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Koptielow J, Szyłak E, Szewczyk-Roszczenko O, Roszczenko P, Kochanowicz J, Kułakowska A, Chorąży M. Genetic Update and Treatment for Dystonia. Int J Mol Sci 2024; 25:3571. [PMID: 38612382 PMCID: PMC11011602 DOI: 10.3390/ijms25073571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/17/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
A neurological condition called dystonia results in abnormal, uncontrollable postures or movements because of sporadic or continuous muscular spasms. Several varieties of dystonia can impact people of all ages, leading to severe impairment and a decreased standard of living. The discovery of genes causing variations of single or mixed dystonia has improved our understanding of the disease's etiology. Genetic dystonias are linked to several genes, including pathogenic variations of VPS16, TOR1A, THAP1, GNAL, and ANO3. Diagnosis of dystonia is primarily based on clinical symptoms, which can be challenging due to overlapping symptoms with other neurological conditions, such as Parkinson's disease. This review aims to summarize recent advances in the genetic origins and management of focal dystonia.
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Affiliation(s)
- Jan Koptielow
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (E.S.); (J.K.); (A.K.); (M.C.)
| | - Emilia Szyłak
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (E.S.); (J.K.); (A.K.); (M.C.)
| | - Olga Szewczyk-Roszczenko
- Department of Synthesis and Technology of Drugs, Medical University of Bialystok, Kilinskiego 1, 15-089 Bialystok, Poland; (O.S.-R.); (P.R.)
| | - Piotr Roszczenko
- Department of Synthesis and Technology of Drugs, Medical University of Bialystok, Kilinskiego 1, 15-089 Bialystok, Poland; (O.S.-R.); (P.R.)
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (E.S.); (J.K.); (A.K.); (M.C.)
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (E.S.); (J.K.); (A.K.); (M.C.)
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (E.S.); (J.K.); (A.K.); (M.C.)
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Grunwald C, Krętowska-Grunwald A, Adamska-Patruno E, Kochanowicz J, Kułakowska A, Chorąży M. The Role of Selected Interleukins in the Development and Progression of Multiple Sclerosis-A Systematic Review. Int J Mol Sci 2024; 25:2589. [PMID: 38473835 PMCID: PMC10932438 DOI: 10.3390/ijms25052589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 02/18/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Multiple sclerosis is a disabling inflammatory disorder of the central nervous system characterized by demyelination and neurodegeneration. Given that multiple sclerosis remains an incurable disease, the management of MS predominantly focuses on reducing relapses and decelerating the progression of both physical and cognitive decline. The continuous autoimmune process modulated by cytokines seems to be a vital contributing factor to the development and relapse of multiple sclerosis. This review sought to summarize the role of selected interleukins in the pathogenesis and advancement of MS. Patients with MS in the active disease phase seem to exhibit an increased serum level of IL-2, IL-4, IL-6, IL-13, IL-17, IL-21, IL-22 and IL-33 compared to healthy controls and patients in remission, while IL-10 appears to have a beneficial impact in preventing the progression of the disease. Despite being usually associated with proinflammatory activity, several studies have additionally recognized a neuroprotective role of IL-13, IL-22 and IL-33. Moreover, selected gene polymorphisms of IL-2R, IL-4, IL-6, IL-13 and IL-22 were identified as a possible risk factor related to MS development. Treatment strategies of multiple sclerosis that either target or utilize these cytokines seem rather promising, but more comprehensive research is necessary to gain a clearer understanding of how these cytokines precisely affect MS development and progression.
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Affiliation(s)
- Cezary Grunwald
- Department of Neurology, Medical University of Bialystok, Marii Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (J.K.); (A.K.)
| | - Anna Krętowska-Grunwald
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Jerzego Waszyngtona 17, 15-274 Białystok, Poland;
| | - Edyta Adamska-Patruno
- Clinical Research Center, Medical University of Bialystok, Marii Skłodowskiej-Curie 24A, 15-276 Białystok, Poland;
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Marii Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (J.K.); (A.K.)
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Marii Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (J.K.); (A.K.)
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Marii Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (J.K.); (A.K.)
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Podlecka-Piętowska A, Sierdziński J, Nojszewska M, Stawicki J, Bartosik-Psujek H, Lech B, Popiel M, Perenc A, Kułakowska A, Czarnowska A, Kulikowska J, Kapica-Topczewska K, Jamróz-Wiśniewska A, Rejdak K, Zaborski J, Kubicka-Bączyk K, Niedziela N, Wierzbicki K, Adamczyk-Sowa M, Zwiernik J, Zwiernik B, Milewska-Jędrzejczak M, Głąbiński A, Jasińska E, Puz P, Krzystanek E, Stęposz A, Karuga A, Lasek-Bal A, Siuda J, Kściuk B, Walawska-Hrycek A, Patalong-Ogiewa M, Kaczmarczyk A, Siutka K, Brola W, Zakrzewska-Pniewska B. Analysis of seroconversion following COVID-19 vaccination among multiple sclerosis patients treated with disease-modifying therapies in Poland. Neurol Neurochir Pol 2024; 58:112-119. [PMID: 38251955 DOI: 10.5603/pjnns.96425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/09/2023] [Accepted: 11/30/2023] [Indexed: 01/23/2024]
Abstract
CLINICAL RATIONALE FOR THE STUDY The rapid spread of SARS-CoV-2 throughout the world has highlighted the importance of vaccinations to control the pandemic and to protect people at risk for severe disease courses. Disease-modifying therapies (DMT) in multiple sclerosis (MS), whether immunomodulatory or immunosuppressive, may affect the immune response. Therefore, the question arose as to whether these vaccinations would be effective. AIM OF THE STUDY We planned a study to assess the immune response to SARS-CoV-2 vaccines by type of therapy. MATERIAL AND METHODS Participants were recruited from 14 Polish MS centres. The data was obtained by neurologists using a questionnaire. We collected data on 353 MS patients (269 females, 84 males) who received complete primary SARS-CoV-2 vaccination. All persons with MS (PwMS) were treated with disease-modifying therapies. RESULTS 305 out of 353 PwMS (86.4%) were positive for IgG Abs against SARS-CoV-2 S domain S1 Ag after vaccination. A strong immune response was noted in 129 PwMS (36.5%). The rate of seroconversion after SARS-CoV-2 vaccination in PwMS who received immunomodulatory DMTs (interferon beta, glatiramer acetate, teriflunomide, dimethyl fumarate, natalizumab) was 91.5%, in PwMS receiving immune reconstruction therapy (alemtuzumab, cladribine) was 92%, and in immunosuppressive DMTs (fingolimod, ocrelizumab), the seroconversion rate was 59%. CONCLUSIONS AND CLINICAL IMPLICATIONS Our study shows that, in PwMS receiving immunomodulatory therapy, the immune response to vaccination is generally excellent. Even in immunosuppressive patients, seroconversion is satisfactory.
