Poland, Sklodowska-Curie 24a, 15-276 Bialystok, Poland
| | - Adam Jacek Krętowski
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok Clinical Hospital, Marii Skłodowskiej-Curie 24a, 15-276 Bialystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University in Bialystok, Bialystok, Poland, Sklodowska-Curie 24a, 15-276 Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University in Bialystok, Bialystok, Poland, Sklodowska-Curie 24a, 15-276 Bialystok, Poland
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Czarnowska A, Kapica-Topczewska K, Zajkowska O, Świerzbińska R, Chorąży M, Tarasiuk J, Zajkowska J, Kochanowicz J, Kułakowska A. Herpesviridae Seropositivity in Patients with Multiple Sclerosis: First Polish Study. Eur Neurol 2019; 80:229-235. [PMID: 30661064 DOI: 10.1159/000496402] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 12/04/2018] [Accepted: 12/18/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that leads to inflammation, demyelination and neurodegeneration. Viral aetiology has been suspected to be an MS trigger for a long time, and herpesviruses (HSs) are among the potential pathogens involved. OBJECTIVES The present investigation aims to detect the presence of antibodies against the herpes simplex virus (HSV), varicella-zoster virus, Epstein-Barr virus (EBV), human cytomegalovirus (CMV) and human herpesvirus 6 (HHV6) in the serum of MS patients and control individuals in north-eastern Poland. METHOD Plasma was collected from 141 MS patients and 44 blood donors who served as the control group. These individuals were assessed for the presence of antibodies using an enzyme-linked immunosorbent assay. RESULTS The statistical analysis showed a higher probability of EBV (p = 0.037, OR 4.359) and HHV6 (p = 0.020, OR 3.343) antibody presence in patients with MS compared to that in the control group. In the MS patient group, the prevalence of CMV IgG antibodies was significantly higher in females (p = 0.025). Patients who tested positive for anti-EBV IgG were diagnosed 7.9 years earlier than patients who tested negative for anti-EBV IgG (p = 0.048). CONCLUSIONS The study showed that MS patients in north-eastern Poland were more likely to be seropositive for EBV and HHV6 than healthy individuals. Further work should be undertaken in other regions of Poland and other European countries with particular attention paid to testing seropositivity in all HSs, particularly in the MS patient population, to evaluate the impact of HSs on MS patients in different environments.
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Affiliation(s)
- Agata Czarnowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland,
| | | | - Olga Zajkowska
- Department of Applied Mathematics, Faculty of Applied Informatics and Mathematics, Warsaw University of Life Sciences, Warsaw, Poland
| | - Renata Świerzbińska
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
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Wawrusiewicz-Kurylonek N, Chorąży M, Posmyk R, Zajkowska O, Zajkowska A, Krętowski AJ, Tarasiuk J, Kochanowicz J, Kułakowska A. The FOXP3 rs3761547 Gene Polymorphism in Multiple Sclerosis as a Male-Specific Risk Factor. Neuromolecular Med 2018; 20:537-543. [PMID: 30229436 PMCID: PMC6244921 DOI: 10.1007/s12017-018-8512-z] [Citation(s) in RCA: 13] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/12/2018] [Indexed: 12/21/2022]
Abstract
The FOXP3 gene encodes a transcription factor and is predominantly expressed in the CD4+CD25+ regulatory T cells which plays a pivotal role in the maintenance of immune homeostasis. The defect of FOXP3 gene may provide a critical link between autoimmunity and immune deficiency. The purpose of our study was to evaluate the association of chosen polymorphisms of FOXP3 gene (rs3761549, rs3761548, rs3761547) with different clinical multiple sclerosis (MS) data of our relapsing-remitting groups of patients and in control group. The study was performed on a group consisting of 174 relapsing-remitting MS patients, diagnosed under 40 years of life, and 174 healthy volunteers. Genotyping was performed using a real-time PCR-based method by TaqMan Assays. Significant differences in distribution of allele C rs3761547 were found in male MS patients in comparison to the male healthy group (p = 0.046, OR 1.95, CI 95%). No association between MS and the other two polymorphisms was observed in males and females of both studied groups. Our data may suggest that FOXP3 rs3761547 gene polymorphism are related notably with the increased risk of MS development in males patients. To our knowledge this is the first study which indicates gender-specific relation between rs3761547 FOXP3 gene polymorphism and multiple sclerosis.
