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Kalvaitis L, Gedvilaite-Vaicechauskiene G, Kriauciuniene L, Balnyte R, Liutkeviciene R. TNF-alfa Gene Polymorphism Associations with Multiple Sclerosis. J Clin Med 2024; 13:3693. [PMID: 38999258 PMCID: PMC11242879 DOI: 10.3390/jcm13133693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/16/2024] [Accepted: 06/20/2024] [Indexed: 07/14/2024] Open
Abstract
Background:TNF-α has a dual role in multiple sclerosis (MS), contributing to both protective and harmful effects. It activates immune cells, promotes the formation of inflammatory lesions in the central nervous system, and stimulates the production of other pro-inflammatory cytokines and chemokines, leading to myelin destruction and neuronal damage. Our research focused on investigating the relationship between TNF-alpha (rs1800630, rs1800629, and rs361525) gene polymorphisms and MS. Methods: 250 healthy controls and 250 multiple sclerosis (MS) patients were included in the study. DNA was extracted from leucocytes from peripheral venous blood by salt precipitation. Single nucleotide polymorphisms (SNPs) were tested using RT-PCR. Statistical analysis of the data was performed using IBM SPSS Statistics 29.0 data analysis software. Results: The analysis revealed that the rs361525 AG genotype was significantly less frequent in the MS group compared to the control group (4.0% vs. 7.2%, p = 0.042). Sex-specific analysis showed a significant difference in genotype distribution (GG, AG, AA) among males between the MS group and the control group (97.7%, 0%, 2.3% vs. 90.6%, 9.4%, 0%, p = 0.005). For the rs1800629 polymorphism, significant results were also found. In subjects younger than 39 years, the A allele was significantly less frequent in the MS group than in the control group (8.6% vs. 15.0%, p = 0.030). The most robust model indicated that the AA genotype reduced the odds of MS by approximately 2 fold compared to the AG + GG genotype (p = 0.044), and each A allele reduced the odds of MS by approximately 2 fold (p = 0.028). The rs1800630 A allele was significantly more common in males in the MS group than in the control group (21.0% vs. 12.9%, p = 0.046). Conclusions: In conclusion, our study identifies significant associations between TNF-alpha gene variants and MS. Specifically, the rs631525 AG genotype was less common in the MS group, with notable sex-specific differences observed. The rs1800629 A allele was statistically significantly less frequent in the MS group than in the control group, and the AA genotype reduced the odds of MS occurrence by ~2 fold compared with the AG + GG genotypes. Additionally, each A allele of rs1800629 was linked to a 2-fold decreased odds of MS occurrence. In males, the rs1800630 A allele was more frequent in the MS group. These findings highlight the relevance of TNF-alpha genetic variations in MS susceptibility, suggesting potential avenues for further research and therapeutic exploration.
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Affiliation(s)
- Lukas Kalvaitis
- Medical Faculty, Lithuanian University of Health Sciences, Medical Academy, LT-50161 Kaunas, Lithuania
| | - Greta Gedvilaite-Vaicechauskiene
- Medical Faculty, Lithuanian University of Health Sciences, Medical Academy, LT-50161 Kaunas, Lithuania
- Neuroscience Institute, Lithuanian University of Health Sciences, Medical Academy, LT-50161 Kaunas, Lithuania
| | - Loresa Kriauciuniene
- Neuroscience Institute, Lithuanian University of Health Sciences, Medical Academy, LT-50161 Kaunas, Lithuania
| | - Renata Balnyte
- Department of Neurology, Lithuanian University of Health Sciences, Medical Academy, LT-50161 Kaunas, Lithuania
| | - Rasa Liutkeviciene
- Neuroscience Institute, Lithuanian University of Health Sciences, Medical Academy, LT-50161 Kaunas, Lithuania
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2
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Gedvilaite G, Pileckaite E, Ramanauskas I, Kriauciuniene L, Balnyte R, Liutkeviciene R. Investigating the Potential Influence of TAS2R16 Genetic Variants and Protein Levels on Multiple Sclerosis Development. J Pers Med 2024; 14:402. [PMID: 38673029 PMCID: PMC11051568 DOI: 10.3390/jpm14040402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