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Affiliation(s)
| | - Janusz Sierdziński
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland
| | - Monika Nojszewska
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | - Jakub Stawicki
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów
| | - Beata Lech
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska
| | - Małgorzata Popiel
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska
| | - Adam Perenc
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Kulikowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | | | | | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Jacek Zaborski
- Department of Neurology and Neurorehabilitation, Miedzyleski Specialist Hospital, Warsaw, Poland
| | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Natalia Niedziela
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Krzysztof Wierzbicki
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Jacek Zwiernik
- Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland
| | - Beata Zwiernik
- Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland
| | | | - Andrzej Głąbiński
- Department of Neurology and Stroke, Medical University of Lodz, Lodz, Poland
| | | | - Przemysław Puz
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Ewa Krzystanek
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Arkadiusz Stęposz
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Aleksandra Karuga
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Anetta Lasek-Bal
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Joanna Siuda
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Barbara Kściuk
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Anna Walawska-Hrycek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Maja Patalong-Ogiewa
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Aleksandra Kaczmarczyk
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Katarzyna Siutka
- Department of Neurology, Specialist Hospital in Konskie, Collegium Medicum, Jan Kochanowski University Kielce, Konskie, Poland
| | - Waldemar Brola
- Department of Neurology, Specialist Hospital in Konskie, Collegium Medicum, Jan Kochanowski University Kielce, Konskie, Poland
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Kazimierczyk E, Dąbrowska M, Gierlotka M, Kapica-Topczewska K, Karaszewski B, Kobayashi A, Krasiński Z, Kubica J, Kułakowska A, Kurek K, Ładny R, Pleban E, Rejdak K, Rydzewska G, Słowik A, Szopiński P, Woźniak A, Tycińska A. The use of andexanet alpha in the Polish setting: An interdisciplinary protocol. Expert consensus statement of the Polish Cardiac Society. Kardiol Pol 2024; 82:123-139. [PMID: 38230495 DOI: 10.33963/v.kp.98059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 01/18/2024]
Abstract
Andexanet alfa (AA) is a recombinant inactive analog of human activated factor X (FXa), effectively reversing the effects of its inhibitors - rivaroxaban and apixaban, which are available in Poland. The drug was approved for clinical use registration after the publication of the results of the ANNEXA-4 trial (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of FXa Inhibitors 4), in which its efficacy in restoring hemostasis in life-threatening hemorrhages in patients receiving using the aforementioned anticoagulants was demonstrated. Hence, AA is now recommended for patients on apixaban or rivaroxaban therapy with massive and uncontrollable hemorrhages, including hemorrhagic strokes (HS) and gastrointestinal bleeding. Drug-specific chromogenic anti-Xa assays are generally best suited for estimating rivaroxaban and apixaban plasma levels, aside from direct assessment of their concentrations. The absence of anti-Xa activity, determined using these assays, allows us to rule out the presence of clinically relevant plasma concentrations of any FXa inhibitor. On the other hand, the dose of AA should not be modified based on the results of coagulation tests, as it depends solely on the time that elapsed since the last dose of FXa inhibitor and oon the dose and type of FXa inhibitor. AA is administered as an intravenous (i.v.) bolus, followed by an i.v. infusion of the drug. The maximum reversal of anti-Xa activity occurs within two minutes of the end of the bolus treatment, with the continuation of the continuous i.v. infusion allowing the effect to be maintained for up to two hours afterwards. Because anticoagulant activity can reappear after the infusion is completed, it is currently unclear at what point after AA administration FXa inhibitors or heparin should be re-administered. In Poland AA is starting to become available and its urgent need to administer it to patients with severe bleeding on apixaban or rivaroxaban.
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Affiliation(s)
- Ewelina Kazimierczyk
- Department of Cardiology, University Clinical Hospital in Bialystok, Białystok, Poland.
| | - Milena Dąbrowska
- Department of Hematology Diagnostic, University Clinical Hospital in Bialystok, Białystok, Poland
| | - Marek Gierlotka
- Department of Cardiology, University Clinical Hospital in Opole, Opole, Poland
| | | | | | - Adam Kobayashi
- Department of Pharmacology and Clinical Pharmacology, Institute of Medical Sciences, Faculty of Medicine - Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, Warszawa, Poland
| | - Zbigniew Krasiński
- Department of Vascular, Endovascular, Angiology and Phlebology Surgery (CNWA), Poznan University of Medical Sciences, Poznań, Poland
| | - Jacek Kubica
- Department of Cardiology and Internal Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
| | - Alina Kułakowska
- Department of Neurology and Stroke Unit, University Clinical Hospital in Bialystok, Białystok, Poland
| | - Krzysztof Kurek
- Department of Gastroenterology and Internal Medicine, University Clinical Hospital in Bialystok, Białystok, Poland
| | - Robert Ładny
- 1st Clinic of General and Endocrine Surgery, University Clinical Hospital in Bialystok, Białystok, Poland
| | - Eliza Pleban
- Vascular Surgery Clinic, Cardinal Stefan Wyszynski National Institute of Cardiology in Warsaw, Warszawa, Poland
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Grażyna Rydzewska
- Department of Internal Medicine and Gastroenterology and Subdivision of Inflammatory Bowel Diseases of the Ministry of Internal Affairs and Administration in Warsaw, Warszawa, Poland
| | - Agnieszka Słowik
- Clinical Department of Neurology, University Hospital in Krakow, Kraków, Poland
| | - Piotr Szopiński
- Vascular Surgery Clinic, Cardinal Stefan Wyszynski National Institute of Cardiology in Warsaw, Warszawa, Poland
| | - Arkadiusz Woźniak
- Department of Vascular Surgery, University Clinical Hospital in Bialystok, Białystok, Poland
| | - Agnieszka Tycińska
- Department of Cardiology, University Clinical Hospital in Bialystok, Białystok, Poland
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5
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Wilski M, Wnuk M, Brola W, Szcześniak M, Żak M, Sobolewski P, Kapica-Topczewska K, Tarasiuk J, Czarnowska A, Kułakowska A, Zakrzewska-Pniewska B, Bartosik-Psujek H, Kubicka-Bączyk K, Morawiec N, Adamczyk-Sowa M, Stepien A, Jacek Z, Ratajczak A, Ratajczak M, Szałachowski R, Kroplewski Z, Lech B, Perenc A, Popiel M, Potemkowski A. Religious meaning system and life satisfaction: the mediating role of meaning in life among Polish people with multiple sclerosis. Front Psychiatry 2024; 14:1352021. [PMID: 38274416 PMCID: PMC10808159 DOI: 10.3389/fpsyt.2023.1352021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/22/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction The complexity of the associations between religiosity and indicators of well-being suggests the presence of a mediating mechanism. Previous studies indicate that religion may influence subjective well-being because it helps to find meaning and purpose. Therefore, the aim of our study was to examine the mediating role of the presence and search dimensions of meaning in life in the relationship between religious meaning system and life satisfaction in patients with multiple sclerosis (MS). Methods This cross-sectional study included 600 MS patients recruited from Poland who completed the Satisfaction with Life Scale (SWLS), the Religious Meaning System Questionnaire (RMS) and the Meaning in Life Questionnaire (MLQ). Model 6 of Hayes PROCESS was used to test the hypotheses. Results The results of our research indicate that there was a significant indirect effect of religious meaning system on life satisfaction through the presence of meaning in life. The specific indirect effect of religious meaning system on life satisfaction through searching for meaning in life was not significant. Discussion The results of our study are relevant because they show that religion as a meaning system is positively related to the presence of meaning in life, which in turn positively predicts life satisfaction. This is particularly important in the case of incurable illness, where finding meaning in life is one of the natural stages of adaptation. By incorporating these findings into mental health practice, professionals can enhance the holistic well-being of people coping with MS and contribute to a more comprehensive and effective approach to mental health care.
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Affiliation(s)
- Maciej Wilski
- Department of Adapted Physical Activity, Poznan University of Physical Education, Poznan, Poland
| | - Marcin Wnuk
- Department of Psychology, Adam Mickiewicz University, Poznań, Poland
| | - Waldemar Brola
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | | | - Marek Żak
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | | | | | - Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | | | | | | | - Natalia Morawiec
- Department of Neurology, Medical University of Silesia, Katowice, Poland
| | | | - Adam Stepien
- Military Institute of Medicine (Poland), Warsaw, Poland
| | - Zaborski Jacek
- Department of Neurology and Neurorehabilitation, Międzyleski Specialist Hospital, Warsaw, Poland
| | | | | | | | | | - Beata Lech
- Clinical Provincial Hospital No. 2 im. St. Jadwiga Królowej in Rzeszów, Rzeszów, Poland
| | - Adam Perenc
- Clinical Provincial Hospital No. 2 im. St. Jadwiga Królowej in Rzeszów, Rzeszów, Poland
| | - Małgorzata Popiel
- Clinical Provincial Hospital No. 2 im. St. Jadwiga Królowej in Rzeszów, Rzeszów, Poland
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Czarnowska A, Groth M, Okrzeja J, Garkowski A, Kristoferitsch W, Kułakowska A, Zajkowska J. A fatal case of tick-borne encephalitis in an immunocompromised patient: case report from Northeastern Poland and review of literature. Ticks Tick Borne Dis 2024; 15:102273. [PMID: 37984275 DOI: 10.1016/j.ttbdis.2023.102273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 09/24/2023] [Accepted: 10/05/2023] [Indexed: 11/22/2023]
Abstract
Tick-borne encephalitis (TBE) is an infectious illness of the central nervous system caused by the TBE virus, which is commonly transmitted through a tick-bite. TBE is endemic in Europe and mid-Asia. In this study, we report a case of a 36-year-old woman, living in Northeastern Poland, with a history of double corneal transplantation and post-transplant immunosuppressive therapy who was admitted to hospital because of progressive weakness, acute headache, nausea, vertigo, vomiting, and fever. The patient was diagnosed with TBE. However, the diagnosis was challenging as the initial serological tests for antibodies against the TBE virus were negative. We want to raise the awareness among the clinicians that the course of TBE is often unpredictable and that it tends to be more severe in immunocompromised individuals.. Delayed production of antibodies against TBE virus, which might inhibit the diagnosis of the disease, is observed in some immunocompromised patients.
