OX40 gene and serum protein expression profiles in patients with Parkinson's disease

Objective: Inflammation of the immune system and the central nervous system has been known as an important predisposing factor for Parkinson's disease [PD]. Increased expression of OX40 protein [CD134] is a known factor for increased inflammation and initiation of NF-kappa-B signaling pathway in different diseases. We aimed to investigate the expression of OX40 at the transcript and serum protein levels

Materials and Methods: Twenty individuals with PD and 20 healthy individuals, as controls, were enrolled in this casecontrol study. Expression of OX40 at the transcript level and serum protein levels were measured by quantitative real-time polymerase chain reaction [qRT-PCR] and enzyme-linked immunosorbent assays respectively

Results: The mean expression level of OX40 was increased in patients but not at a significant level [P>0.05]. Consistently, the mean serum concentration of OX40 showed a mild, but non-significant, increase in the patients [P>0.05]

Conclusion: We conclude that OX40 expression at either the transcript or protein level has no diagnostic utility in asymptomatic PD. This shows the need for clinical, cellular and interventional research to detect new robust biomarkers

effect of plasma exchange on theexpression of FOXP3 and rorc2 inrelapsed multiple sclerosis patients

Background: Lack of sufficient information on the mechanism of plasma exchange[PE] therapy in multiple sclerosis [MS], has limited this treatment to individual patientswith severe relapses who have been refractory to other treatments. This is while PE isused very successfully as a first-line standard treatment in many other neuro-immunedisorders. Recent data suggest that Treg/Th17 counterbalance may indicate theboundaries between promotion and regulation of inflammatory responses in MS andTreg/Th17 ratio may be useful as a marker for monitoring the efficiency of MStherapies

Objective: To evaluate the effect of PE on the frequency and ratio ofTreg/Th17 cells through concomitant measurement of the expression levels of Treg andTh17 lineage specific transcription factors, FOXP3 and RORC2, respectively

Methods: Peripheral blood mononuclear cells of 8 relapsed MS patients were obtainedbefore and after a complete course of PE therapy and the FOXP3 and RORC2 mRNAlevels were assayed using real-time PCR approach

Results: No significant change inthe expression levels of individual transcription factors existed, but a significantincrease in FOXP3/RORC2 ratio [p=0.036] was observed

Conclusions: Our resultssuggest that PE therapy influences Treg/Th17 ratio and this maybe a mechanism bywhich this procedure exerts its improving effects in MS disease

Preventive effects of a three-month yoga intervention on endothelial function in patients with migraine

Migraine is a neurovascular disorder and any interventions improving endothelial function may contribute to its treatment and prevention of vascular complications like ischemic stroke. Yoga has been shown to have several beneficial effects on cardiovascular systems. However, no randomized controlled studies to date have investigated its effects on endothelial function of migraineurs. A total of 42 women patients with migraine were enrolled and randomized into either a Yoga exercise group or a control group. The control group received only medication for 12 weeks and the Yoga group was placed in yoga training program in addition to the same medical treatment. Blood test was given from all patients in order to measure plasma levels intercellular adhesion molecule [ICAM] and vascular cell adhesion molecule [VCAM] after yoga training program. Totally 32 patients were participated in the final analyses [yoga: n - 18, control: n - 14]. By analyzing data between yoga and control groups after the treatment period, there was a significant decreased in plasma level of VCAM in yoga group compare with the control group [15.29 +/- 2.1 ng/ml vs. 21.70 +/- 3.0 ng/ml, P < 0.05], whereas there was no significant difference in ICAM level between groups [19.1 +/- 1.8 ng/ml vs. 20.97 +/- 1.9 ng/ml P>0.05]. It seems that yoga exercises, as a complementary treatment beside pharmacological treatments, can be potentially an effective way of improving vascular functions in migraineurs

single-subject study to examine the effects of constrained-induced aphasia therapy on naming deficit

