ABSTRACT
Myelin basic protein [MBP] is one of the most important constituents of the CNS myelin sheaths. It is supposed that an autoimmune response directed against MBP is crucial in the demyelination process in patients with multiple sclerosis. Studies have proved that free anti-MBP level in CSF of MS patients is declined when the patient entered into clinical remission. Some researchers evaluate the changes in serum or CSF level of this antibody during immunomodulatory therapy; the results are different and the relation between the changes in this antibody and response to treatment is poorly investigated
The objective of this study was to assess the relation between the changes in serum level of anti-MBP and clinical remission in patients during treatment with fingolimod. 37 MS patients that were non responder to interferon and glatiramer acetate and were candidates to receive fingolimod were nominated for this study. In this study, the serum level of anti-MBP was evaluated before and after 3 and 6 months of therapy and clinical remission was assessed by changes in Expanded Disability Status Scale [EDSS] scores
The result of this study showed that MS patients, after treatment with interferon, have lower serum anti-MBP level than healthy control group and this difference is statistically significant [p =0.03]
The present study demonstrated that the serum anti-MBP level in MS patient during 6 months of treatment with fingolimod significantly decreased [p<0.001]. However, there was no significant difference in EDSS of MS patients during 6 months of treatment with fingolimod [p < 0.001]
ABSTRACT
Background: Little in known regarding the clinical relevance of SIRT1 in multiple sclerosis [MS]. Here, we aimed to evaluate mRNA expression, protein level and enzyme activity of SIRT1 in peripheral blood mononuclear cells [PBMCs] isolated from relapsing -remitting MS patients [RRMS] and healthy controls
Materials and Methods: Twenty patients with RR-MS and twenty two age- and sex-matched healthy subjects were enrolled in this case-control study. Following PBMCs isolation, mRNA expression was evaluated by real time-PCR. SIRT1 activity and SIRT1 protein level were measured using a fluorometric assay and an enzyme-linked immunosorbent assay [ELISA] respectively, in PBMC lysates
Results: There was no statistically significant difference in the mRNA expression of SIRT1 [p=0.56] and its protein levels [p=0.15] between MS patients and healthy subjects. By contrast, SIRT1 enzyme activity were significantly [p=0.008] lower in RRMS patients compared with that in healthy subjects
Conclusion: Our findings demonstrated that enzyme activity of SIRT1 is significantly lower in PBMCs of RRMS patients in comparison with healthy subjects. However, more investigations are essential to clarify the role of SIRT1 in MS pathogenesis.Keywords: enzyme activity, multiple sclerosis, pathogenesis
ABSTRACT
Background: it is evident that oxidative stress plays a crucial role in etiology of multiple sclerosis [MS]. Dysregulation of antioxidant enzymes have been implicated in demylination and neuronal loss in MS. The aim of this study was to evaluate mRNA expression and activity of manganese superoxide dismutase [MnSOD], and catalase in peripheral blood mononuclear cells [PBMCs] from patients with relapsing-remitting multiple sclerosis [RRMS] and healthy controls
Materials and Methods: we recruited 20 RRMS patients and 20 age-and sexmatched healthy subjects. PBMCs were isolated, RNA was extracted and real time-PCR was used to evaluate mRNA expression of MnSOD and catalase. Enzyme activity of MnSOD and catalase were measured using colorimetric assays
Results: we found a significant increase in mRNA expression and activity of catalase in PBMCs from patients compared with controls, which was accompanied by reduced activity and expression of MnSOD in MS patients
Conclusion: it appears that impaired antioxidant enzymes in term of high activity of catalase and decreased activity of MnSOD are involved in MS pathogenesis, however further studies are needed to establish this concept
ABSTRACT
Background: Neuro-Behcet’s disease (NBD) is similar to multiple sclerosis (MS) in multiple aspects. This study was conducted to investigate the sensitivity, specificity, accuracy, positive and negative predictive values for the 2005 revised McDonald MRI criteria for the diagnosis of MS and NBD. Methods: This study enrolled 28 consecutive patients with a diagnosis of NBD and 48 patients with a diagnosis of clinically definite MS, who were referred to the Nemazee Hospital, Shiraz University of Medical Sciences, between March 2009 and March 2010. Brain and spinal cord magnetic resonance imaging (MRI) were obtained. Two Radiologists, blinded to clinical diagnosis, reviewed the MRI. We investigated the sensitivity, specificity, accuracy, and positive and negative predictive values of the 2005 revision of the McDonald criteria for dissemination in space for the diagnosis of MS and NBD. Results: There were a total of 10 men and 38 women with a mean age of 32.76±7.5 years, with a diagnosis of MS, and 18 men and 10 women with a mean age of 26.8±5.9 years with a diagnosis of parenchymal NBD. The interobserver agreement for the diagnosis of MS using the 2005 revision of the McDonald criteria for dissemination in space with the use of the Cohen kappa scores was 0.82. The sensitivity, specificity, accuracy, and positive and negative predictive values were 80%, 61%, 71.5%, 77% and 64%, respectively. Conclusion: The accuracy and specificity of the McDonald criteria for dissemination in space for the differentiation of MS and NBD are not optimal.