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Affiliation(s)
- Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Poland.
| | - Monika Groth
- Department of Infectious Diseases and Neuroinfection, Medical University of Białystok, Poland
| | - Jakub Okrzeja
- Department of Radiology, Medical University of Białystok, Poland
| | - Adam Garkowski
- Department of Radiology, Medical University of Białystok, Poland
| | - Wolfgang Kristoferitsch
- Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Vienna, Austria
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Poland
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfection, Medical University of Białystok, Poland
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7
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Grunwald C, Adamska-Patruno E, Wawrusiewicz-Kurylonek N, Czarnowska A, Snarska K, Dardzińska-Głębocka A, Kapica-Topczewska K, Mirończuk A, Bazylewicz M, Kochanowicz J, Krętowski A, Kułakowska A, Chorąży M. Multiple sclerosis susceptibility may be associated with the coding rs20541 (R130Q) IL-13 gene polymorphism in the Polish population. Sci Rep 2023; 13:22083. [PMID: 38086930 PMCID: PMC10716410 DOI: 10.1038/s41598-023-49615-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/10/2023] [Indexed: 12/18/2023] Open
Abstract
Some of the multiple autoimmune diseases have been already associated with IL-13 single-nucleotide polymorphisms (SNPs). However, there are only few studies regarding multiple sclerosis (MS) risk and IL-13 rs20541 (R130Q) polymorphism, and their results are conflicting. Therefore, the aim of our study was to investigate the frequency of the IL-13 gene rs20541 (R130Q) polymorphism in MS participants and its association with MS clinical subsets in the Polish population. We conducted a case‒control study including 94 relapsing remitting MS patients and 160 healthy volunteers. We genotyped the rs20541 polymorphism in the IL-13 gene and analysed the genotype frequency, age of MS onset and clinical condition (EDSS values) of the MS participants. Fisher's exact test was used for statistical analysis, and the log-linear model was applied to test for associations. Allele A, as well as the AA and AG genotypes, was observed to be significantly more common in the MS subjects. The OR (odds ratio) for the A compared to the G allele was 1.71 (1.14-2.56), whereas OR 2.33 (0.86-6.26) and OR 1.92 (1.11-3.30) were obtained for the AA and AG genotypes, respectively. We did not identify any significant associations of the studied IL-13 SNP with the investigated clinical parameters of the MS participants. Our results suggest that the rs20541 polymorphism in the IL-13 gene may play an important role in MS predisposition but not in investigated clinical parameters in MS subjects of the Polish population.
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Affiliation(s)
- Cezary Grunwald
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland.
| | - Edyta Adamska-Patruno
- Clinical Research Support Centre, Medical University of Bialystok, Białystok, Poland.
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Białystok, Poland.
| | - Natalia Wawrusiewicz-Kurylonek
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Białystok, Poland
- Department of Clinical Genetics, Medical University of Bialystok, Białystok, Poland
| | - Agata Czarnowska
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Katarzyna Snarska
- Department of Clinical Medicine, Medical University of Bialystok, Białystok, Poland
| | - Agnieszka Dardzińska-Głębocka
- Department of Mechanics and Computer Science, Faculty of Mechanical Engineering, Bialystok University of Technology, Białystok, Poland
| | - Katarzyna Kapica-Topczewska
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Anna Mirończuk
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland
| | - Marcin Bazylewicz
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland
| | - Jan Kochanowicz
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Adam Krętowski
- Clinical Research Support Centre, Medical University of Bialystok, Białystok, Poland
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Białystok, Poland
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Białystok, Poland
| | - Alina Kułakowska
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Monika Chorąży
- Department of Neurology and Stroke Department, University Clinical Hospital in Bialystok, Białystok, Poland.
- Department of Neurology, Medical University of Bialystok, Białystok, Poland.
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8
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Brola W, Szcześniak M, Wilski M, Żak M, Sobolewski P, Wnuk M, Szałachowski RR, Kapica-Topczewska K, Czarnowska A, Tarasiuk J, Kułakowska A, Zakrzewska-Pniewska B, Kubicka-Bączyk K, Morawiec N, Adamczyk-Sowa M, Stępień A, Zaborski J, Bartosik-Psujek H, Lech B, Perenc A, Popiel M, Ratajczak A, Ratajczak M, Kroplewski Z, Potemkowski A. Sense of happiness in Polish patients with multiple sclerosis. Neurol Neurochir Pol 2023; 57:484-491. [PMID: 38009502 DOI: 10.5603/pjnns.97534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/22/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Happiness is crucial to patient well-being and their acceptance of their disease. The aim of this study was to assess the sense of happiness in persons with multiple sclerosis (PwMS), compare it to the level of happiness in patients with other neurological conditions, and determine which factors affect the sense of happiness in PwMS. MATERIAL AND METHODS Five hundred and eighty-nine PwMS and 145 control subjects (post-stroke patients with chronic pain syndromes and neuropathies) were included in the study. Due to the differences between the groups in terms of demographic variables, an adjusted group of PwMS (n = 145) was selected from the entire group of PwMS. All patients were assessed using the Oxford Happiness Questionnaire (OHQ), the Satisfaction with Life Scale (SLS), and the Family APGAR Questionnaire. Based on regression analysis, the study examined which variables affected the level of happiness in the groups. RESULTS Analysis of the OHQ scores showed that PwMS had a lower sense of happiness compared to the control group in the overall score [113.21 (25-42) vs. 119.88 (25-49), respectively; p = 0.031] and the subscales (OHQ subscale 1 - 54.52 vs. 57.84, respectively; p = 0.027; subscale 2 - 35.61 vs. 37.67; respectively; p = 0.044). Based on linear regression analysis, life satisfaction (β = 0.40; p < 0.001), positive orientation (β = 0.32; p < 0.001), and primary education (β = 0.08; p = 0.009) were the most significant predictors of a higher level of happiness in PwMS. Similar results were found in the control group. CONCLUSIONS The sense of happiness in PwMS was lower than in patients with other conditions. The most important factors influencing happiness included life satisfaction and positive orientation. Influencing these predictors should be the aim of psychological interventions, especially in patients with a reduced sense of happiness.
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Affiliation(s)
- Waldemar Brola
- Department of Neurology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland.
| | | | - Maciej Wilski
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznan, Poland
| | - Marek Żak
- Department of Neurology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Piotr Sobolewski
- Department of Neurology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Marcin Wnuk
- Department of Psychology, Adam Mickiewicz University in Poznan, 60-568 Poznan, Poland
| | | | | | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | | | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Natalia Morawiec
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland
| | - Jacek Zaborski
- Department of Neurology and Neurological Rehabilitation and Stroke Sub-Division, Specialist Hospital in Mięedzylesie, Warsaw, Poland
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Beata Lech
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2, Rzeszow, Poland
| | - Adam Perenc
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2, Rzeszow, Poland
| | - Małgorzata Popiel
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2, Rzeszow, Poland
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9
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Stępień A, Pogoda-Wesołowska A, Tokarz-Kupczyk E, Słowik A, Puz P, Adamczyk-Sowa M, Kurkowska-Jastrzębska I, Kułakowska A, Chorąży M, Piasecka-Stryczyńska K, Jamróz-Wiśniewska A, Bartosik-Psujek H, Rejdak K. Cladribine tablets for highly active relapsing-remitting multiple sclerosis in Poland: a real-world, multi-centre, retrospective, cohort study during the COVID-19 pandemic. Neurol Neurochir Pol 2023; 57:371-378. [PMID: 37490356 DOI: 10.5603/pjnns.a2023.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/01/2023] [Accepted: 05/11/2023] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Treatment with cladribine tablets is indicated in highly active relapsing-remitting multiple sclerosis (RRMS). Cladribine tablets proved safe and effective in the pivotal CLARITY trial, but that trial included primarily treatment-naïve patients. In clinical practice however, cladribine tablets are often given to patients who have failed other treatments. Therefore, this study investigated the real-world safety and efficacy of cladribine tablets. MATERIAL AND METHODS We gathered data from nine MS clinical centres across Poland for patients with RRMS who started treatment with cladribine tablets from December 2019 to June 2022. RESULTS We enrolled 140 patients, with follow-up data available for 136 in year 1 and for 66 in year 2. At baseline, the mean age was 35.6 years, mean disease duration was 7.3 years, median EDSS score was 2.5, and 94% of patients were treatment- -experienced. Thirty-nine patients (27.9%) had undergone COVID-19, and 94 (67.1%) were vaccinated against COVID-19. The annualised relapse rate (ARR) decreased from 1.49 at baseline to 0.33 in year 1 (p < 0.001) and to 0.25 in year 2 (p < 0.001). The percentage of relapse-free patients increased from 11.5% at baseline to 70.2% in year 1 and 82.1% in year 2. The percentage of patients with active lesions decreased from 91.4% at baseline to 36.2% in year 1 and 18.2% in year 2. EDSS score remained stable or improved in 83.7% of patients in year 1 and 89.6% in year 2. No evidence of disease activity (NEDA-3) was achieved in 42.7% of patients in year 1 and 66.7% in year 2. Only one patient (0.72%) had grade 4 lymphopenia and 21 (15.1%) had grade 3 lymphopenia. Varicella zoster virus infections occurred in three patients. Eight patients discontinued treatment with cladribine: five due to inefficacy, one due to lymphopenia, and two due to a personal decision. CONCLUSIONS Cladribine tablets proved safe and effective in a real-world cohort of treatment-experienced patients. However, the efficacy measures improved to a lesser extent in our cohort than in the pivotal clinical trial, which is probably due to a higher proportion of treatment-experienced patients in our cohort.