Aphasia is prevalent in people following stroke, which can have a significant impact on the quality of life of the patients with stroke. One of the new methods for treatment of patients with aphasia is constraint-induced aphasia therapy [CIAT]. The aim of this study was to investigate the efficacy of CIAT on naming deficits in individuals with chronic aphasia. This study had a prospective, single-subject study with A-B-A design. The CIAT was administered to two patients with chronic aphasia. Participants were a 57-year-old male and a 45-year-old female and had a stroke 60 and 36 months ago, respectively. In this study, the naming test was used as the outcome measure. The naming test was administered in three baseline sessions with 1 week interval between tests [phase A]. Patients received CIAT for four consecutive weeks [3 days/week]. Four measurements were taken during the treatment phase [phase B]. In follow-up phase [phase A] two other measurements were performed. Visual analysis consisting of level, regression line, and variability were used to determine the effects of CIAT on naming. Both participants increased scores on naming test after phase A and B. The mean of the naming score improved from the baseline to the intervention phase in both participants. There was a positive trend in naming scores during the treatment phase compared with the trend in the baseline demonstrated by both participants. The results of this study showed that the CIAT can be effective in improving the naming deficit in patients with chronic post-stroke aphasia

Stem cell therapy in stroke: a review literature

Stroke is an important cause of death in the world and disability world-wide especially in developed countries. Following acute phase of stroke, some procedures and medical treatment such as thrombolytic agents has been recommended; nevertheless many patients have enduring deficits. Thus, there is a realistic need to develop treatment strategies for reducing neurological deficits. However, the stem cell [SC] therapy could arrange an alternative intervention for disease modifying therapy. In this article, we present a brief review of different methods of SC therapy in stroke patients and discuss the results with different cell types and routes of administration

literature review on the efficacy and safety of botulinum toxin: an injection in post-stroke spasticity

A variety of techniques for the management of spasticity have been suggested, including positioning, cryotherapy, splinting and casting, biofeedback, electrical stimulation, and medical management by pharmacological agents, Botulinum toxin A [BTA] is now the pharmacological treatment of choice in focal spasticity. BTA by blocking acetylcholine release at neuromuscular junctions accounts for its therapeutic action to relieve spasticity. A computerized search of Pub Med was carried out to find the latest result about efficacy of BTA in management of post stroke spasticity. Among 84 articles were found, frothy of them included in this review and divided to lower and upper extremity. BTA is a treatment choice in reducing tone and managing post stroke spasticity

What is the real fate of vitamin D in multiple sclerosis?

Multiple sclerosis [MS] is a multifactorial disease [caused by both environmental and genetic features] that could results from a demyelination of the myelin sheath. Subsequently, it leads to many scars or lesions in different places within the central nervous system. The symptoms that occur depend on the site and rigorousness of the lesions and this is why people with MS experience different symptoms. Although, it is not clearly known that why people develop MS, research suggests that vitamin D plays a key role in preventing or repairing the damaged myelin. Previous studies have shown that vitamin D is a potent natural immune-regulator and has an anti-inflammatory action. Increased exposure to vitamin D may result in changed immunologic profiles or commotion that donates to MS risk. Vitamin D deficiency is caused by insufficient sunlight exposure or low dietary vitamin D[3] intake. Recent studies have also indicated that, there are several polymorphisms for vitamin D receptor [VDR] gene, but the effect of VDR gene polymorphisms on protein function of VDR and how exerts second signaling pathways in cells is still unknown. Therefore, this review focuses on vitamin D metabolism and genetic polymorphisms related to VDR and MS to better understand of discrepancies among patients

role of melatonin in the pathogenesis of multiple sclerosis: a case-control study

The association between the prevalence of multiple sclerosis [MS] and latitude gradient indicates the importance of environmental factors in MS susceptibility. Sunlight's ultraviolet radiation, its ability to influence melatonin, and an imbalance of melatonin in the central nervous system [CNS] may be involved in this process. This case-control study was conducted in Isfahan MS Society [IMSS], Isfahan, Iran. Enrollment was limited to patients with MS referring to the MS clinic of Alzahra and Kashani hospital during January and February 2012. Thirty-five patients with MS and 35 healthy individuals were included in our study. The melatonin levels were analyzed using enzyme-linked immunosorbent assay [ELISA] kits. There was no significant difference between saliva melatonin level of two groups [patients and healthy individuals] [P = 0.417]; however, after controlling the effect of age, a significant difference [P= 0.022] was found. In the present study, it is proposed that environmental conditions in Isfahan city might have increased the susceptibility to MS, but more studies in different parts of the world are needed to evaluate this claim

Restless legs syndrome in Iranian multiple sclerosis patients: a case-control study

