ABSTRACT
The paper summarized an experience of pronoran (piribedil) treatment of 516 patients with Parkinson's disease (primary parkinsonism) conducted in the district outpatient clinics of 7 Moscow administrative areas. In 84 cases, the medication was used as a monotherapy and in 432--in combination with levodopa-contained drug madopar. An improvement of patient's state, with reducing of bradikinesia, tremor and rigidity, was achieved in 73.0 +/- 20.4% of the patients. Combined therapy allowed decreasing of madopar dosage in 58.5 +/- 16.7% of the patients. Pronoran (piribedil) is well tolerated. The authors recommend it for the treatment of outpatients with Parkinson's disease.
Subject(s)
Dopamine Agonists/therapeutic use , Parkinson Disease/drug therapy , Ambulatory Care , Dopamine Agonists/administration & dosage , Dopamine Agonists/classification , Drug Administration Schedule , HumansABSTRACT
Multiple sclerosis (MS) as an autoimmune disease is characterized by occurrence of high titres of antibodies (AB) to cell structures and autoantigens. Various AB-mediated effector mechanisms can participate directly in the pathogenesis of demyelinisation damaging myelin, oligodendrocytes and nervous fibres. Antinuclear AB, including anti-DNA AB are an example of activation of humoral immunity in MS. Pathogenetic and clinical value of these AB is investigated insufficiently. The aim of this study was estimation of the AB titers in MS patients from two populations of Russia in relation to clinical features of MS. Results of examination of 83 patients with definite MS from Novosibirsk and Moscow (49 and 34 patients) are analyzed. Groups of comparison consisted of healthy donors and patients with SLE of the same age. Use of identical methods in the analysis of the data received in two various populations made the data objective as much as possible and revealed the strongest clinico-biochemical associations. Levels of AB to both native and denaturated DNA were studied. Comparison of several test-systems showed that the system produced by "Specialized scientific Labs" Company has the best sensitivity. In two populations of MS patients the levels of AB in plasma were similar and associated between each other, higher than in donors, but lower than in SLE patients. In both groups MS patients with secondary progressive MS had higher percent of samples of plasma with average and high levels of AB. In the Novosibirsk group associations of levels of AB with parameters of disease severety (EDSS and a number of FS scales) were seen. In the Moscow group levels of AB to DNA were significantly associated with time from the disease onset to certain level of disability (EDSS 3); both the analysis of average values and the correlation analysis showed a weak association of AB to DNA level and MS duration. The data testify that AB to DNA play a more important role in MS pathogenesis than was considered earlier. Catalytic AB as a part of anti-DNA AB may play a special role.
Subject(s)
Antibodies, Antinuclear/immunology , Multiple Sclerosis, Chronic Progressive , T-Lymphocytes/immunology , Adult , Chronic Disease , Disability Evaluation , Female , Genetic Markers/genetics , Genetic Markers/immunology , Humans , Immunoglobulin G/blood , Immunoglobulin G/cerebrospinal fluid , Immunoglobulin G/immunology , Male , Multiple Sclerosis, Chronic Progressive/blood , Multiple Sclerosis, Chronic Progressive/genetics , Multiple Sclerosis, Chronic Progressive/immunology , Nucleic Acid Denaturation/genetics , Severity of Illness IndexABSTRACT
The review addresses an analysis of the causes of neurodegenerative process development in multiple sclerosis (MS) as well as the modern approaches to the treatment of the disease. The best-studied mechanisms of degenerative alterations and clinical and experimental evidence supported the protective influence of beta-interferons treatment in MS are discussed. Neuroprotection is highlighted among the future directions. The main features of the various groups of neurotrophic factors and the possible ways of their therapy-targeted transport into brain tissues are analyzed.