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Affiliation(s)
- Adam Stępień
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland.
| | | | | | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Przemysław Puz
- Department of Neurology, Upper-Silesian Medical Center of the Silesian Medical University, Katowice, Poland
| | | | | | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Karolina Piasecka-Stryczyńska
- Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
- Department of Neurology, SPZOZ MSWiA, Poznan, Poland
| | | | | | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
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10
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Wawrzyniak S, Rakoca M, Kułakowska A, Bartosik-Psujek H, Koziarska D, Kapica-Topczewska K, Kubicka-Bączyk K, Adamczyk-Sowa M. Multiple sclerosis and autoimmune diseases - a case control study. Neurol Neurochir Pol 2023; 57:344-351. [PMID: 37341190 DOI: 10.5603/pjnns.a2023.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/01/2023] [Accepted: 05/10/2023] [Indexed: 06/22/2023]
Abstract
INTRODUCTION Multiple sclerosis (MS) is one of the most common autoimmune diseases worldwide, and various autoimmune comorbidities have been reported with MS. The aim of this study was to estimate the prevalence of autoimmune disease comorbidity in patients with MS and their relatives in a Polish population. MATERIAL AND METHODS In this retrospective multicentre study, we investigated a group of patients with MS, and their relatives, in terms of age, gender, and the presence of simultaneous autoimmune diseases such as Graves's Disease, Hashimoto's thyroiditis, type 1 diabetes mellitus, myasthenia gravis, psoriasis, ulcerative enteritis, Crohn's Disease, coeliac disease, rheumatoid arthritis, autoimmune hepatitis and systemic lupus erythematous. RESULTS This study included 381 patients with MS, of whom 52.23% were women. 27 patients (7.09%) had at least one autoimmune disease. The most common comorbidity was Hashimoto's thyroiditis (14 patients). 77 patients (21.45%) had relatives with an autoimmune disease, of which the most common was Hashimoto's thyroiditis. CONCLUSIONS Our study revealed that the probability of autoimmune diseases co-occurring in patients with MS, and in their relatives, is higher and we found the greatest risk to be for Hashimoto's thyroiditis.
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Affiliation(s)
- Sławomir Wawrzyniak
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Bydgoszcz, Poland.
| | - Michał Rakoca
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Bydgoszcz, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Dorota Koziarska
- Department of Neurology, Pomeranian Medical University, Szczecin, Poland
| | | | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
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11
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Bartosik-Psujek H, Adamczyk-Sowa M, Kułakowska A, Głażewska J, Smaga A, Brola W. Course of therapy in patients with active relapsing-remitting multiple sclerosis despite first-line treatment. Postep Psychiatr Neurol 2023; 32:59-67. [PMID: 37497199 PMCID: PMC10367503 DOI: 10.5114/ppn.2023.129048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/28/2023] [Indexed: 07/28/2023]
Abstract
Purpose Treatment of patients with relapsing-remitting multiple sclerosis (RRMS) in Poland begins with first-line therapy; however, the treatment often fails. The aim of this study was to investigate the course of first-line treatment in patients who, despite experiencing an active course of the disease, did not receive more efficacious treatment due to the existing criteria in the drug program. Methods The study included 139 patients from 45 treatment centers. Medical data concerning the course of treatment were collected with the use of specific forms. Results The most frequently used drugs were β-interferons, and treatment was initiated with these drugs in most cases; however, administration of dimethyl fumarate was also common. The median treatment duration was 30.9 months, with the longest treatment duration observed for β-interferons. The most common reason for therapy switching or termination was treatment failure. Conclusions First-line therapy in the studied population was based mainly on β-interferons and dimethyl fumarate. For most medications, the discontinuation of therapy or drug switching were very common and the main reason was total or partial treatment failure. These observations suggest the need for earlier implementation of more effective treatment, based on drugs with high efficacy, in the study population.
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Affiliation(s)
- Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | | | - Anna Smaga
- National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
| | - Waldemar Brola
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
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12
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Bazylewicz M, Gudowska-Sawczuk M, Mroczko B, Kochanowicz J, Kułakowska A. COVID-19: The Course, Vaccination and Immune Response in People with Multiple Sclerosis: Systematic Review. Int J Mol Sci 2023; 24:9231. [PMID: 37298185 PMCID: PMC10253145 DOI: 10.3390/ijms24119231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
When the Coronavirus Disease 2019 (COVID-19) appeared, it was unknown what impact it would have on the condition of patients with autoimmunological disorders. Attention was focused on the course of infection in patients suffering from multiple sclerosis (MS), specially treated with disease-modifying therapies (DMTs) or glucocorticoids. The impact of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection on the occurrence of MS relapses or pseudo-relapses was important. This review focuses on the risk, symptoms, course, and mortality of COVID-19 as well as immune response to vaccinations against COVID-19 in patients with MS (PwMS). We searched the PubMed database according to specific criteria. PwMS have the risk of infection, hospitalization, symptoms, and mortality due to COVID-19, mostly similar to the general population. The presence of comorbidities, male sex, a higher degree of disability, and older age increase the frequency and severity of the COVID-19 course in PwMS. For example, it was reported that anti-CD20 therapy is probably associated with an increased risk of severe COVID-19 outcomes. After SARS-CoV-2 infection or vaccination, MS patients acquire humoral and cellular immunity, but the degree of immune response depends on applied DMTs. Additional studies are necessary to corroborate these findings. However, indisputably, some PwMS need special attention within the context of COVID-19.
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Affiliation(s)
- Marcin Bazylewicz
- Department of Neurology, Medical University of Bialystok, M. Skłodowskiej-Curie 24A St., 15-276 Bialystok, Poland
| | - Monika Gudowska-Sawczuk
- Department of Biochemical Diagnostics, Medical University of Bialystok, Waszyngtona 15A St., 15-269 Bialystok, Poland
| | - Barbara Mroczko
- Department of Biochemical Diagnostics, Medical University of Bialystok, Waszyngtona 15A St., 15-269 Bialystok, Poland
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Waszyngtona 15A St., 15-269 Bialystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, M. Skłodowskiej-Curie 24A St., 15-276 Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, M. Skłodowskiej-Curie 24A St., 15-276 Bialystok, Poland
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13
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Czarnowska A, Zajkowska J, Kułakowska A. Response to the Letter to the Editors on the article reviewing the complex subject of 'Impact of SARS-CoV-2 on the nervous system'. Neurol Neurochir Pol 2023; 57:227-228. [PMID: 37013989 DOI: 10.5603/pjnns.a2023.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 04/05/2023]
Affiliation(s)
- Agata Czarnowska
- Depertment of Neurology, Medical University of Bialystok, Bialystok, Poland.
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Białystok, Poland
| | - Alina Kułakowska
- Depertment of Neurology, Medical University of Bialystok, Bialystok, Poland
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14
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Kułakowska A. SARS-CoV-2 and the nervous system. Neurol Neurochir Pol 2023; 57:3-7. [PMID: 36855849 DOI: 10.5603/pjnns.2023.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 02/17/2023] [Indexed: 03/02/2023]
Affiliation(s)
- Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland.