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Affiliation(s)
- Natalia Wawrusiewicz-Kurylonek
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Białystok, Poland
- Department of Clinical Genetics, Medical University of Bialystok, Białystok, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Renata Posmyk
- Department of Perinatology, Medical University of Bialystok, Białystok, Poland
| | - Olga Zajkowska
- Faculty of Applied Informatics and Mathematics, Warsaw University of Life Sciences SGGW, Warsaw, Poland
| | - Agata Zajkowska
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Adam Jacek Krętowski
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Białystok, Poland
- Clinical Research Centre, Medical University of Bialystok, Białystok, Poland
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
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Kułakowska A, Tarasiuk J, Kapica-Topczewska K, Chorąży M, Pogorzelski R, Kulczyńska-Przybik A, Mroczko B, Bucki R. Pathophysiological implications of actin-free Gc-globulin concentration changes in blood plasma and cerebrospinal fluid collected from patients with Alzheimer's disease and other neurological disorders. ADV CLIN EXP MED 2018; 27:1075-1080. [PMID: 29905407 DOI: 10.17219/acem/70441] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The extracellular actin scavenging system (EASS) is composed of plasma Gc-globulin and gelsolin, and is responsible for the elimination of toxic actin from the bloodstream. OBJECTIVES In this study, we assessed the actin-free Gc-globulin concentrations in blood plasma and cerebrospinal fluid (CSF) obtained from subjects with neurodegenerative and inflammatory diseases of the central nervous system (CNS) as well as in a control group. MATERIAL AND METHODS Using an enzyme-linked immunosorbent assay (ELISA), we measured the actinfree Gc-globulin concentrations in blood plasma and CSF obtained from subjects diagnosed with Alzheimer's disease (AD) (n = 20), amyotrophic lateral sclerosis (ALS) (n = 12), multiple sclerosis (MS) (n = 42), tick-borne encephalitis (TBE) (n = 12), and from a control group (n = 20). RESULTS The concentrations of free Gc-globulin in plasma collected from patients diagnosed with AD (509.6 ±87.6 mg/L) and ALS (455.5 ±99.8 mg/L) did not differ significantly between each other, but were significantly higher compared to the reference group (311.7 ±87.5 mg/L) (p < 0.001 and p < 0.006, respectively) as well as to MS (310.8 ±66.6 mg/L) (p < 0.001 and p < 0.001, respectively) and TBE (256.7 ±76 mg/L) (p < 0.001 and p < 0.003, respectively). In CSF collected from patients diagnosed with AD and ALS, the concentrations of free Gc-globulin were 2.6 ±1.1 mg/L and 2.7 ±1.9 mg/L, respectively. They did not differ significantly between each other and were significantly higher compared to the reference group (1.5 ±0.9 mg/L) (p < 0.005 and p < 0.041, respectively). Interestingly, in patients with AD, significantly higher values of Gcglobulin were detected compared to multiple sclerosis patients (1.7 ±0.9 mg/L) (p < 0.013). CONCLUSIONS Higher concentrations of free Gc-globulin in blood plasma and CSF collected from patients suffering from neurodegenerative diseases may indicate a potential role of this protein in their pathogenesis, and represent a potential tool for the diagnosis of CNS diseases.