The study aimed to investigate the association between the TAS2R16 gene (rs860170, rs978739, rs1357949), TAS2R16 serum levels, and multiple sclerosis (MS). A total of 265 healthy control subjects and 218 MS patients were included in the study. Single nucleotide polymorphisms (SNPs) were tested by real-time polymerase chain reaction (RT-PCR). The serum concentration of TAS2R16 was measured using the ELISA method. Analyses revealed that the TAS2R16 rs860170 TT genotype was statistically significantly less frequent in the MS group than in the control group (p = 0.041), and the CC genotype was statistically significantly more frequent in the MS group than in the control group (p < 0.001). In the most robust (codominant) model, the CC genotype was found to increase the odds of MS by ~27-fold (p = 0.002), and each C allele increased the odds of MS by 1.8-fold (p < 0.001). Haplotype analysis of the rs860170, rs978739, and rs1357949 polymorphisms showed that the C-C-A haplotype was associated with a ~12-fold increased odds of MS occurrence (p = 0.02). Serum TAS2R16 levels were elevated in the MS group compared to control subjects (p = 0.014). Conclusions: The rs860170, rs978739, and rs1357949 polymorphisms demonstrated that the C-C-A haplotype and elevated TAS2R16 serum levels can promote the development of MS. These preliminary findings underscore the importance of specific genetic variants, such as rs860170, rs978739, and rs1357949, in MS risk. Additionally, elevated TAS2R16 serum levels in MS patients suggest a potential role in MS pathogenesis. These findings provide insights into the genetic and molecular mechanisms underlying MS and pave the way for personalized diagnostic and therapeutic strategies. Integrating genetic and serum biomarker data in MS research offers promising avenues for improving clinical outcomes and advancing precision medicine approaches in the future.
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Affiliation(s)
- Greta Gedvilaite
- Neuroscience Institute, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania; (G.G.); (L.K.); (R.L.)
- Medical Faculty, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania;
| | - Enrika Pileckaite
- Neuroscience Institute, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania; (G.G.); (L.K.); (R.L.)
- Medical Faculty, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania;
| | - Ignas Ramanauskas
- Medical Faculty, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania;
| | - Loresa Kriauciuniene
- Neuroscience Institute, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania; (G.G.); (L.K.); (R.L.)
| | - Renata Balnyte
- Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania;
| | - Rasa Liutkeviciene
- Neuroscience Institute, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania; (G.G.); (L.K.); (R.L.)
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Alito A, Fontana JM, Franzini Tibaldeo E, Verme F, Piterà P, Miller E, Cremascoli R, Brioschi A, Capodaglio P. Whole-Body Cryostimulation in Multiple Sclerosis: A Scoping Review. J Clin Med 2024; 13:2003. [PMID: 38610768 PMCID: PMC11012586 DOI: 10.3390/jcm13072003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/15/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Multiple sclerosis (MS) is the most common cause of non-traumatic long-term disability in young adults. Whole-body cryostimulation (WBC) is a cold-based physical therapy known to induce physiological exercise-mimicking changes in the cardiovascular, neuromuscular, immune, and endocrine systems and to influence functional and psychological parameters by exposing the human body to cryogenic temperatures (≤-110 °C) for 2-3 min. The purpose of this scoping review is to present an overall view on the potential role of WBC as an adjuvant therapy in the treatment of MS. PubMed, ScienceDirect, Embase, and Web of Science were searched up to 30 November 2023, and a total of 13 articles were included. WBC may have beneficial antioxidant effects as a short-term adjuvant treatment in MS. There were no significant changes in antioxidant enzymes, nitric oxide levels, metalloproteinase levels, blood counts, rheology, and biochemistry. WBC can lead to a reduction in fatigue and an improvement in functional status, with a significant effect on both mental and physical well-being. There were no reported adverse effects. The results suggest that WBC may complement therapeutic options for patients with MS, as the effects of cryogenic cold stimulation have been shown to activate antioxidant processes and improve functional status, mood, anxiety, and fatigue.