Restless legs syndrome [RLS] is a common movement disorder. The occurrence of this syndrome is due to genetic factors and lifestyle. This study performed to determine restless legs syndrome [RLS] prevalence in Iranian multiple sclerosis [MS] patients and the possible risk factors. This cross-sectional study was conducted with MS patients, and the age- and sex-matched control group comprised healthy persons. Then, all subjects were asked about RLS symptoms. After the diagnosis of RLS, the patients were divided into two groups: With and without RLS. In both groups, the following variables were evaluated: Age, sex, other underlying disease, duration of MS, MS course, family history of RLS, history of anemia, and drug intakes. The severity of the disease in subjects diagnosed with RLS was also evaluated. A total of 126 patients in the MS group and 126 healthy controls were included in the study, with no statistically significant differences between them in terms of age and gender. In MS group, 82 [65.1%] and, in control group, 16 [12.7%] had RLS. The frequency of RLS in the MS patients was significantly higher than that in the control group. Among MS patients, 60 male [73.2%] and 22 female [26.8%] had RLS. Mean age of MS patients with RLS was significantly higher than that in MS patients without RLS. MS patients and higher EDSS score had more RLS symptoms. We suggest that RLS always be considered during neurological examinations of MS patients

effect of pioglitazone on the Alzheimer's disease-induced apoptosis in human umbilical vein endothelial cells

Alzheimer's disease [AD] is a progressive neurodegenerative disease and nowadays the role of endothelial cell [EC] injury has been proposed in pathological process in AD. Peroxisome proliferator-activated receptor- gamma [PPAR- gamma] agonist has anti-inflammatory properties through activation in glial cells and improves vascular function and prevent atherosclerotic disease progression. The aim of this study is evaluation of pioglitazone effects as a drug of PPAR- gamma agonist on endothelial apoptosis induced by sera from AD patients. Human umbilical vein endothelial cells [HUVECs] were treated with sera from AD patients [n = 10] and sera from controls [n = 10]. Apoptosis was identified by annexin V-propidium iodide staining and cell death detection kit. Apoptosis was evaluated after and before adding of 10 micro M pioglitazone on EC. Nitrite [NO[2]] levels were determined in the culture supernatants. Induced apoptosis by the serum of patients was inhibited markedly when pioglitazone used before treating HUVECs with the sera of AD. Also, the measurement of nitrite concentration showed significantly greater levels of dissolved NO[2]/NO[3] metabolite in the culture media of HUVECs treated by sera of AD patients [P < 0.05], while the rate of nitric oxide significantly decreased when pioglitazone exists in culture media. Further studies are justified to investigate the novel role of the PPARs in the prevention of the neuronal and endothelial damage in neurological disorder and present a new therapeutic approach for Alzheimer's patients

Can vitamin D suppress endothelial cells apoptosis in multiple sclerosis patients?

Multiple sclerosis [MS] is an autoimmune disease of central nerves system, in which neurological disabilities occur in young adults. Despite increasing number of studies on MS, some aspects of this disorder are still unclear. In the previous studies, it has been proven that there is direct relation between MS incidence and vitamin D deficiency. Thereby, strong evidence in MS pathogenesis suggests that endothelial cells [EC] could be harmed in MS. In addition, functional changes in EC and macrovascular injuries lead blood-brain barrier disruption in MS. Current study is the first investigation to elucidate positive influences of vitamin D against EC apoptosis in MS. Human umbilical vein endothelial cells [HUVECs] were cultured and then treated with sera from patients with active MS [in relapse] and sera from healthy volunteer participants as control group [each group n=15]. 3-[4,5-dimethylthiazol-2-yl]-5- [3-carboxymethoxyphenyl]-2-[4-sulfophenyl]-2H-tetrazolium, inner salt [MTS] assay for cell surveillance and cell-death detection kit for evaluating apoptosis were used in this study. There was a significant decrease in apoptosis rate by the serum of patients, just when 1,25[OH][2]D[3] applied before treating HUVECs with sera from active MS [in relapse]. Furthermore, the cells surveillance increased markedly with the presence of 1,25[OH][2]D[3] in culture, too. With regard to increment in EC apoptosis rate, which treated by the sera from MS patients and decrement in apoptosis rate by the presence of vitamin D in culture media, it could be proposed that vitamin D pre-treatment can be used for MS patients, due to its beneficial effects on protecting EC apoptosis

Olanzapine versus haloperidol: which can control stuttering better?

