[Effect of the sera of patients with multiple sclerosis on apoptosis and nitric oxide production of endothelial cells]

Multiple sclerosis [MS] is one of the chronic autoimmune diseases of the central nervous system with unknown etiology. The present study aimed to investigate the apoptosis and nitric oxide [NO] production of endothelial cells treated with serum of patients with MS and response to interferon beta [IFN- beta] therapy. Human umbilical vein endothelial cells were treated with sera from patients with active MS [in relapse], MS in remission, or sera from healthy volunteers [each n = 10]. Nitric oxide [NO] levels were determined in culture supernatants by Greiss method and endothelial cell apoptosis was assessed by annexin V-propidium iodide staining. Effects of IFN-beta-1b on endothelial cell apoptosis and NO production were tested at increasing doses [10, 100, and 1000 U/ml]. Compared with healthy people, only apoptosis of endothelial cells treated with serum of patients with relapsing phase increased, P<0.01; while there was no significant difference between apoptosis of endothelial cells treated with serum of patients in remission phase and healthy controls. Apoptosis of endothelial cells treated with sera of patients in relapse was decreased by IFN-beta-1b at 10 U/ml, P<0.05. The same dose also led to a significant increase in nitric oxide production. The results suggest that endothelial cells injury and apoptosis may play a role in MS etiology and represents a potential therapeutic mechanism of action for IFN-beta-1b in MS therapy

Relationship between cerebral vein thrombosis and non-anticardiolipin antiphospholipid antibodies

Background: anticardiolipin antibody [aCL] has been recognized as a marker for increased risk of Cerebral Vein Thrombosis [CVT]. However, there are only rare reports on CVT associated with other antibodies against different phospholipids such as phosphatidyl inositol, phosphatidyl serine, phosphatidic acid and beta 2 glycoprotein I. In this study, we studied the presence of these antiphospholipid antibodies [aPL], demographic and clinical characteristics in 30 patients with CVT

Methods: after diagnosis of CVT in 30 patients with MRI, we measured the titer of aCL and aPL [IgM and IgG] in all cases. The titers of IgG and IgM type of aPL and aCL were estimated in the sera

Results: anticardiolipin antibody was solely detected in 20% [n=6] and aCL and other aPL in 23.3% [ n=7] of patients, indicating one patient positive for other aPL but not for aCL [non-aCL]. Although the aPL positive group did not differ from the aPL-negative group from the stand point of clinical and demographic characteristics, yet seizure, infarct, superficial veins and sinus involvement and the use of OCP were seen more frequently in aPL-positive group

Conclusion: our findings suggest that in addition to aCL, other antiphospholipid antibodies may be an associated condition that plays a role in the pathogenesis of CVT. The presence of aPL in CVT patients is probably associated with more superficial sinus or veins involvement and as a result death rate was lower in aPL- positive group. Further investigations are necessary to establish this hypothesis

Magnesium sulfate in acute stroke: a randomized double-blind clinical trial

Background: administration of magnesium sulfate has neuroprotective effects and reduces infarct volume in animal models of stroke. Previous small clinical trials have reported beneficial effect of magnesium on the outcome in patients with stroke. This study was a randomized, placebo-controlled, double-blind study , investigated the benefit of magnesium sulfate the administration given intravenously as a neuroprotective

Methods: patients who had cortical infarction in the middle cerebral artery territory [superior or inferior division] with moderate neurologic deficits [Orgogozo scale score greater than 30 and less than 70] and onset less than 24 hours were included. The patients were treated with magnesium sulfate [4gr stat and 1gr/hr] or placebo for 4 days and examined by a blind investigator. NIH Stroke Scale was obtained on admission and fifth day after stroke

Results: eighteen patients were given treatment and nineteen patients were given placebo who demonstrated significant beneficial effects on the difference between NIH Stroke Scales on the day of admission and day 5 [3.16 +/- 0.98 vs. 1.84 +/- 1.06; p = 0.000 respectively]

Conclusion: intravenous magnesium sulfate had significant beneficial effect on acute phase of stroke patients and, as a result, may reduce duration of admission