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Affiliation(s)
- Alina Kułakowska
- Department of Neurology, Medical University of Białystok, Poland
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Białystok, Poland
| | | | - Monika Chorąży
- Department of Neurology, Medical University of Białystok, Poland
| | | | | | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Białystok, Poland
| | - Robert Bucki
- Department of Microbiological and Nanobiomedical Engineering, Medical University of Białystok, Poland
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Andrzejewska K, Snarska K, Chorąży M, Brola W, Szwedziński P, Nadolny K, Ładny J, Kulikowski G. Occurrence of sleep disorders among nursing staff. Med Og Nauk Zdr 2018. [DOI: 10.26444/monz/89532] [Citation(s) in RCA: 3] [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: 11/18/2022] Open
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Snarska KK, Bachórzewska-Gajewska H, Kapica-Topczewska K, Drozdowski W, Chorąży M, Kułakowska A, Małyszko J. Hyperglycemia and diabetes have different impacts on outcome of ischemic and hemorrhagic stroke. Arch Med Sci 2017; 13:100-108. [PMID: 28144261 PMCID: PMC5206364 DOI: 10.5114/aoms.2016.61009] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 10/25/2015] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Stroke is the second leading cause of long-term disability and death worldwide. Diabetes and hyperglycemia may impact the outcome of stroke. We examined the impact of hyperglycemia and diabetes on in-hospital death among ischemic and hemorrhagic stroke patients. MATERIAL AND METHODS Data from 766 consecutive patients with ischemic (83.15%) and hemorrhagic stroke were analyzed. Patients were classified into four groups: ischemic and diabetic; ischemic and non-diabetic; hemorrhagic and diabetic; and hemorrhagic and non-diabetic. Serum glucose was measured on admission at the emergency department together with biochemical and clinical parameters. RESULTS Mean admission glucose in ischemic stroke patients with diabetes was higher than in non-diabetic ones (p < 0.001) and in hemorrhagic stroke patients with diabetes than in those without diabetes (p < 0.05). Mean admission glucose in all patients who died was significantly higher than in patients who survived. In multivariate analysis, the risk factors for outcome in patients with ischemic stroke and without diabetes were age, admission glucose level and estimated glomerular filtration rate (eGFR), while in diabetics they were female gender, admission glucose level, and eGFR; in patients with hemorrhagic stroke and without diabetes they were age and admission glucose levels. The cut-off value in predicting death in patients with ischemic stroke and without diabetes was above 113.5 mg/dl, while in diabetics it was above 210.5 mg/dl. CONCLUSIONS Hyperglycemia on admission is associated with worsened clinical outcome and increased risk of in-hospital death in ischemic and hemorrhagic stroke patients. Diabetes increased the risk of in-hospital death in hemorrhagic stroke patients, but not in ischemic ones.
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Affiliation(s)
- Katarzyna K. Snarska
- Department of Clinical Medicine, Medical University of Bialystok, Bialystok, Poland
| | | | | | - Wiesław Drozdowski
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Jolanta Małyszko
- 2 Department of Nephrology and Hypertension, Medical University of Bialystok, Bialystok, Poland
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Czupryna P, Tarasow E, Moniuszko-Malinowska A, Pancewicz S, Zajkowska O, Targoński A, Chorąży M, Rutkowski K, Dunaj J, Grygorczuk S, Kondrusik M, Zajkowska J. MRI and planimetric CT follow-up study of patients with severe tick-borne encephalitis. Infect Dis (Lond) 2016; 48:74-81. [PMID: 26414745 DOI: 10.3109/23744235.2015.1083119] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of the study was to evaluate the magnetic resonance imaging (MRI) and planimetric computed tomography (CT) of brain lesions in patients with a history of tick-borne encephalitis (TBE); to assess the influence of steroid treatment on the brain and whether lesions were age-dependent. METHODS A total of 19 patients with abnormal initial imaging in the acute stage of the disease had a follow-up MRI after 1 year; 34 patients hospitalized for TBE encephalitis/encephalomyelitis had planimetric CT after 10 years. RESULTS On MRI cortico-subcortical atrophy with widening of anterior horns of the lateral ventricles and vascular changes was more marked on follow-up examination. Virchow-Robin spaces dilatation, widening of the lateral ventricles, periventricular lesions, and cortico-subcortical atrophy correlated with age. Results of planimetric CT study showed increased percentage of tracings, widened anterior horns, lateral ventricles, and III ventricle, which suggest new non-age-related atrophic lesions. CONCLUSIONS Radiological lesions in the acute phase of TBE and after recovery are non-specific. Cortico-subcortical atrophy with widening of the anterior horns of the lateral ventricles and vascular changes are most common. Long-term follow-up confirms the formation of new non-age-related cerebral atrophic lesions due to TBE. The logit model may serve as a background for the hypothesis concerning an accelerated local atrophy of the brain tissues in patients with a history of severe TBE.