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15
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Suprewicz Ł, Fiedoruk K, Czarnowska A, Sadowski M, Strzelecka A, Galie PA, Janmey PA, Kułakowska A, Bucki R. Blood-brain barrier function in response to SARS-CoV-2 and its spike protein. Neurol Neurochir Pol 2023; 57:14-25. [PMID: 36810757 DOI: 10.5603/pjnns.a2023.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023]
Abstract
The typical manifestation of coronavirus 2 (CoV-2) infection is a severe acute respiratory syndrome (SARS) accompanied by pneumonia (COVID-19). However, SARS-CoV-2 can also affect the brain, causing chronic neurological symptoms, variously known as long, post, post-acute, or persistent COVID-19 condition, and affecting up to 40% of patients. The symptoms (fatigue, dizziness, headache, sleep disorders, malaise, disturbances of memory and mood) usually are mild and resolve spontaneously. However, some patients develop acute and fatal complications, including stroke or encephalopathy. Damage to the brain vessels mediated by the coronavirus spike protein (S-protein) and overactive immune responses have been identified as leading causes of this condition. However, the molecular mechanism by which the virus affects the brain still needs to be fully delineated. In this review article, we focus on interactions between host molecules and S-protein as the mechanism allowing the transit of SARS-CoV-2 through the blood-brain barrier to reach the brain structures. In addition, we discuss the impact of S-protein mutations and the involvement of other cellular factors conditioning the pathophysiology of SARS-CoV-2 infection. Finally, we review current and future COVID-19 treatment options.
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Affiliation(s)
- Łukasz Suprewicz
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok, Poland
| | - Krzysztof Fiedoruk
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok, Poland
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Marcin Sadowski
- Institute of Medical Sciences, Collegium Medicum, Jan Kochanowski University of Kielce, Kielce, Poland
| | - Agnieszka Strzelecka
- Institute of Health Science, Collegium Medicum, Jan Kochanowski University of Kielce, Kielce, Poland
| | - Peter A Galie
- Department of Biomedical Engineering, Rowan University, Glassboro, NJ, United States
| | - Paul A Janmey
- Department of Physiology and Institute for Medicine and Engineering, University of Pennsylvania, Philadelphia, PA, United States
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Robert Bucki
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok, Poland.
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16
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Czarnowska A, Zajkowska J, Kułakowska A. Impact of SARS-CoV-2 on the nervous system. Neurol Neurochir Pol 2023; 57:26-35. [PMID: 36799524 DOI: 10.5603/pjnns.a2023.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/18/2023]
Abstract
INTRODUCTION The ongoing COVID-19 pandemic is the largest global public health struggle. The spread of the novel coronavirus had resulted in almost 7 million deaths worldwide by January 2023. STATE OF THE ART The most common symptoms during the acute phase of COVID-19 are respiratory. However, many individuals present various neurological deficits at different stages of the infection. Furthermore, there are post-infectious complications that can be present within weeks after the initial symptoms. Both the central and peripheral nervous systems (CNS and PNS, respectively) can be affected. Many potential mechanisms and hypotheses regarding the neuropathology behind COVID-19 have been proposed. CLINICAL IMPLICATIONS The distribution of neurological symptoms during COVID-19 infection among studies differs greatly, which is mostly due to differing inclusion criteria. One of the most significant is incidence involving CNS circulation. In this review, we present basic information regarding the novel coronavirus, the possible routes along which the pathogen can reach the nervous system, neuropathology mechanisms, and neurological symptoms following COVID-19. FUTURE DIRECTIONS It seems that many factors, resulting both from the properties of the virus and from systemic responses to infection, play a role in developing neurological symptoms. The long-term effect of the virus on the nervous system is still unknown.
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Affiliation(s)
- Agata Czarnowska
- Depertment of Neurology, Medical University of Bialystok, Bialystok, Poland.
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Białystok, Poland
| | - Alina Kułakowska
- Depertment of Neurology, Medical University of Bialystok, Bialystok, Poland
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17
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Czarnowska A, Kapica-Topczewska K, Tarasów E, Tarasiuk J, Chorąży M, Kochanowicz J, Kułakowska A. Case report: First manifestation of multiple sclerosis temporally correlated with COVID-19 vaccination. Front Neurol 2023; 14:1097799. [PMID: 36873437 PMCID: PMC9975751 DOI: 10.3389/fneur.2023.1097799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 01/24/2023] [Indexed: 02/17/2023] Open
Abstract
There are several case reports describing a temporal correlation between the first clinical manifestation of multiple sclerosis (MS) and the occurrence of relapses with vaccination against SARS-CoV-2. Here we report a case of a 33-year-old male who developed partial right upper and lower extremities numbness 2 weeks after receiving Johnson & Johnson's Janssen COVID-19 vaccine. The brain MRI performed during diagnostics in the Department of Neurology detected several demyelinating lesions, one with enhancement. Oligoclonal bands were present in the cerebrospinal fluid. The patient was treated with high-dose glucocorticoid therapy with improvement and the diagnosis of MS was made. It seems plausible that the vaccination revealed the underlying autoimmune condition. Cases like the one we reported here are rare, and-based on current knowledge-the benefits of vaccination against SARS-CoV-2 far outweigh the potential risks.
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Affiliation(s)
- Agata Czarnowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | | | - Eugeniusz Tarasów
- Department of Radiology, Medical University of Białystok, Białystok, Poland
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
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18
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Brola W, Steinborn B, Żak M, Mazurkiewicz-Bełdzińska M, Jóźwiak S, Sobolewski P, Wilski M, Bilska M, Siedlarska M, Puzio-Bochen I, Wencel-Warot A, Lemka M, Kroczka S, Czyżyk E, Bocheńska M, Emich-Widera E, Pietruszewski J, Boćkowski L, Kapica-Topczewska K, Czarnowska A, Kułakowska A, Ujma-Czapska B, Gruna-Ożarowska A, Przysło Ł, Połatyńska K, Dudzińska M, Mitosek-Szewczyk K, Melnyk A, Adamczyk-Sowa M, Kotulska K. The Clinical and Epidemiological Profile of Paediatric-Onset Multiple Sclerosis in Poland. J Clin Med 2022; 11:jcm11247494. [PMID: 36556109 PMCID: PMC9785459 DOI: 10.3390/jcm11247494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/11/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Background. Paediatric-onset MS (POMS) has a unique clinical profile compared to the more prevalent adult-onset MS. For this study, we aimed to determine the demographic and clinical characteristics of POMS in Poland as well as addressing some of its epidemiological aspects. Methods. A retrospective study was conducted based on the Polish Multiple Sclerosis Registry, considering a population of children and adolescents with MS (age ≤ 18 years). Data were collected by all 13 centres across Poland specializing in diagnosing and treating POMS. The actual course of the disease and its clinical properties were compared between child (≤12 years) and juvenile (>12 years) patients. MS onset and its prevalence were assessed at the end of 2019, stratified by age range. Results. A total of 329 paediatric or juvenile patients (228 girls, 101 boys) with a clinically definite diagnosis of MS, in conformity with the 2017 McDonald Criteria, were enrolled. For 71 children (21.6%), the first symptoms appeared before the age of 12. The female: male ratio increased with age, amounting to 1:1 in the ≤12 years group and to 2.9:1 in the >12 years group. In most cases, the disease had multi-symptomatic onset (31.3%), and its course was mostly of a relapsing−remitting character (95.7%). The initial Expanded Disability Status Score for both groups was 1.63 ± 1.1, whereas the annual relapse rate was 0.84 during the first 2 years. The time between the onset of symptoms and diagnosis was longer in the younger patients (8.2 ± 4.2 vs. 4.6 ± 3.6 months; p < 0.005). On 31 December 2019, the age-adjusted prevalence standardized to the European standard population was 5.19/100,000 (95% CI, 4.64−5.78). Significantly higher prevalence was noted in the 13−18 years group (7.12; 95% CI, 6.64−7.86) than in the 9−12 years group (3.41; 95% CI, 2.98−3.86) and the <9 years group (0.56; 95% CI, 0.46−0.64; p < 0.001). Conclusion. POMS commencing at the age of ≤12 years is rare, differing significantly from the juvenile-onset and adult MS in terms of clinical characteristics, course, and incidence, as stratified by gender.