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Affiliation(s)
- Angelo Alito
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy;
| | - Jacopo Maria Fontana
- IRCCS, Istituto Auxologico Italiano, Orthopedic Rehabilitation Unit, Research Laboratory in Biomechanics and Rehabilitation, San Giuseppe Hospital, Piancavallo, 28921 Verbania, Italy; (J.M.F.); (P.C.)
| | - Eleonora Franzini Tibaldeo
- Department of Surgical Sciences, Physical and Rehabilitation Medicine, University of Torino, 10121 Torino, Italy;
| | - Federica Verme
- IRCCS, Istituto Auxologico Italiano, Orthopedic Rehabilitation Unit, Research Laboratory in Biomechanics and Rehabilitation, San Giuseppe Hospital, Piancavallo, 28921 Verbania, Italy; (J.M.F.); (P.C.)
| | - Paolo Piterà
- Department of Clinical and Biological Sciences, University of Turin, 10043 Torino, Italy;
| | - Elzbieta Miller
- Department of Neurological Rehabilitation, Medical University of Lodz, Milionowa 14, 93-113 Lodz, Poland;
| | - Riccardo Cremascoli
- IRCCS, Istituto Auxologico Italiano, Unit of Neurology and Neurorehabilitation, San Giuseppe Hospital, Piancavallo, 28921 Verbania, Italy; (R.C.); (A.B.)
| | - Andrea Brioschi
- IRCCS, Istituto Auxologico Italiano, Unit of Neurology and Neurorehabilitation, San Giuseppe Hospital, Piancavallo, 28921 Verbania, Italy; (R.C.); (A.B.)
| | - Paolo Capodaglio
- IRCCS, Istituto Auxologico Italiano, Orthopedic Rehabilitation Unit, Research Laboratory in Biomechanics and Rehabilitation, San Giuseppe Hospital, Piancavallo, 28921 Verbania, Italy; (J.M.F.); (P.C.)
- Department of Surgical Sciences, Physical and Rehabilitation Medicine, University of Torino, 10121 Torino, Italy;
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Seyedmirzaei H, Salabat D, KamaliZonouzi S, Teixeira AL, Rezaei N. Risk of MS relapse and deterioration after COVID-19: A systematic review and meta-analysis. Mult Scler Relat Disord 2024; 83:105472. [PMID: 38316078 DOI: 10.1016/j.msard.2024.105472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Upper respiratory viral infections have long been considered triggers for multiple sclerosis (MS) relapse and exacerbation. The possible effects of SARS-CoV-2 infection on MS relapse and deterioration remain controversial. METHODS We systematically searched PubMed, Scopus, Embase, Cochrane, and Web of Science databases to find relevant studies assessing changes in relapse rates or Expanded Disability Status Scale (EDSS) following COVID-19 in people with MS. Meta-analyses were performed, and to investigate sources of heterogeneity, subgroup analysis, meta-regression, and sensitivity analysis were conducted. RESULTS We included 14 studies in our systematic review and meta-analysis. The meta-analysis demonstrated that COVID-19 was not associated with a rise in relapse rate (risk ratio (RR): 0.97, 95 % confidence interval (CI): 0.67, 1.41, p-value: 0.87) or a rise in EDSS (standardized mean difference (SMD): -0.09, 95 % CI: -0.22, 0.03, p-value: 0.13). The analysis of EDSS changes indicated a significant heterogeneity (I2: 55 %, p-value: 0.01). Other analyses were not statistically significant. CONCLUSIONS COVID-19 infection was not associated with an increased risk of relapse and clinical deterioration in people with MS.