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Affiliation(s)
- Piotr Czupryna
- a From the Department of Infectious Diseases and Neuroinfections of the Medical University of Bialystok , Białystok , Poland
| | | | - Anna Moniuszko-Malinowska
- a From the Department of Infectious Diseases and Neuroinfections of the Medical University of Bialystok , Białystok , Poland
| | - Sławomir Pancewicz
- a From the Department of Infectious Diseases and Neuroinfections of the Medical University of Bialystok , Białystok , Poland
| | - Olga Zajkowska
- c Faculty of Applied Informatics and Mathematics, Warsaw University of Life Sciences SGGW , Warsaw , Poland
| | | | - Monika Chorąży
- e Department of Neurology , University Hospital of Bialystok , Białystok , Poland
| | | | - Justyna Dunaj
- a From the Department of Infectious Diseases and Neuroinfections of the Medical University of Bialystok , Białystok , Poland
| | - Sambor Grygorczuk
- a From the Department of Infectious Diseases and Neuroinfections of the Medical University of Bialystok , Białystok , Poland
| | - Maciej Kondrusik
- a From the Department of Infectious Diseases and Neuroinfections of the Medical University of Bialystok , Białystok , Poland
| | - Joanna Zajkowska
- a From the Department of Infectious Diseases and Neuroinfections of the Medical University of Bialystok , Białystok , Poland
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Posmyk R, Leśniewicz R, Gogiel M, Chorąży M, Bakunowicz-Łazarczyk A, Sielicka D, Vermeesch J, Nowakowska BA. The smallest de novo deletion of 20q11.21-q11.23 in a girl with feeding problems, retinal dysplasia, and skeletal abnormalities. Am J Med Genet A 2014; 164A:1056-61. [PMID: 24459047 DOI: 10.1002/ajmg.a.36394] [Citation(s) in RCA: 9] [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] [Received: 10/03/2012] [Accepted: 11/10/2013] [Indexed: 11/09/2022]
Abstract
We report on a de novo interstitial deletion of 20q11.21-q11.23 in a 2-year-old girl with a set of dysmorphic features, cleft palate, heart defect, severe feeding problems, failure to thrive, developmental delay, preaxial polydactyly (right thumb), and retinal dysplasia. Interstitial microdeletions of the long arm of chromosome 20 are rare. Exclusively rare are proximal microdeletions involving 20q11-q12 region. Our patient is the fourth described so far and has the smallest deleted region 20q11.21-q11.23 of 5.7 Mb. The defined clinical phenotype of our patient is very similar to previously published cases and confirms the existence of retinal dysplasia and skeletal abnormalities as a part of phenotypic spectrum for deletion 20q11-q12. Description of four similar patients, including two almost identical, suggests a new distinct, phenotypicaly recognizable microdeletion syndrome associated with the loss of 20q11-q12 region.
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Affiliation(s)
- Renata Posmyk
- Podlaskie Center of Clinical Genetics, Bialystok, Bialystok, Poland
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Posmyk R, Leśniewicz R, Chorąży M, Wołczyński S. New case of Primrose syndrome with mild intellectual disability. Am J Med Genet A 2011; 155A:2838-40. [DOI: 10.1002/ajmg.a.34257] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 07/18/2011] [Indexed: 11/08/2022]
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