ABSTRACT
Multiple sclerosis [MS] is an inflammatory disease of central nervous system [CNS] and sexual dysfunction [SD] is one of the most common disabilities of MS women. The aim of this study was to determine sexual function of women with MS [multiple sclerosis]. One hundred definite MS patients MS patients and fifty age-matched healthy controls were enrolled. Demographic data [sex, age], duration of the disease and disease pattern extracted from patient's files and Kurtzke Expanded Disability Status Scale [EDSS] recorded for each patient by an expert neurologist. Participants were asked to answer the valid and reliable Persian version of Beck depression inventory [BDI] and Female Sexual Function Index [FSFI] questionnaires. The total FSFI score and subscale scores differed significantly between the MS patients and the controls. There was a significant negative correlation between EDSS and FSFI scores [rho=-0.44, P<0.001] and significant positive correlation between EDSS and BDI [rho=0.36,P<0.001] in patients. Mean BDI and all subscales of FSFI differed significantly between patients with total FSFI score higher and lower than 26.55. Sexual dysfunction should be considered in women with multiple sclerosis
ABSTRACT
Multiple Sclerosis [MS] is a disease with high disabling disorders and considerable social and economic impacts. This study was conducted to analyze the spatial distribution of MS disease in Tehran, Iran during 2001-2012. The existing information in the MS patients' medical files who had registered in Iranian MS Society [IMSS], located in Tehran office, was used for analysis. The relationship between diseases incidences in 22 zones of Tehran based on estimated socio-economic status [SES] of each zone was evaluated. High and low clustering approach was used in order to investigate the disease's distribution pattern meanwhile, Getis Ord's Gi test and Hot Spot analysis approach has been used to detect high risk zones of the disease. A total of 6027 MS patients were registered between 2001- 2012 which 4580 [%75.99] were women. During the study period, zone number 6 figured as the most high risk zone for the disease [P<0.1]. A heterogeneous distribution was shown for the disease. Cumulative incidence of the disease in northern zones [101.73 per 100,000 inhabitants] was two times more of Southern zones [53.79 per 100,000 inhabitants]. There seems to be a direct linear relationship between estimated incidence rate of the disease in each zones with the level of SES [P<0.001]. Heterogeneous geographical distribution of MS and its higher estimated incidence for northern zones in Tehran may be because of higher SES and other factors in mentioned zones. It is recommended to consider the surveillance with long-term and cost-effective interventional strategies along with disease in high risk zones
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Cognitive impairment can emerge in the earliest phases of multiple sclerosis. It strongly impacts different aspects of multiple sclerosis [MS] patients' lives, like employment, social relationships and the overall quality of life; thus, its on-time recognition and treatment is mandatory. This paper discusses issues, diagnostic methods and treatment options for cognitive dysfunctions in MS. This paper is a descriptive review of the related studies in the recent 10 years, performing a keyword search in the main databases. Cognitive impairment mostly involves aspects of information processing, memory and executive functioning in MS. Neuropsychological tests like MACFIMS and BRB-N are recommended for its assessment. Still, there is no fully efficient treatment for cognitive impairment. Researchers have shown some positive effects, using disease-modifying therapies and cognitive rehabilitation. Depression, pain, fatigue and other factors influencing cognitive functions must be paid attention to. Recognizing cognitive impairment as a major symptom for MS, makes studying this subject one of the priorities in dealing with the disease. Therefore, a consecutive research for identification and management of this part of quality of life in MS patients is obligatory