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Affiliation(s)
- Homa Seyedmirzaei
- Universal Scientific Education and Research Network (USERN), Tehran, Iran; Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Interdisciplinary Neuroscience Research Program (INRP), Tehran University of Medical Sciences, Tehran, Iran
| | - Dorsa Salabat
- Universal Scientific Education and Research Network (USERN), Tehran, Iran; School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sara KamaliZonouzi
- Universal Scientific Education and Research Network (USERN), Tehran, Iran; School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Antônio L Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Nima Rezaei
- Universal Scientific Education and Research Network (USERN), Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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5
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Aghajanian S, Shafiee A, Akhondi A, Abadi SRF, Mohammadi I, Ehsan M, Mohammadifard F. The effect of COVID-19 on Multiple Sclerosis relapse: A systematic review and meta-analysis. Mult Scler Relat Disord 2024; 81:105128. [PMID: 37979408 DOI: 10.1016/j.msard.2023.105128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 07/08/2023] [Accepted: 11/04/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic autoimmune disease, affecting over 2.5 million people worldwide. There has been growing concern about the impact of COVID-19 on the clinical course of MS. However, these findings remain controversial, and there is a lack of high-quality evidence to establish the relationship between COVID-19 and MS. METHODS A comprehensive search was done to identify relevant studies reporting relapse rate in patients with MS (pwMS), those comparing the relapse rate of COVID-19 pwMS and MS controls, and studies investigating the effect of COVID-19 on relapse rate of pwMS. The results were presented as proportion of COVID-19 pwMS experiencing relapse and odds ratio determining the impact of COVID-19 on relapse rate. RESULTS Fourteen studies were included in the analyses. The proportion of COVID-19 positive pwMS with relapse was 7.71 per 100 cases (95 % confidence interval, CI: 4.41-13.89, I2=96 %). Quantitative evaluation of studies with pwMS without COVID-19 did not demonstrate a statistically significant difference in relapse rate of patients with COVID-19 (OR: 0.75, 95 %CI: 0.44-1.29, I2= 54 %). Subgroup and sensitivity analyses did not alter the lack of significance of association between COVID-19 and MS relapse. Sensitivity analysis excluding the outlying study was largely in favor of no difference between the groups (OR:1.00, 95 %CI: 0.72-1.38, I2=34 %) CONCLUSION: The results of this review does not suggest that COVID-19 influences the relapse rate in pwMS. While the findings alleviate the concerns regarding the co-occurrence of the diseases, further studies are needed to investigate the effects of confounding factors.
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Affiliation(s)
- Sepehr Aghajanian
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Iran; Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Arman Shafiee
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Iran
| | - Amirhossein Akhondi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Iran
| | | | - Ida Mohammadi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Iran
| | | | - Fateme Mohammadifard
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Iran
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6
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Lebel Y, Milo T, Bar A, Mayo A, Alon U. Excitable dynamics of flares and relapses in autoimmune diseases. iScience 2023; 26:108084. [PMID: 37915612 PMCID: PMC10616393 DOI: 10.1016/j.isci.2023.108084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/04/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
Many autoimmune disorders exhibit flares in which symptoms erupt and then decline, as exemplified by multiple sclerosis (MS) in its relapsing-remitting form. Existing mathematical models of autoimmune flares often assume regular oscillations, failing to capture the stochastic and non-periodic nature of flare-ups. We suggest that autoimmune flares are driven by excitable dynamics triggered by stochastic events auch as stress, infection and other factors. Our minimal model, involving autoreactive and regulatory T-cells, demonstrates this concept. Autoimmune response initiates antigen-induced expansion through positive feedback, while regulatory cells counter the autoreactive cells through negative feedback. The model explains the decrease in MS relapses during pregnancy and the subsequent surge postpartum, based on lymphocyte dynamics. Additionally, it identifies potential therapeutic targets, predicting significant reduction in relapse rate from mild adjustments of regulatory T cell activity or production. These findings indicate that excitable dynamics may underlie flare-ups across various autoimmune disorders, potentially informing treatment strategies.