The aim of this study was to compare the effects of olanzapine versus haloperidol to control the signs and symptoms of stuttering. Ninety-three patients were recruited in a 12-week single-blind randomized clinical trial, which was held between October 2009 and October 2010. Forty-three patients received olanzapine [5 mg/day] and 50 patients, haloperidol [2.5 mg/day]. Before and after the study, they were evaluated by a speech pathologist by Van Riper's questionnaire. The data were analyzed using the SPSS version 16. T-test was used to compare the data between the two groups. Mean of stuttering score [SD] before treatment was 4.67 [0.81] and 4.40 [1.14] in haloperidol and olanzapine groups, respectively [P > 0.05]. After treatment, the mean [SD] score was 2.87 [1.32] and 1.56 [0.71] in haloperidol and olanzapine groups, respectively [P = 0.000]. It seems that olanzapine does have better impact in controlling stuttering, and it may be recommended to prescribe olanzapine for stutters as the first choice to control the stuttering under a careful follow-up

Preliminary study related the incidence of methylprednisolone pulse therapy in patients visited multiple sclerosis clinic located at the Isfahan Kashani hospital

To manage relapsing-remitting multiple sclerosis [MS] in the course of acute exacerbations, methylprednisolone [MP] [Medrol or Solu-Medrol], has the ability to lock the injured blood-brain barrier and decrease irritation in the central nervous system. The aim of this preliminary study was to investigate the frequency and time interval related to MP pulse therapy in patients with MS. This Study is conducted in the MS clinic of the Isfahan Kashani hospital, that was carried out on patients [n= 901] from June 2011 to December 2012. Patients who visited MS clinic just for once disinterested from analysis. According to the incidence of MP pulse therapy in females and males, two groups were made. Group 1 included patients with 2-3 times and Group 2 included patients with more than 4 times pulse therapy. Demographical data, pharmacological variables including number and time interval related to pulse therapy for each individual were recorded in dBase. The statistical analyses of d-Base were performed using SPSS. 901 patients in 1592 occasions were studied. The mean age of patients was 34.6 years old [ranged: 8-87 years old]. 586 patients included 465 females and 121 males visited MS clinic just for once. 245 females in 797 occasions and 70 males in 209 occasions received pulse therapy with a mean of 4 times [ranged: 2-11 times]. 51.1% and 48.9% of patients received MP pulse therapy for two and more than two up to 11 times respectively. In the 70% of the patients' time interval between pulse therapy was with a mean of 137 days [ranged: 28-480 days]. For pulse therapy, it seems that the female subjects refer to clinic are approximately 3.7 times higher than male subjects. To reduce the demand of patients to pulse therapy, disease management could be rationalized on the basis of illness expansion and its correlation to inter and intra individual variability. Finally, to understand the effectiveness of pharmacotherapy, in MS population [Isfahan/Iran], clinical neuropharmacology in relation to better understand of the individualized pharmacokinetics could be useful

Study of type A and B behavior patterns in patients with multiple sclerosis in an Iranian population

In adults, throughout life, uniqueness maintains the equivalent; but, it might be tailored in the track of neurological disarrays. As in the partition of cognitive function associated with multiple sclerosis [MS], numerous studies have been performed, but there are very few reports in this area of behavior. The aim of this study was to investigate the prevalence of personality types A and B in relation to individuals' behaviors with MS and type A behavior with demographic characteristics and the level of disability. A cross-sectional descriptive study was performed between September 2010 and March 2011 on 50 patients who were referred to MS clinic [located at the Kashani hospital], Isfahan Neurosciences Research Centre [INRC]. The subjects were evaluated using Friedman and Rosenman questioner and the Expanded Disability Status Scale [EDSS]. The data were analyzed by SPSS software [version 17] based on Chi-square test and independent T-test. Of the subjects, 65% were of personality type A and 35% were of personality type B [X2: 3.5, P < 0.05]. There were no significant differences in individuals with type A behavior in relation to gender and marital status. In connection to EDSS [EDSS < 4.5 or EDSS > 4.5], patients with higher EDSS score, i.e., individuals with EDSS > 4.5 mostly had type A behavior pattern. People with type A behavior pattern are reported to have more stress, nervousness, and anxiety. In this study, MS patients had more characteristics of type A than type B behavior. This behavior was increased in individuals with EDSS score >4.5