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Affiliation(s)
- Waldemar Brola
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
- Correspondence: ; Tel.: +48-601313415
| | - Barbara Steinborn
- Department of Developmental Neurology, Poznan University of Medical Sciences, 61-545 Poznań, Poland
| | - Marek Żak
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
| | | | - Sergiusz Jóźwiak
- Department of Child Neurology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Piotr Sobolewski
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Maciej Wilski
- Department of Adapted Physical Activity, Poznań University of Physical Education, 61-871 Poznań, Poland
| | - Małgorzata Bilska
- Department of Child Neurology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Magdalena Siedlarska
- Department of Child Neurology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Iwona Puzio-Bochen
- Department of Neurology and Epileptology, The Children’s Memorial Health Institute, 04-783 Warsaw, Poland
| | - Agnieszka Wencel-Warot
- Department of Developmental Neurology, Poznan University of Medical Sciences, 61-545 Poznań, Poland
| | - Małgorzata Lemka
- Department of Developmental Neurology, Medical University of Gdańsk, 80-952 Gdańsk, Poland
| | - Sławomir Kroczka
- Department of Child and Adolescent Neurology, Medical College, Jagiellonian University in Kraków, 30-663 Kraków, Poland
| | - Elżbieta Czyżyk
- Clinical Department of Child Neurology, Clinical Central Hospital No 2 in Rzeszow, 35-301 Rzeszów, Poland
| | - Małgorzata Bocheńska
- Clinical Department of Child Neurology, Clinical Central Hospital No 2 in Rzeszow, 35-301 Rzeszów, Poland
| | - Ewa Emich-Widera
- Department of Pediatric Neurology, School of Medicine in Katowice, Medical University of Silesia Katowice, 41-808 Katowice, Poland
| | - Jerzy Pietruszewski
- Department of Pediatric Neurology, School of Medicine in Katowice, Medical University of Silesia Katowice, 41-808 Katowice, Poland
| | - Leszek Boćkowski
- Department of Pediatric Neurology and Rehabilitation, Medical University of Białystok, 15-274 Białystok, Poland
| | | | - Agata Czarnowska
- Department of Neurology, Medical University of Białystok, 15-276 Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, 15-276 Bialystok, Poland
| | - Barbara Ujma-Czapska
- Department of Social Pediatrics, Faculty of Health Sciences, Wrocław Medical University, 51-618 Wrocław, Poland
| | - Agata Gruna-Ożarowska
- Department of Social Pediatrics, Faculty of Health Sciences, Wrocław Medical University, 51-618 Wrocław, Poland
| | - Łukasz Przysło
- Department of Developmental Neurology, Polish Mother’s Memorial Hospital Research Institute, 93-338 Łódź, Poland
| | - Katarzyna Połatyńska
- Department of Developmental Neurology, Polish Mother’s Memorial Hospital Research Institute, 93-338 Łódź, Poland
| | - Magdalena Dudzińska
- Children’s Neurology Ward, Dr. E. Hanke Centre of Pediatrics and Oncology of Chorzów, 41-500 Chorzów, Poland
| | | | - Aleksandra Melnyk
- Department of Child Neurology, Regional Specialized Children’s Hospital, Olsztyn, Poland, and Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-082 Olsztyn, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 40-055 Katowice, Poland
| | - Katarzyna Kotulska
- Department of Neurology and Epileptology, The Children’s Memorial Health Institute, 04-783 Warsaw, Poland
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Pikora K, Jamiołkowska J, Janosz P, Betlejewska J, Warpechowski J, Kapica-Topczewska K, Czarnowska A, Supronik A, Kochanowicz J, Kułakowska A. Flammer syndrome – characteristics and prevalence among multiple sclerosis patients. Aktualn Neurol 2022. [DOI: 10.15557/an.2022.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Flammer syndrome, which has been described in literature only recently, combines two basic components: primary vascular dysregulation and symptoms not directly related to vascular function (prolonged sleep onset time, low pain threshold or specific personality traits). Some health-protective effects, such as a reduced risk atherosclerosis and metabolic syndrome, have also been noted. Flammer syndrome most often coexists with ocular diseases, normal tension glaucoma in particular, as well as with neurological disorders, such as multiple sclerosis. Diagnosis is based on a detailed physical examination; however, standardised diagnostic methods are missing. A three-component therapeutic strategy, including appropriate lifestyle, proper nutrition and pharmacotherapy in the form of magnesium preparations or low-dose calcium channel blockers, is used for Flammer syndrome. Clinical studies in 2016 and 2019 showed that multiple sclerosis patients are significantly more likely to develop typical symptoms of Flammer syndrome compared to controls. These included dizziness, low body weight, non-migraine headaches, reduced feeling of thirst, prolonged sleep onset time, and a tendency towards perfectionism. Although the aetiology of Flammer syndrome and multiple sclerosis or the causes underlying the clinical correlations between them have not been clarified so far, expanded research may contribute to better care for those at increased risk of developing multiple sclerosis, as well as improved therapy and support for patients, with consideration given to challenges that may arise from the coexistence of both diseases.
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Wielemborek PT, Kapica-Topczewska K, Pogorzelski R, Bartoszuk A, Kułakowski R, Mirowska-Guzel D, Kochanowicz J, Kułakowska A. Manual therapy improves symptom severity and disability in patients with carpal tunnel syndrome. Aktualn Neurol 2022. [DOI: 10.15557/an.2022.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Aim: The aim of the study was to assess early outcomes of manual therapy in patients with carpal tunnel syndrome. Materials and methods: In this study, patients diagnosed with electrophysiologically confirmed carpal tunnel syndrome received manual therapy. The therapy was used in 41 individuals who received one session in line with IFOMPT (International Federation of Orthopaedic Manipulative Physical Therapists) standards per week for 5 weeks. Grip strength was assessed using a dynamometer, disability was assessed using the DASH (Disability of Arm, Shoulder and Hand) questionnaire, and the quality of life was assessed using VASEQ5D5L (Visual Analog Scale of the 5-level EQ-5D). Data was collected before the first treatment and one week after the last treatment. Results: We observed significant change in DASH score and quality of life. Grip strength tended to improve, but the effect was statistically significant only in patients over 50 years of age. Symptom severity (Carpal Tunnel 6 score, Douleur Neuropathique 4 score and peripheral cutaneous threshold assessed with Semmes–Weinstein monofilament) improved significantly. There was no significant correlation between changes in DASH score and grip strength. Conclusion: Manual therapy significantly improves quality of life and reduces upper limb disability in patients with carpal tunnel syndrome.
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Kulikowska J, Czarnowska A, Gudowska-Sawczuk M, Kulczyńska-Przybik A, Bazylewicz M, Collins F, Chorąży M, Mroczko B, Kochanowicz J, Kapica-Topczewska K, Kułakowska A. Antibodies against SARS-CoV-2 S and N proteins in relapsing-remitting multiple sclerosis patients treated with disease-modifying therapies. Neurol Neurochir Pol 2022; 57:121-130. [PMID: 36421067 DOI: 10.5603/pjnns.a2022.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/10/2022] [Accepted: 10/19/2022] [Indexed: 11/25/2022]
Abstract
CLINICAL RATIONALE FOR THE STUDY The course of COVID-19 in people with multiple sclerosis (PwMS) has been described, while the serological status after SARS-CoV-2 infection or vaccination, especially in patients treated with disease-modifying therapies (DMT), is still under investigation. This is a significant clinical problem, as certain DMTs may predispose to a severe course of viral infections. AIM OF THE STUDY We analyzed the presence of antibodies against spike (S) and nucleocapsid (N) proteins of SARS-CoV-2 in relapsing-remitting PwMS treated with DMT, especially dimethyl fumarate, interferon beta, and glatiramer acetate, in a single multiple sclerosis (MS) centre in north-eastern Poland (the Department of Neurology, Medical University of Bialystok). MATERIAL AND METHODS The presence of antibodies against S and N proteins in PwMS was assessed twice: on visit one (between May and June 2020) (n = 186) and on visit two (between May and June 2021) (n = 88). Samples were taken from 68 individuals on both visits. Demographic and clinical data was collected: duration of MS, Expanded Disability Status Scale Score (EDSS), type of DMT, history of COVID-19 (positive PCR or antigen test in the past), vaccination status, and the type of vaccine. RESULTS It was shown that on visit one: 3.7% (n = 7) PwMS were positive for IgA against S protein (IgA-S), 3.2% (n = 6) for IgG against S (IgG-S) protein, and none of those examined was positive for IgG against N protein (IgG-N). On visit two, the most common detected antibodies were IgG-S (71.3%; n = 62), then IgA-S (65.1%; n = 55), and the least common was IgG-N (18.2%; n = 16). On visit two: 20.45% of PwMS had a history of a positive SARS-CoV-2 PCR or antigen test during the last year. By the time of visit two, 42.05% (n = 37) of patients who participated in visit two had been full-course vaccinated against COVID-19. It was demonstrated that vaccination against SARS-CoV-2 significantly induces the production of IgG-S and IgA-S (p < 0.0001), while no difference between vaccinated and unvaccinated patients was shown in the detection of IgG-N. There was no correlation between COVID-19 infection and antibodies against proteins S and N in the study group. Moreover, the presented study did not show any relationship between the ability to produce antibodies against the S protein with any of the used DMTs. CONCLUSIONS AND CLINICAL IMPLICATIONS According to our study, PwMS treated with dimethyl fumarate, interferon beta, or glatiramer acetate can efficiently produce antibodies against SARS-CoV-2 both after infection and after vaccination.
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Affiliation(s)
- Joanna Kulikowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland.
