Fraction of IL-10+ and IL-17+ CD8 T cells is increased in MS patients in remission and during a relapse, but is not influenced by immune modulators

In the present study, circulating proportions of CD8(+) T (Tc) cell subsets, including IL-17 (Tc17) and IL-10 (Tc10) producing cells, were assessed in relapsing-remitting MS (RRMS) patients and a possible effect of beta interferon (IFN-β), glatiramer acetate (GA), and vitamin D (VitD) on these cell subsets was investigated. We show that both Tc17 and Tc10 cell fractions are elevated in the circulation of RRMS patients in remission compared to healthy subjects and that these Tc subsets remain unaffected by current immune modulating regimens.

Association of vitamin D metabolite levels with relapse rate and disability in multiple sclerosis

BACKGROUND

Multiple Sclerosis is associated with low serum levels of 25-hydroxyvitamin D (25(OH)D). We investigated the association between serum levels of 25(OH)D and 1,25-dihydroxyvitamin D (1,25(OH)2D), the biologically active metabolite, and clinical MS severity as expressed by EDSS-score and relapse rate.

STUDY-DESIGN

Cross-sectional study.

PATIENTS AND METHODS

Serum samples from 267 MS patients were collected for 25(OH)D and 1,25(OH)2D measurement. Clinical MS parameters at the date of serum sampling were determined.

RESULTS

Both metabolite levels were significantly lower in the progressive forms compared to the relapsing remitting (RR)MS phenotype. In RRMS patients (disease course < or = 5 years), high 25(OH)D levels were associated with a high chance of remaining relapse-free. Low 25(OH)D levels were associated with high EDSS-scores. 1,25(OH)2D was not directly associated with relapse rate or EDSS-score, and was dependent of age and 25(OH)D level.

CONCLUSION

Serum levels of 25(OH)D were associated with both relapse rate and disability in MS patients. These results are suggestive for a disease modulating effect of the serum concentrations of 25(OH)D on MS. The low circulating 1,25(OH)2D levels in progressive MS are due to older age and lower 25(OH)D levels. The potential consequences for vitamin D supplementation in MS will be discussed.

Long-term follow-up after open cholecystectomy

The long-term outcome of open cholecystectomy was investigated. Follow-up data at a median of 10 years were obtained from physicians' records on 325 (92.6 per cent) of 351 patients treated for symptomatic gallbladder stones by open cholecystectomy between 1978 and 1980. One 79-year-old patient died after operation, from a pulmonary complication. Of the 325 patients, 81.5 per cent were currently asymptomatic or had not had symptoms during follow-up until death. Sixty patients (18.5 per cent) had complaints after 10 years. Stone recurrence was found in five patients (1.5 per cent); ten others (3.1 per cent) had biliary tract-related complaints during follow-up. Blood samples were obtained in 67.3 per cent of surviving patients with biliary complaints. There were no laboratory findings associated with biliary obstruction. Patients with typical symptoms of gallstone disease before surgery had significantly fewer complaints during follow-up than those with typical as well as atypical symptoms (14.8 versus 26.5 per cent, P < 0.02). However, most of these complaints were not related to the procedure. It is concluded that the majority of patients reported no complaints or postcholecystectomy symptoms 10 years after surgery.

Changes in basal plasma testosterone, cortisol, and dehydroepiandrosterone sulfate in previously untrained males and females preparing for a marathon

In the present study 25 males and 11 females were monitored for an 18- to 20-month training period during which the training distance was gradually increased. The training period was divided into three periods of 6, 5, and 7 months, respectively. The first, second, and third period were concluded with a 15-, 25-, and 42-km road race, respectively. The competitive distance always exceeded the maximal distance covered in any previous training session. Before and after three contests of 15, 25, and 42.195 km, the plasma concentration of testosterone, cortisol, and dehydroepiandrosterone sulfate (DHEAS) were determined. The decrease of plasma testosterone concentration in males was dependent on the distance of the contests. Moreover, the plasma testosterone concentration was increased in males during the course of the training period. In females no clear relation between plasma testosterone levels and the contests could be observed, and no changes in basal levels were found in the course of the training period. DHEAS seems to be a more useful stress marker than the plasma cortisol concentration. The plasma levels of this hormone remained elevated both in males and females for 1-2 days after the contests. The amplitude of DHEAS increments, however, was greater after the marathon.

Metabolic changes induced by sustained exhaustive cycling and diet manipulation

Thirteen highly trained subjects were studied concerning the effect of consuming a normal carbohydrate-rich diet (N) on energy exchange, substrate metabolism, and performance. Six of these subjects performed the same protocol receiving N supplemented with a high-maltodextrin, low-fructose beverage (Mf). The studies were performed in random order. The subjects performed 2 days of sustained exhausting cycling, preceded and followed by a standardized resting day, in a respiration chamber, allowing continuous gas analysis, weighed food and fluid intake procedures, collection of excretes, and drawing of blood samples at 7:00 AM, 12:00 AM (halfway exercise) and 3:00 PM at exhaustion. Muscle biopsies were taken prior to, 45 min after, and 24 h after exercise (energy expenditure 25.2-26.6 MJ.day-1). The results showed that while consuming a normal diet, the cyclists developed a negative energy balance (-9 MJ.day-1) and regulated their hormone levels in such a way that fat oxidation and protein breakdown were increased and CHO oxidation became depressed. When supplemented with Mf, the subjects showed increased blood glucose, insulin and decreased glucagon levels. Fat metabolism was significantly depressed as indicated by the levels of blood fatty acids, glycerol, and ketones. A significant glycogen sparing, as well as supercompensation within 24 h of recovery, was observed after Mf supplementation. The normal CHO-rich diet, available ad libitum, was insufficient to fully restore glycogen within 24 h. The changes in substrate availability and glycogen depletion were accompanied by a significant performance improvement, 126% when cycling a final 90% Wmax bout, when supplemented with Mf compared with N.

Effect of carbohydrate intake during warming-up on the regulation of blood glucose during exercise

It has been shown that the intake of carbohydrate (CHO)-containing beverages under resting conditions may lead to a rebound hypoglycemia and decreased performance when exercise is performed thereafter. The aim of the present investigation was to study the effect of CHO beverage consumption with different CHO sources and different concentrations, during warming-up under practice-like circumstances, on the regulation of blood glucose during exercise. Eighteen highly trained cyclists consumed a standardized breakfast at 8:00 AM and performed a warming-up procedure at 10:00 AM for 20 min. Warming-up was followed by a 7-min break after which the subjects cycled for 45 min at a heart rate of 150. During warming-up a CHO-containing beverage (either sucrose, fructose, maltodextrin, or glucose) or a placebo was consumed in random order. The test was performed twice, with 300 ml and 600 ml intake, to study a possible dose-response effect. The results of the study showed that warming-up and final exercise lead to an increase of the catecholamines and a decrease of insulin. During the 7-min break this response was reversed. Glucose and maltodextrin induced the same insulin response. Increasing volume and higher CHO concentrations induced a longer increase in blood glucose level compared with the placebo intake. The results showed that intake of CHO-containing beverages during warming-up followed by a small break does not lead to rebound hypoglycemia, independent of the amount of CHO ingested, but instead increases blood glucose.