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Affiliation(s)
- Yael Lebel
- Department Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100 Israel
| | - Tomer Milo
- Department Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100 Israel
| | - Alon Bar
- Department Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100 Israel
| | - Avi Mayo
- Department Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100 Israel
| | - Uri Alon
- Department Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100 Israel
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7
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Adabanya U, Awosika A, Khan A, Oluka E, Adeniyi M. Pediatric multiple sclerosis: an integrated outlook at the interplay between genetics, environment and brain-gut dysbiosis. AIMS Neurosci 2023; 10:232-251. [PMID: 37841344 PMCID: PMC10567585 DOI: 10.3934/neuroscience.2023018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 10/17/2023] Open
Abstract
Multiple sclerosis (MS) is a debilitating autoimmune condition caused by demyelination, neurodegeneration and persistent inflammation of the central nervous system. Pediatric multiple sclerosis (PMS) is a relatively rare form of the disease that affects a significant number of individuals with MS. Environmental exposures, such as viral infections and smoking, can interact with MS-associated human leukocyte antigens (HLA) risk alleles and influence the immune response. Upregulation of immune response results in the disruption of immune balance leading to cascade of inflammatory events. It has also been established that gut microbiome dysbiosis poses a higher risk for pro-inflammation, and it is essentially argued to be the greatest environmental risk factor for MS. Dysbiosis can cause an unusual response from the adaptive immune system and significantly contribute to the development of disease in the host by activating pro-inflammatory pathways that cause immune-mediated disorders such as PMS, rendering the body more vulnerable to foreign attacks due to a weakened immune response. All these dynamic interactions between biological, environmental and genetic factors based on epigenetic study has further revealed that upregulation or downregulation of some genes/enzyme in the central nervous system white matter of MS patients produces a less stable form of myelin basic protein and ultimately leads to the loss of immune tolerance. The diagnostic criteria and treatment options for PMS are constantly evolving, making it crucial to have a better understanding of the disease burden on a global and regional scale. The findings from this review will aid in deepening the understanding of the interplay between genetic and environmental risk factors, as well as the role of the gut microbiome in the development of pediatric multiple sclerosis. As a result, healthcare professionals will be kept abreast of the early diagnostic criteria, accurately delineating other conditions that can mimic pediatric MS and to provide comprehensive care to individuals with PMS based on the knowledge gained from this research.
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Affiliation(s)
- Uzochukwu Adabanya
- Anatomical Sciences, Edward Via College of Osteopathic Medicine, Monroe, USA
| | - Ayoola Awosika
- College of Medicine, University of Illinois, Chicago, USA
| | - Anosh Khan
- Emergency Medicine, Trinity health Livonia Hospital, Livonia USA
| | - Ejike Oluka
- Department of pathophysiology, St. George's University School of Medicine, Grenada
| | - Mayowa Adeniyi
- Department of Physiology, Federal University of Health Sciences Otukpo, Benue State, Nigeria
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8
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Soleimani A, Ezabadi SG, Möhn N, Esfandabadi ZM, Khosravizadeh Z, Skripuletz T, Azimzadeh M. Influence of hormones in multiple sclerosis: focus on the most important hormones. Metab Brain Dis 2023; 38:739-747. [PMID: 36595158 DOI: 10.1007/s11011-022-01138-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/30/2022] [Indexed: 01/04/2023]
Abstract
Hormonal imbalance may be an important factor in the severity of multiple sclerosis (MS) disease. In this context, hormone therapy has been shown to have immunoregulatory potential in various experimental approaches. There is increasing evidence of potentially beneficial effects of thyroid, melatonin, and sex hormones in MS models. These hormones may ameliorate the neurological impairment through immunoregulatory and neuroprotective effects, as well as by reducing oxidative stress. Expanding our knowledge of hormone therapy may be an effective step toward identifying additional molecular/cellular pathways in MS disease. In this review, we discuss the role of several important hormones in MS pathogenesis in terms of their effects on immunoregulatory aspects and neuroprotection.
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Affiliation(s)
- Alireza Soleimani
- Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Sajjad Ghane Ezabadi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nora Möhn
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | | | - Zahra Khosravizadeh
- Clinical Research Development Unit, Amiralmomenin Hospital, Arak University of Medical Sciences, Arak, Iran
| | | | - Maryam Azimzadeh
- Department of Medical Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran.
- Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran.
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AL-MIDFAI YOUNUS, Kujundzic W, Uppal S, Oakes D, Giezy S. Acute Multiple Sclerosis Exacerbation After Vaccination With the Johnson & Johnson COVID-19 Vaccine: Novel Presentation and First Documented Case Report. Cureus 2022; 14:e24017. [PMID: 35547449 PMCID: PMC9090220 DOI: 10.7759/cureus.24017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2022] [Indexed: 11/05/2022] Open
Abstract
Multiple sclerosis (MS) is a neurologic disease caused by a chronic autoimmune process resulting in the demyelination of axons within the central nervous system. MS occurs through combined genetic susceptibility and environmental triggers. MS relapses (MSR) are characterized by acute inflammatory reactions and symptoms. Here we present a novel case of MSR following the second dose of the Johnson & Johnson coronavirus disease 2019 (COVID-19) vaccine (Johnson & Johnson, New Brunswick, New Jersey, United States), presenting with paresthesias and left foot deficit. Additional research and studies are necessary to explore the relationship of COVID-19 vaccinations with MSR.