ABSTRACT
Multiple sclerosis [MS] is an autoimmune disease that affects physical and emotional aspects of patient's lives. The aim of this study was to evaluate Emotional Intelligence [EI] in cases with MS. One hundred sixty six clinically definite MS and 110 healthy subjects were enrolled in this study. All participants filled valid and reliable Persian version Emotional Quotient inventory [EQ-i] questionnaire, which had been developed due to Bar-On model. Mean EI total score and 12 out of 15 subscales were significantly different between patients and controls. Total EI score and most of its subscales were significantly higher in patients with RR [Relapsing Remitting] than Secondary Progressive [SP] ones. There was significant negative correlation between EDSS and total EI score [rho=-0.4, P<0.001]. Multiple linear regression analysis between the EI as a dependent variable and sex, type of disease, level of education, age and marital status as independent variables in patients showed that type of disease and level of education were independent predictors of EI. Emotional intelligence as the ability to behave better and communicate with others should be considered in MS cases as their physical and psychological health are affected by their illness
Subject(s)
Humans , Male , Female , Multiple Sclerosis , Surveys and Questionnaires , Cross-Sectional StudiesABSTRACT
Impaired quality of life [QOL] is an issue considered in patients with multiple sclerosis [MS]. There are limited studies evaluated poor sleep and impaired QOL in these cases. The aim of this study was to evaluate quality of sleep and poor sleep in Iranian patients with MS and the relationship between Pittsburgh Sleep Quality Index [PSQI] score and QOL subscales. One-hundred and fourteen cases with definite MS due to MC Donald criteria enrolled who referred to MS clinic of Sina and Imam Hospitals were enrolled. Patients asked to fill valid and reliable Persian versions of PSQI and MSQOL-54 questionnaires. Demographic data [sex, age], duration of the disease, education level and marital status were extracted from patients medical files. After neurological examination, Kurtzke Expanded Disability Status Scale [EDSS] was assessed. Ninety-one [79.8%] patients were female and 23 [20.2%] were male. Mean age and EDSS was 34.7 +/- 9.6 years and 2.3 [median: 1.5]. Mean PSQI score and overall QOL score were 4.5 and 57. Sixty-seven cases were good sleepers [PSQI 5]. Except five subscales, all others were significantly different between good and poor sleepers. There was significant positive correlation between PSQI score and EDSS [r = 0.24, P < 0.001] and negative correlation between EDSS and physical and mental health [r = -0.48, P < 0.001, r = -0.43, P < 0.001]. EDSS and total PSQI score were independent predictors of physical and mental health composites. Sleep quality as a factor which affecting QOL should be considered and evaluated properly in MS patients
Subject(s)
Humans , Male , Female , Sleep , Quality of Life , Cross-Sectional StudiesABSTRACT
Stem cells are undifferentiated cells with the ability of proliferation, regeneration, conversion to differentiated cells and producing various tissues. Stem cells are divided into two categories of embryonic and adult. In another categorization stem cells are divided to Totipotent, Multipotent and Unipotent cells. So far usage of stem cells in treatment of various blood diseases has been studied [such as lymphoblastic leukemia, myeloid leukemia, thalassemia, multiple myeloma and cycle cell anemia]. In this paper the goal is evaluation of cell therapy in treatment of Parkinson's disease, Amyotrophic lateral sclerosis, Alzheimer, Stroke, Spinal Cord Injury, Multiple Sclerosis, Radiation Induced Intestinal Injury, Inflammatory Bowel Disease, Liver Disease, Duchenne Muscular Dystrophy, Diabetes, Heart Disease, Bone Disease, Renal Disease, Chronic Wounds, Graft-Versus-Host Disease, Sepsis and Respiratory diseases. It should be mentioned that some disease that are the target of cell therapy are discussed in this article
