RESUMO
Pain is experienced by approximately two-thirds of all people with multiple sclerosis (MS) at some time during the course of their disease. Pain in MS occurs as a consequence of both the disease and the disability that it produces. Pain in MS is receiving more attention as clinical trials in the past decade have focused not solely on the immune system modulators of disease but also on symptomatic management as well. Nurses with their keen communication and assessment skills and their unique advocacy role are particularly equipped to effect pain management for people with multiple sclerosis.
Assuntos
Esclerose Múltipla/complicações , Manejo da Dor , Dor/etiologia , Doença Aguda , Analgésicos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Doença Crônica , Comunicação , Humanos , Esclerose Múltipla/imunologia , Fármacos Neuromusculares/uso terapêutico , Relações Enfermeiro-Paciente , Avaliação em Enfermagem/métodos , Dor/diagnóstico , Medição da Dor/métodos , Medição da Dor/enfermagem , Defesa do PacienteRESUMO
Transforming growth factor (TGF)-beta2 is a pleiotropic cytokine associated with remissions in multiple sclerosis (MS) and amelioration of allergic encephalomyelitis. We assessed the safety of TGF-beta2 in an open-label trial of 11 patients with secondary progressive (SP) MS. Five patients had a reversible decline in the glomerular filtration rate. There was no change in expanded disability status scale or MRI lesions during treatment. Systemic TGF-beta2 may be associated with reversible nephrotoxicity, and further investigation of its therapeutic potential in MS should be performed with caution.
Assuntos
Esclerose Múltipla/tratamento farmacológico , Fator de Crescimento Transformador beta/administração & dosagem , Fator de Crescimento Transformador beta/toxicidade , Adulto , Nitrogênio da Ureia Sanguínea , Líquido Cefalorraquidiano/citologia , Doença Crônica , Feminino , Taxa de Filtração Glomerular/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Circulação Renal/efeitos dos fármacos , Fator de Crescimento Transformador beta/farmacocinéticaRESUMO
Viruses have long been suggested to be involved in the etiology of multiple sclerosis (MS). This suggestion is based on (1) epidemiological evidence of childhood exposure to infectious agents and increase in disease exacerbations with viral infection; (2) geographic association of disease susceptibility with evidence of MS clustering; (3) evidence that migration to and from high-risk areas influences the likelihood of developing MS; (4) abnormal immune responses to a variety of viruses; and (5) analogy with animal models and other human diseases in which viruses can cause diseases with long incubation periods, a relapsing-remitting course, and demyelination. Many of these studies involve the demonstration of increased antibody titers to a particular virus, whereas some describe isolation of virus from MS material. However, no virus to date has been definitively associated with this disease. Recently, human herpesvirus 6 (HHV-6), a newly described beta-herpes virus that shares homology with cytomegalovirus (CMV), has been reported to be present in active MS plaques. In order to extend these observations, we have demonstrated increased IgM serum antibody responses to HHV-6 early antigen (p41/38) in patients with relapsing-remitting MS (RRMS), compared with patients with chronic progressive MS (CPMS), patients with other neurologic disease (OND), patients with other autoimmune disease (OID), and normal controls. Given the ubiquitous nature of this virus and the challenging precedent of correlating antiviral antibodies with disease association, these antibody studies have been supported by the detection of HHV-6 DNA from samples of MS serum as a marker of active viral infection.