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10
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Ghasempour G, Zamani-Garmsiri F, Shojaei S, Rahmani-Fard S, Bagherieh M, Rashno S, Najafi M. Vitamin D3 and estradiol alter PAD2 expression and activity levels in C6 glioma cells. Mult Scler Relat Disord 2021; 56:103221. [PMID: 34461573 DOI: 10.1016/j.msard.2021.103221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 08/05/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022]
Abstract
Multiple Sclerosis (MS) is known as a chronic demyelinating disease with multifactorial etiology. It is suggested that the deimination of myelin basic proteins (MBPs) by peptidyl arginine deiminase 2 (PAD2) may increase citrulline residues resulting in the reduction of myelin sheath density and the progression of multiple sclerosis. The aim of this study was to investigate the effects of vitamin D (25-hydroxy cholecalciferol (D3)) and estradiol on PAD2 gene expression level and its catalytic activity in rat C6 glioma cells. C6 glioma cells were cultured in DMEM medium and were treated with vitamin D (10 and 100 ng/ml) and estradiol (10 and 100 µM) based on the cellular viability. Then, the PAD2 gene expression and catalytic activity were evaluated using real-time qRT-PCR and spectrophotometry techniques, respectively. The PAD2 gene expression level and its catalytic activity increased significantly in estradiol-treated cells (P = 0.0435 and P = 0.0015, respectively). Conversely, vitamin D downregulated significantly the PAD2 gene expression level (P < 0.015) and its activity (P < 0.017). The study results suggested that estradiol conversely with vitamin D increases the activity of the PAD2 enzyme so that it might develop multiple sclerosis, especially in women.
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Affiliation(s)
- Ghasem Ghasempour
- Department of Clinical Biochemistry, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Clinical Biochemistry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Zamani-Garmsiri
- Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahla Shojaei
- Department of Clinical Biochemistry, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Human Anatomy and Cell Science, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Soheil Rahmani-Fard
- Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Disease, Iran University of Medical Sciences, Tehran, Iran
| | - Molood Bagherieh
- Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sajjad Rashno
- Department of Clinical Biochemistry, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Najafi
- Department of Clinical Biochemistry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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11
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Burkhard A, Toliver J, Rascati K. Association between multiple sclerosis disease severity and adherence to disease-modifying therapies. J Manag Care Spec Pharm 2021; 27:915-923. [PMID: 34185555 PMCID: PMC10391086 DOI: 10.18553/jmcp.2021.27.7.915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND: For multiple sclerosis (MS) patients taking disease-modifying therapies (DMTs), adherence to treatment is a key component of achieving beneficial outcomes, such as delayed disease progression and the reduction and prevention of symptoms and relapses. OBJECTIVES: The aim of this study was to assess the impact of a claims-based measure of MS disease severity on DMT adherence in a one-year study period. METHODS: Patients were identified from Humana Medicare Advantage claims data from January 1, 2013 to December 31, 2015. Patients over the age of 18 with at least 12 months of continuous enrollment and > 1 outpatient MS visit with DMT use prior to the index date were included. Patients who switched DMT type (oral, platform, IV) during the study period were excluded. Medication possession ratios (MPR) for DMTs were calculated from pharmacy and medical claims over 12 months of claims data, and a previously developed claims algorithm was used to determine MS disease severity. Patients with MPRs of 0.8 or higher were considered adherent to DMT treatment. Multivariable logistic regression was used to evaluate the association of MS disease severity, gender, DMT type, and age category with DMT adherence. RESULTS: The study population of 3,347 patients had an average MPR of 84.7 (75% were classified as adherent). Multivariable logistic analysis demonstrated that compared to the 18-45 age group, the 46-64 and 65+ age groups were 1.33 (OR: 1.33 [95% CI 1.08-1.64]) and 1.55 (OR: 1.55, [95% CI 1.18-2.05]) times more likely to be adherent. Patients with a high level of MS disease severity were 53% (OR: 0.47, [95% CI 0.36-0.62]) less likely to be adherent compared to those with low MS disease severity. No significant difference was identified for gender or DMT type (oral, platform, or IV). CONCLUSIONS: Increased age and lower MS disease severity were associated with better DMT adherence. MS disease severity should be considered when assessing risk for low DMT adherence. DISCLOSURES: No funding supported this project. The authors have nothing to disclose. Preliminary results were previously presented virtually at AMCP Annual 2020 in April 2020.