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Monika Gudowska-Sawczuk
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | | | - Marcin Bazylewicz
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | | | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Jan Kochanowicz
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | | | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
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22
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Brola W, Adamczyk-Sowa M, Kułakowska A, Głażewska J, Smaga A, Bartosik-Psujek H. Highly active disease and access to disease-modifying treatments in patients with relapsing-remitting multiple sclerosis in Poland. Neurol Neurochir Pol 2022; 56:256-260. [PMID: 35766058 DOI: 10.5603/pjnns.a2022.0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/26/2022] [Accepted: 06/08/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION In Poland, access to second-line disease-modifying treatments (DMTs) for relapsing-remitting multiple sclerosis is limited by reimbursement criteria that require evidence of more aggressive disease compared to the approved indications. MATERIAL AND METHODS In a retrospective study carried out in DMT clinics across Poland, we asked neurologists to provide patient data on relapses and neuroimaging disease activity. Included were only patients with active disease, defined as one or more relapse and at least one new lesion between starting DMT and the last visit. For patients who had not received DMT, active disease was defined as at least one gadolinium-positive lesion or two or more new T2 lesions and two or more relapses within 12 months. We analysed the proportions of patients eligible for second-line DMTs based on the current reimbursement criteria and based on the broader criteria, which were in line with the approved indications. RESULTS In total, 48 neurologists provided data for 641 patients (women 64%; mean age 38 years). Of the 641 patients, 610 (95%) received DMTs: 532 first-line and 78 second-line. Of the 532 patients on first-line DMTs, 40 (7.5%) were eligible for second-line treatment based on the current reimbursement criteria, and an additional 126 (23.6%) would be eligible for second-line treatment based on the broader criteria. Of the 31 patients who did not receive any DMTs, one patient was eligible for second-line treatment, and another two patients would be eligible for second-line treatment based on the broader criteria. Moreover, 13 previously treated patients would be eligible for second-line DMTs based on the broader criteria. When extrapolated to the whole of Poland, our study shows that an additional 1,581 patients would be eligible for second-line DMTs if the current reimbursement criteria were to be replaced by broader criteria complying with the approved indications. CONCLUSIONS An urgent change is required in the reimbursement criteria in order to expand access to second-line DMTs for patients with relapsing-remitting MS in Poland.
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Affiliation(s)
- Waldemar Brola
- Collegium Medicum, Jan Kochanowski Univeristy, Kielce, Poland.
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Poland
| | | | - Anna Smaga
- National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
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Czarnowska A, Tarasiuk J, Zajkowska O, Wnuk M, Marona M, Nowak K, Słowik A, Jamroz-Wiśniewska A, Rejdak K, Lech B, Popiel M, Rościszewska-Żukowska I, Perenc A, Bartosik-Psujek H, Świderek-Matysiak M, Siger M, Ciach A, Walczak A, Jurewicz A, Stasiołek M, Kania K, Dyczkowska K, Kalinowska-Łyszczarz A, Galus W, Walawska-Hrycek A, Krzystanek E, Chojdak-Łukasiewicz J, Ubysz J, Pokryszko-Dragan A, Kapica-Topczewska K, Chorąży M, Bazylewicz M, Mirończuk A, Kulikowska J, Kochanowicz J, Białek M, Stolarz M, Kubicka-Bączyk K, Niedziela N, Warmus P, Adamczyk-Sowa M, Podlecka-Piçtowska A, Nojszewska M, Zakrzewska-Pniewska B, Jasińska E, Zaborski J, Milewska-Jȩdrzejczak M, Zwiernik J, Zwiernik B, Potemkowski A, Brola W, Kułakowska A. Analysis of Side Effects Following Vaccination Against COVID-19 Among Individuals With Multiple Sclerosis Treated With DMTs in Poland. Front Neurol 2022; 13:913283. [PMID: 35775049 PMCID: PMC9237390 DOI: 10.3389/fneur.2022.913283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives Since vaccination against COVID-19 is available for over a year and the population of immunized individuals with autoimmune disorders is higher than several months before, an evaluation of safety and registered adverse events can be made. We conducted a large study of side effects following the COVID-19 vaccine among patients with multiple (MS) sclerosis treated with disease-modifying therapies (DMTs) and analyzed factors predisposing for particular adverse events. Methods We gathered data of individuals with MS treated with DMTs from 19 Polish MS Centers, who reported at least one adverse event following COVID-19 vaccination. The information was obtained by neurologists using a questionnaire. The same questionnaire was used at all MS Centers. To assess the relevance of reported adverse events, we used Fisher's exact test, t-test, and U-Menn-Whutney test. Results A total of 1,668 patients with MS and reports of adverse events after COVID-19 vaccination were finally included in the study. Besides one case marked as “red flag”, all adverse events were classified as mild. Pain at the injection site was the most common adverse event, with a greater frequency after the first dose. Pain at the injection site was significantly more frequent after the first dose among individuals with a lower disability (EDSS ≤2). The reported adverse events following immunization did not differ over sex. According to age, pain at the injection site was more common among individuals between 30 and 40 years old, only after the first vaccination dose. None of the DMTs predisposed for particular side effects. Conclusions According to our findings, vaccination against COVID-19 among patients with MS treated with DMTs is safe. Our study can contribute to reducing hesitancy toward vaccination among patients with MS.
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Affiliation(s)
- Agata Czarnowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
- *Correspondence: Agata Czarnowska
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Olga Zajkowska
- Faculty of Economic Sciences, University of Warsaw, Warsaw, Poland
| | - Marcin Wnuk
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Monika Marona
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Klaudia Nowak
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Beata Lech
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska, Poland
| | - Małgorzata Popiel
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska, Poland
| | - Iwona Rościszewska-Żukowska
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | - Adam Perenc
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska, Poland
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | | | - Małgorzata Siger
- Department of Neurology, Medical University of Lodz, Łódz, Poland
| | - Agnieszka Ciach
- Department of Neurology, Medical University of Lodz, Łódz, Poland
| | - Agata Walczak
- Department of Neurology, Medical University of Lodz, Łódz, Poland
| | - Anna Jurewicz
- Department of Neurology, Medical University of Lodz, Łódz, Poland
| | | | - Karolina Kania
- Department of Neurology, Poznan University of Medical Sciences, Poznań, Poland
| | - Klara Dyczkowska
- Department of Neurology, Poznan University of Medical Sciences, Poznań, Poland
| | | | - Weronika Galus
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Anna Walawska-Hrycek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Ewa Krzystanek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | | | - Jakub Ubysz
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | | | | | - Monika Chorąży
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Marcin Bazylewicz
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Anna Mirończuk
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Joanna Kulikowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Marta Białek
- Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, Bytom, Poland
| | - Małgorzata Stolarz
- Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, Bytom, Poland
| | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Natalia Niedziela
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Paweł Warmus
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | | | - Monika Nojszewska
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | | | - Elżbieta Jasińska
- Jan Kochanowski University, Collegium Medicum, Kielce, Poland
- Clinical Center, Resmedica, Kielce, Poland
| | - Jacek Zaborski
- Department of Neurology and Neurorehabilitation, Miedzyleski Szpital Specjalistyczny, Warsaw, Poland
| | | | - Jacek Zwiernik
- Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland
- Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland
| | - Beata Zwiernik
- Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland
- Clinic of Neurology, University of Warmia and Mazury, Olsztyn, Poland
| | - Andrzej Potemkowski
- Department of Clinical Psychology and Psychoprophylaxis, University of Szczecin, Szczecin, Poland
| | - Waldemar Brola
- Department of Neurology, Specialist Hospital in Końskie, Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
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Szcześniak M, Potemkowski A, Brola W, Kroplewski Z, Szałachowski RR, Zak M, Wilski M, Sobolewski P, Bartosik-Psujek H, Kapica-Topczewska K, Tarasiuk J, Czarnowska A, Kułakowska A, Zakrzewska-Pniewska B, Kubicka-Bączyk K, Morawiec N, Adamczyk-Sowa M, Stępień A, Zaborski J, Ratajczak A, Ratajczak M. The Big Five Personality Traits and Positive Orientation in Polish Adults with Multiple Sclerosis: The Role of Meaning in Life. Int J Environ Res Public Health 2022; 19:ijerph19095426. [PMID: 35564821 PMCID: PMC9099940 DOI: 10.3390/ijerph19095426] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 02/05/2023]
Abstract
Scientific achievements concerning the direct relation between personality traits and positive orientation among patients with multiple sclerosis do not explain the role of potential mediators. In fact, some researchers argue that the traits–positivity association is much more complex than it seems to be. For this reason, we made an attempt to analyze the indirect relationship between the above-mentioned variables, including meaning in life as a mediator. In total, 618 patients with MS took part in the study. The NEO Five-Factor Inventory, the Positive Orientation Scale, and the Meaning in Life Questionnaire were used. The results showed that positive orientation/the presence of meaning/searching for meaning correlated positively with extraversion, openness to experience, agreeableness, and conscientiousness, and were negatively associated with neuroticism. Moreover, meaning in life in both its dimensions acted as a mediator in 9 of 10 models. It can be assumed that a propensity to establish interpersonal relationships (extraversion), use active imagination (openness), inspire confidence among others (agreeableness), and take responsibility (conscientiousness) can have an impact on someone’s positive attitude toward oneself and the surrounding world (positive orientation) when people have meaning in life and when they are seeking it.