Preliminary investigation of economics issues in hospitalized patients with stroke

The study of economics is important in Iranian stroke patients, because it is one of the costly diseases that could be linked to disability, mortality, and morbidity. The aim of this preliminary study was to investigate total treatment costs of hospitalized patients with stroke. A cross-sectional study of 24 patients conducted to Isfahan Neurosciences Research Centre was carried out between April 1, 2012 and September 31, 2012. Demographic [sex, age] and economic variables [Raise tariffs, accumulated surplus, the total amount, of patients', patients' paid, and home insurance contribution] were extracted from the patients' profiles. All information recorded and processed using Excel. The mean age of patients was 71 years [ranged; 40-93 years old]. Preliminary analysis of available costs issues could be described as: Raise tariffs [mean: 3500256 Rial, ranged: 504460-9775455 Rial], accumulated surplus [mean: 565578 Rial, ranged: 56700-2343664 Rial], the total amount [mean: 4045556 Rial, ranged: 715460-12219119 Rial], of patients' [mean: 756037 Rial, ranged: 0-8365447 Rial], patients' paid [mean: 1307762 Rial, ranged: 45300-9193000 Rial], and home insurance contribution [mean: 3070713 Rial, ranged 0-8887907 Rial]. The cost disparity within this study after stroke could be mainly connected to variations in duration of hospital stay. Inspecting agenda towards this direction could reduce the economic cost of stroke significantly. Therefore, further assessment correlated to attain strategies in order to reduce costs associated to patients' paid and home insurance contribution could be much more advantageous

Antibodies to Interferon beta in Patients with Multiple Sclerosis Receiving CinnoVex, Rebif, and Betaferon

Treatment with interferon beta (IFN-beta) induces the production of binding antibodies (BAbs) and neutralizing antibodies (NAbs) in patients with multiple sclerosis (MS). NAbs against IFN-beta are associated with a loss of IFN-beta bioactivity and decreased clinical efficacy of the drug. The objective of this study was to evaluate the incidence and the prevalence of binding antibodies (BAbs) and neutralizing antibodies (NAbs) to IFN-beta in MS patients receiving CinnoVex, Rebif, or Betaferon. The presence of BAbs was studied in serum samples from 124 MS patients using one of these IFN-beta medications by ELISA. The NAbs against IFN-beta were measured in BAb-positive MS patients receiving IFN-beta using an MxA gene expression assay (real-time RT-PCR). Of the 124 patients, 36 (29.03%) had BAbs after at least 12 months of IFN-beta treatment. The proportion of BAb+ was 38.1% for Betaferon, 21.9% for Rebif, and 26.8% for CinnoVex. Five BAb-positive MS patients were lost to follow-up; thus 31 BAb-positive MS patients were studied for NAbs. NAbs were present in 25 (80.6%) of BAb-positive MS patients receiving IFN-beta. In conclusion, the three IFN-beta preparations have different degrees of immunogenicity.

Interferon-beta in pediatric multiple sclerosis patients: safety in short-term prescription

None of the approved immunomodulatory drugs in adults Multiple Sclerosis [MS] patients have been officially approved for the pediatric patients and are currently used off-label in this population. In this study, we evaluated the effectiveness and tolerability of intramuscular interferon beta1-a [Avonex[registered]] and subcutaneously injected interferon beta1-b [Betaferon[registered]] in children with definite relapsing-remitting MS [RRMS]. Thirteen patients aged younger than 16, who were recently diagnosed with definite RRMS according to the McDonald's criteria, were enrolled in this study. Six patients were treated with Avonex[registered] 30 micro g, intramuscularly every week, and seven patients were treated with Betaferon[registered] 250 micro g, subcutaneously every other day. All patients were treated with adult doses; initially interferon-beta was prescribed with half dose, and it was increased to full adult dose steadily. Eleven girls and two boys, mean [SD] age of 14.7 [1.9] years, were studied. Following nine months of using interferon-beta, nine patients [69.2%] had no relapses and the remaining four, experienced only one relapse. The mean EDSS score was decreased significantly after the study period. The present study provides reasonable data for the use of interferon-beta in Pediatric MS due to lack of short-term complications and safety. Studies with larger sample size and longer follow up duration are required to shed light on the long term impact of the interferon-beta therapy in children