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Mansoor F, Kumar V, Kumar S, Kaur N, Naz S, Shahid S, Anees F, Memon S, Rizwan A. Association Between Serum Vitamin D Levels and Frequency of Relapses in Patients With Multiple Sclerosis. Cureus 2021; 13:e14383. [PMID: 33987049 PMCID: PMC8110290 DOI: 10.7759/cureus.14383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction Multiple sclerosis (MS) is an immune-mediated inflammatory disease of the central nervous system affecting the myelin sheath of neurons with a wide range of symptoms. Among various risk factors studied that can increase the relapse, vitamin D is also a potential risk factor. In this study, we will determine the association between vitamin D status and frequency of relapses in patients with MS. Material and methods Seventy-four (74) patients with a confirmed diagnosis of MS, with more than one (01) relapse per year, for a minimum of two years, were included in the case group. Seventy-four (74) participants with a confirmed diagnosis of MS with one (01) or no relapse per year, for a minimum of two years, were included in the control group. After informed consent, the patient blood was drawn via phlebotomy and was sent to the lab for vitamin D levels. Results The mean serum vitamin D level was significantly lower in case group compared to control group (18.21 ± 4.21 ng/mL vs. 29.21 ± 5.72 ng/mL; p-value: < 0.0001). The number of participants with vitamin D level less than 30 ng/mL were significantly higher in patients with case group compared to control group (78.37% vs. 50.0%; p-value: 0.0003) Conclusion In this study, patients with more relapses per year had low level of serum vitamin D. There is emerging strong evidence that vitamin D plays an important role in the pathogenesis, progression, and disease burden of autoimmune disease, including MS.
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Affiliation(s)
- Farah Mansoor
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Vikash Kumar
- Neurology, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Suneel Kumar
- Neurology, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Navneet Kaur
- Internal Medicine, Adesh institute of Medical Sciences and Research, Bathinda, IND
| | - Sidra Naz
- Internal Medicine, University of Health Sciences, Lahore, PAK
| | - Simra Shahid
- Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Faryal Anees
- Obstetrics and Gynecology, Agha Khan University Hospital, Karachi, PAK.,Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Sidra Memon
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Amber Rizwan
- Family Medicine, Jinnah Post Graduate Medical Center, Karachi, PAK
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Pavelek Z, Novotný M, Klímová B, Peterka M, Potužník P, Kövári M, Vališ M. DORADA adherence study: full view into RebiSmart subdomains parameters in multiple sclerosis treatment. Curr Med Res Opin 2021; 37:589-596. [PMID: 33538199 DOI: 10.1080/03007995.2021.1880886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this article is to provide unique and detailed data on how patients rate the RebiSmart 2.0 in the specific User Study Questionnaire (USQ) domains, and the relationship between their rating and individual level of disability, baseline demographic/socioeconomic factors, and adherence. PATIENTS AND METHODS Twelve-month, phase IV, observational, multicenter study (no placebo or comparator) to evaluate the ease of use of the RebiSmart autoinjector for self-injection during treatment of CIS/RRMS subjects with Rebif 44 mcg sc three times a week by USQ. A total of 290 subjects participated in the study, with 249 (85.86%) completing the entire study period. RESULTS The endpoint results demonstrated a very high proportion (>95%) of patients with a positive evaluation of the overall convenience of RebiSmart at each study visit. At the end of the study, all patients would recommend the device to others who need Rebif therapy. The proportion of patients rating the RebiSmart ease of use by individual domains (self-injection steps, changing the cartridge, using the device away from home) as "very easy to use" or "easy to use" and the proportion of patients rating the RebiSmart functions as "helpful" or "very helpful" were more than 80% for each domain at each study visit. CONCLUSION These findings are in line with the potential benefits of RebiSmart to treatment adherence. They demonstrate an overall, very good perception of the device by patients and its individual functions.