Subject(s)
Humans , Animals , Pluripotent Stem Cells , Totipotent Stem Cells , Hematologic Diseases/therapy , Nervous System Diseases/therapy , Therapeutics , Bone Diseases/therapyABSTRACT
Fatigue is one of the most frequent symptoms in patients with multiple sclerosis [MS] and it is difficult to clarify the nature of this symptom and manage it. This study was aimed to evaluate the frequency of fatigue, depression and sleep disturbances in Iranian patients with MS. 100 patients from the outpatient MS clinic of Sina hospital were asked to complete Beck Depression Inventory [BDI], Pittsburg Sleep Quality Index [PSQI], Sleep Disorder Questionnaire [SDQ], Modified Fatigue Impact Scale [MFIS] and Epworth Sleepiness Scale [ESS] questionnaires. Student's t-test, ANOVA, Spearman correlation and Stepwise multiple linear regressions by SPSS version 15.0 were used for data analysis. From participants, 64 had fatigue complaint during day time and 36 did not feel fatigued. BDI, PSQI, MFIS and SDQ scores were significantly higher in fatigued patients than non-fatigued group but there were no statistically significant differences in ESS, EDSS and duration of disease between fatigued and non-fatigued cases. There were significant correlations between MFIS and BDI scores [r=0.49, P=0.01], MFIS and PSQI scores [r=0.399, P=0.01] and MFIS and ESS [r=0.25, P=0.01]. This study demonstrates that depression is not the only cause of fatigue in patients with MS and it is also associated with sleep disorders, so this complaint should be carefully evaluated and managed in these patients
Subject(s)
Humans , Male , Female , Fatigue , Depression , Sleep Wake Disorders , Surveys and Questionnaires , Cross-Sectional StudiesABSTRACT
BACKGROUND: Juvenile myoclonic epilepsy is a heterogeneous syndrome, both in genetic and clinical aspects. AIMS: This study was conducted to compare the efficacy of valproic acid in familial versus sporadic cases of this syndrome. SETTINGS AND DESIGN: Seventy patients with JME were identified; 24 patients (34.3%) had positive history of JME in their first degree relatives (group I) and 46 patients (65.7%) were sporadic (group II). MATERIALS AND METHODS: Valproic acid was started for the patients with upward titration. The cases were followed for one year after final titration of the drug with regular blood monitoring. Patients, who had no myoclonic, absence and grand mal seizures within one year, were considered excellent responders. STATISTICAL ANALYSIS: We used Student T-test and Fisher's exact test for quantitative and qualitative variables respectively. Logistic Regression test was used to evaluate the predictive factors for final treatment outcomes. RESULTS: Mean dosage of valproic acid was 800 mg/d in both groups (13 mg/kg and 12.4 mg/kg respectively). Mean therapeutic levels of the drug in group I and II were 74 microg/ml and 78.4 microg/ml respectively. Excellent responders' rate was 66.7% in group I and 76.1% in group II. History of absences and older age at the onset of grand mal seizures decreased excellent responders' rate in both groups. CONCLUSIONS: Considering response to valproic acid, there is no significant difference in familial versus sporadic cases of JME, whereas history of absences and older age at the onset of grandmal seizures, decrease the probability of being excellent responders in this syndrome.
Subject(s)
Adolescent , Adult , Anticonvulsants/therapeutic use , Child , Electroencephalography , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Myoclonic Epilepsy, Juvenile/drug therapy , Valproic Acid/therapeutic useABSTRACT
Succinylcholine is used during induction of anesthesia, and it may induce fasciculations. In this study we demonstrated that intravenous diazepam [1 mg/kg] or lidocaine [1.5 mg/kg] can decrease fasciculations induced by succinylcholine. There is no significant difference between these two drugs in reducing fasciculations moreover these drugs can also prevent raised blood pressure and heart rate during intubation