[A retrospective analysis of the effect of pregnancy on the course of multiple sclerosis]. / Retrospektivnyi analiz vliianiia beremennosti na techenie rasseiannogo skleroza.

AIM: For a long time it was believed that pregnancy worsens the clinical course of multiple sclerosis. In several European countries, there have been several studies that have demonstrated remission of autoimmune aggression during pregnancy. We studied the effect of pregnancy on the course of multiple sclerosi. MATERIAL AND METHODS: A retrospective analysis of disease course of 279 patients was performed for the first time in three major Russian centers (Moscow, Novosibirsk, Tyumen). RESULTS AND CONCLUSION: There was a remission of autoimmune aggression during pregnancy. The use of DMT before pregnancy was a predictor of a more favorable course of the disease after delivery. An earlier beginning of DMT after delivery led to a significant risk reduction of relapses.

[The effect of genetic factors on the phenotypic expression of multiple sclerosis].

A total of 326 patients with multiple sclerosis (MS) according to the McDonald criteria (2005) were recruited to the study. Single nucleotide polymorphisms in the CD40 gene (rs6074022, rs1883832, rs1535045 and rs11086998) and the KIF1B gene (rs10492972 and rs3135388) were genotyped using TaqMan technology. We found a significant association of rs1883832 (risk allele T, OR=1.74, 95% CI 1.34-2.32, p=2.96·10-7) and rs3135388 (risk allele T, OR=3.23, 95% CI 2.43-4.29, p=3.8·10-17) with the risk of MS in the Novosibirsk region population. The study demonstrated a significant effect of genetic factors on phenotypic expression of MS: an C allele of rs6074022 polymorphism (CD40) was associated with a higher rate of MS progression, and the TT genotype of rs1535045 was associated with a slower progression of MS and early MS onset. A more benign course and a higher frequency of an T allele of rs3135388 (44% vs 33%, p=0.003) was found in familial cases compared to sporadic cases. The further specific research is needed for understanding the genetic basis of susceptibility to MS.

[Combined therapy of aggressive remitted multiple sclerosis with mitoxantrone in combination with copaxone].

Patients with so called aggressive multiple sclerosis were treated. The course of disease is considered aggressive if there are clinical and tomographic signs of high disease activity with the frequency of exacerbations not less than 3 during 2 years. Nine patients with this course of disease were examined. They received a combined therapy including the induction phase in which immunosuppressive drugs played a key role, and a phase of supporting therapy with immunomodulators. A variant based on drugs with opposite mechanisms of action (mitoxantron and copaxon) was worked out for the most effective use of possibilities of combined therapy. Stabilization and improvement of a patient's state by 77.8%, along with a reduction of exacerbation frequency, was found.