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Affiliation(s)
- Zbyšek Pavelek
- Department of Neurology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Michal Novotný
- Department of Neurology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Blanka Klímová
- Department of Neurology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Marek Peterka
- Department of Neurology, University Hospital Plzen, Plzen, Czech Republic
| | - Pavel Potužník
- Department of Neurology, University Hospital Plzen, Plzen, Czech Republic
| | - Martina Kövári
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Martin Vališ
- Department of Neurology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
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Pajoohesh-Ganji A, Karl M, Garrison E, Osei-Bonsu NA, Clarkson-Paredes C, Ahn J, Miller RH. Developmental ablation of mature oligodendrocytes exacerbates adult CNS demyelination. Brain Behav Immun Health 2020; 7:100110. [PMID: 34589870 PMCID: PMC8474627 DOI: 10.1016/j.bbih.2020.100110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/19/2020] [Indexed: 11/28/2022] Open
Abstract
Multiple sclerosis (MS) is a CNS neurodegenerative autoimmune disease characterized by loss of oligodendrocytes and myelin in the brain and the spinal cord that results in localized functional deficits. Several risk factors have been associated with MS, however none fully explain the enhanced susceptibility seen in older individuals. Epidemiological data, based on geographical prevalence studies suggest that susceptibility is established early in life and frequently long before the diagnosis of disease raising the possibility that developmental events influence adult disease onset and progression. Here we test the hypothesis that selective loss of mature oligodendrocytes during postnatal development results in enhanced susceptibility to a demyelinating insult to the mature CNS. A transgenic mouse model was utilized to specifically induce apoptotic cell death in a subset of mature oligodendrocytes (MBP-iCP9) during the first 2 postnatal weeks followed by either a local LPC spinal cord injection or the induction of EAE in the adult animal. Immunostaining, immunoblotting, behavioral testing, and electron microscopy were utilized to examine the differences in the response between animals with developmental loss of oligodendrocytes and controls. We show that during development, oligodendrocyte apoptosis results in transient reductions in myelination and functional deficits that recover after 10–14 days. Compared to animals in which oligodendrocyte development was unperturbed, animals subjected to postnatal oligodendrocyte loss showed delayed recovery from an LPC lesion to the mature spinal cord. Unexpectedly, the induction and severity of MOG induced EAE was not significantly altered in animals following oligodendrocyte developmental loss even though there was a substantial increase in spinal cord tissue damage and CNS inflammation. It is unclear why the elevated glial responses seen in developmentally compromised animals were not reflected in enhanced functional deficits. These observations suggest that developmental loss of oligodendrocytes results in long lasting tissue changes that alter its response to subsequent insults and the capacity for repair in the adult. Developmental oligodendrocyte apoptosis induces transient myelin and functional loss. Developmental loss of oligodendrocytes compromises adult remyelination after LPC. Developmental loss of oligodendrocytes enhances CNS immune response in EAE. Elevated CNS glial reactivity does not alter course of EAE.
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Affiliation(s)
- Ahdeah Pajoohesh-Ganji
- Department of Anatomy and Cell Biology, The George Washington University, School of Medicine and Health Sciences, Washington, DC, United States
| | - Molly Karl
- Department of Anatomy and Cell Biology, The George Washington University, School of Medicine and Health Sciences, Washington, DC, United States
| | - Eric Garrison
- Department of Anatomy and Cell Biology, The George Washington University, School of Medicine and Health Sciences, Washington, DC, United States
| | - Nana Adwoa Osei-Bonsu
- Department of Anatomy and Cell Biology, The George Washington University, School of Medicine and Health Sciences, Washington, DC, United States
| | - Cheryl Clarkson-Paredes
- Department of Anatomy and Cell Biology, The George Washington University, School of Medicine and Health Sciences, Washington, DC, United States
| | - Julie Ahn
- Department of Anatomy and Cell Biology, The George Washington University, School of Medicine and Health Sciences, Washington, DC, United States
| | - Robert H Miller
- Department of Anatomy and Cell Biology, The George Washington University, School of Medicine and Health Sciences, Washington, DC, United States
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