The level of cytokines in tears as a novel indicator of demyelinating diseases.

INTRODUCTION: A novel research objective is to identify new molecules in more readily accessible biological fluids that could be used in the diagnosis of multiple sclerosis (MS) and other demyelinating disorders. AIM: To compare the level of selected cytokines in tears between patients with MS or other demyelinating disorder and healthy controls. MATERIAL AND METHODS: 84 patients with diagnosed MS during remission or with other demyelinating disease of the CNS and 70 healthy controls were enrolled in the study. Tears were collected without any stimulation and stored till the day of assessment. The concentration of selected cytokines was measured by the Bio-Plex Pro Human cytokine screening panel 27 cytokines assay according to the manufacturer's instructions. Statistical analysis was performed with Statistica 13. RESULTS: IL-1b level was significantly lower in the study group compared to the control group [3,6 vs 8.71, p < 0.001]. The same pattern was observed for IL-6 [3,1 vs 5.26, p = 0.027] and IL-10 [1,7 vs 10.92, p < 0.001] (Table 1). In the study group, IL-1RA (p = 0.015), IL-5 (p = 0.04), IL-9 (p = 0.014), and IL-15 (p = 0.037) showed significant correlations with age. In the total sample, IL-1Ra (p = 0.016) and IFN-g (p = 0.041) were significantly correlated with age, while in the control group, IL-8 (p = 0.09), MIP-1a (p = 0.009), and RANTES (p = 0.031) showed significant correlations. CONCLUSIONS: Our results show that MS and other demyelination diseases lead to decrease in the overall level of cytokines in tears. Further research is needed to determine the role of tear fluid in the assessment of demyelinating disorders like MS.

Calcium-phosphate homeostasis in secondary progressive multiple sclerosis patients during mitoxantrone therapy.

OBJECTIVES: To assess calcium-phosphate parameters in SPMS patients treated with mitoxantrone (MTX). METHODS: Thirty eight SPMS patients eligible for MTX therapy in the Department of Neurology in Zabrze, Poland were enrolled in a prospective study from March 2016 to November 2019. The parameters of serum calcium-phosphate metabolism and the neurological status according to the Expanded Disability Status Scale (EDSS) were assessed. In patients with hypovitaminosis D, vitamin D (VitD) supplementation was introduced (4000 IU/day for 1 month and later 2000 IU /day). RESULTS: Most patients were women [57.89%]. The mean age [years] was 56.11 (±7.74). The median time from diagnosis to inclusion day (ID) was 7.50 [4.00-14.00] [years]. Due to VitD supplementation, an increase in serum VitD was observed during the study. 84.21% of patients presented with hypovitaminosis D before MTX treatment compared to 47.37% after treatment. Before MTX therapy, none of the patients underwent surgical repair of the fracture compared to 42.11% of patients after MTX treatment (p < 0.01). DISCUSSION: Deficiency of VitD was observed at the baseline in most SPMS patients eligible for MTX therapy. Due to adverse reactions to MTX treatment, this therapy requires patient compliance, cautious drug administration and monitoring during the therapy.

Atrial fibrillation as an important clinical condition of cognitive decline; diagnosis, comorbidities and severity of symptoms in patients with dementia.

Objective: To determine the time of dementia diagnosis, symptom intensity and to assess the comorbidities.Methods: 110 patients with dementia or mild cognitive impairment were enrolled in this retrospective study. The study group was divided into subgroups: patients with a maximum of three (S ≤ 3 n = 62) and four or more symptoms (S ≥ 4 n = 48). Baseline characteristics, disease duration and the number of comorbidities were analyzed.Results: The median time from the first symptoms to diagnosis [months] (FS-D) was 12.0, while from diagnosis to enrollment (D-E) was 42.66. The median time from D-E was significantly longer in S ≥ 4 and significant correlation was observed between the median time from D-E and number of symptoms [n] (R = 0.3240, p < 0.05). Significantly more patients were newly diagnosed with AF [%] [14.58 vs. 3.23, p = 0.032], Parkinson's disease [29.17 vs. 8.06, p = 0.004] and depression [31.25 vs. 6.45, p = 0.001] in S ≥ 4 compared to S ≤ 3, respectively. Conclusions: A considerable delay in the diagnosis of dementia was confirmed. Clinical features were associated with the disease duration and the severity of symptoms. Appropriate diagnosis of AF in patients with dementia is of great importance.