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Affiliation(s)
- Małgorzata Szcześniak
- Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland; (A.P.); (Z.K.); (R.R.S.)
- Correspondence:
| | - Andrzej Potemkowski
- Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland; (A.P.); (Z.K.); (R.R.S.)
| | - Waldemar Brola
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (W.B.); (M.Z.); (P.S.)
| | - Zdzisław Kroplewski
- Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland; (A.P.); (Z.K.); (R.R.S.)
| | | | - Marek Zak
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (W.B.); (M.Z.); (P.S.)
| | - Maciej Wilski
- Department of Adapted Physical Activity, Poznan University of Physical Education, 61-871 Poznań, Poland;
| | - Piotr Sobolewski
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (W.B.); (M.Z.); (P.S.)
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszów University, 35-959 Rzeszów, Poland;
| | - Katarzyna Kapica-Topczewska
- Department of Neurology, Medical University of Białystok, 15-276 Białystok, Poland; (K.K.-T.); (J.T.); (A.C.); (A.K.)
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Białystok, 15-276 Białystok, Poland; (K.K.-T.); (J.T.); (A.C.); (A.K.)
| | - Agata Czarnowska
- Department of Neurology, Medical University of Białystok, 15-276 Białystok, Poland; (K.K.-T.); (J.T.); (A.C.); (A.K.)
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, 15-276 Białystok, Poland; (K.K.-T.); (J.T.); (A.C.); (A.K.)
| | | | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (K.K.-B.); (N.M.); (M.A.-S.)
| | - Natalia Morawiec
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (K.K.-B.); (N.M.); (M.A.-S.)
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (K.K.-B.); (N.M.); (M.A.-S.)
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, 01-755 Warszawa, Poland;
| | - Jacek Zaborski
- Department of Neurology and Neurological Rehabilitation and Stroke Sub-Division, Specialist Hospital in Międzylesie, 04-749 Warszawa, Poland;
| | - Anna Ratajczak
- Postgraduate Study, Pomeranian Medical University, 70-204 Szczecin, Poland;
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Tarasiuk J, Kapica-Topczewska K, Czarnowska A, Chorąży M, Kochanowicz J, Kułakowska A. Co-occurrence of Fatigue and Depression in People With Multiple Sclerosis: A Mini-Review. Front Neurol 2022; 12:817256. [PMID: 35242093 PMCID: PMC8886154 DOI: 10.3389/fneur.2021.817256] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/20/2021] [Indexed: 12/11/2022] Open
Abstract
Fatigue and depression are common conditions diagnosed in people with multiple sclerosis (MS). Fatigue defined as subjective lack of physical and/or mental energy is present in 35–97% of people with MS, who classify it as one of the most serious symptoms interfering with daily activities and influencing the quality of life. Depression is diagnosed in about 50% of people with MS. Since fatigue and depression frequently coexists, it may be quite hard to differentiate them. Primary fatigue and primary depression in MS are caused by inflammatory, oxidative/nitrosative, and neurodegenerative processes leading to demyelination, axonal damage, and brain atrophy. In people with MS and comorbid fatigue and/or depression there is reported increased serum and cerebrospinal fluid concentration of inflammatory mediators such as tumor necrosis factor, interleukins (IL-1a, IL-1b, IL-6), interferon γ and neopterin. Moreover, the brain atrophy of prefrontal, frontal, parietotemporal regions, thalamus, and basal ganglia was observed in people with MS with fatigue and/or depression. The secondary fatigue and secondary depression in people with MS may be caused by emotional factors, sleep disorders, pain, the coexistence of other diseases, and the use of medications. In some studies, the use of disease-modifying therapies positively influenced fatigue, probably by reducing the inflammatory response, which proves that fatigue and depression are closely related to immunological factors. In this mini-review, the pathogenesis, methods of evaluation and differentiation, and possible therapies for fatigue and depression in MS are discussed.
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Affiliation(s)
- Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | | | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Białystok, Poland
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Dzięcioł-Anikiej Z, Malinowska P, Daunoraviciene K, Pauk J, Kułakowska A, Dardzińska-Głębocka A, Sulewska A. Quantitative parameters of gait imbalance in multiple sclerosis patients. Acta Bioeng Biomech 2022. [DOI: 10.37190/abb-02028-2022-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose: The purpose is to identify objective quantitative parameters for a more accurate evaluation of gait imbalance and relate it to Body Mass Index and age. Methods: 25 multiple sclerosis (MS) and 30 healthy people (CG) aged between 22 and 66 years old (50.4 ± 9.5) were examined in static and dynamic tasks. The demographic data were as follows: body mass (72.4 ± 18.4 kg in CG vs. 66.8 ± 11.5 kg in MS); body height (1.78 ± 0.15 m in CG vs. 1.70 ± 0.11 m in MS); BMI (24.7 ± 4.5 kg/m2 in CG vs. 23.5 ± 3.0 kg/m2 in MS). First, all individuals remained static for baropodometric, pulse and saturation evaluation. Later on, a 6-minute walk and timed up and go tests were performed and additionally included quantitative measurements by barometry and pulse oximeter. Results: The dynamic condition revealed meaningful differences in the foot surface and hindfoot loading, in addition to foot max. loading between study groups. TUG disclosed significantly different results between groups in time and the number of steps. For MS in statics, the moderate positive correlations between BMI and the right forefoot and right hindfoot, and in MS statics, the correlation of the age vs. maximal left foot loading, forefoot loading and hindfoot loading was observed. In the dynamic, the age and plantar angle of the foot had weak relation. Conclusions: Quantitative parameters defining balance deviations of MS are related to BMI and age in statics and dynamics, therefore should be taken into account during MS imbalance assessment.
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Brola W, Steinborn B, Niewada M, Mazurkiewicz-Bełdzińska M, Jóźwiak S, Sobolewski P, Żak M, Wilski M, Bilska M, Siedlarska M, Puzio-Bochen I, Wencel-Warot A, Lemka M, Kroczka S, Czyżyk E, Bocheńska M, Emich-Widera E, Pietruszewski J, Boćkowski L, Kapica-Topczewska K, Chorąży M, Kułakowska A, Ujma-Czapska B, Przysło Ł, Połatyńska K, Dudzińska M, Mitosek-Szewczyk K, Melnyk A, Knap M, Kotulska K. Pediatric-onset multiple sclerosis in Poland: A registry-based retrospective cohort study. Mult Scler Relat Disord 2022; 57:103344. [DOI: 10.1016/j.msard.2021.103344] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/14/2021] [Accepted: 10/21/2021] [Indexed: 11/28/2022]
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Dzięcioł-Anikiej Z, Malinowska P, Daunoraviciene K, Pauk J, Kułakowska A, Dardzińska-Głębocka A, Sulewska A. Quantitative parameters of gait imbalance in multiple sclerosis patients. Acta Bioeng Biomech 2022; 24:15-21. [PMID: 38314455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
PURPOSE The purpose is to identify objective quantitative parameters for a more accurate evaluation of gait imbalance and relate it to Body Mass Index and age. METHODS 25 multiple sclerosis (MS) and 30 healthy people (CG) aged between 22 and 66 years old (50.4 ± 9.5) were examined in static and dynamic tasks. The demographic data were as follows: body mass (72.4 ± 18.4 kg in CG vs. 66.8 ± 11.5 kg in MS); body height (1.78 ± 0.15 m in CG vs. 1.70 ± 0.11 m in MS); BMI (24.7 ± 4.5 kg/m2 in CG vs. 23.5 ± 3.0 kg/m2 in MS). First, all individuals remained static for baropodometric, pulse and saturation evaluation. Later on, a 6-minute walk and timed up and go tests were performed and additionally included quantitative measurements by barometry and pulse oximeter. RESULTS The dynamic condition revealed meaningful differences in the foot surface and hindfoot loading, in addition to foot max. loading between study groups. TUG disclosed significantly different results between groups in time and the number of steps. For MS in statics, the moderate positive correlations between BMI and the right forefoot and right hindfoot, and in MS statics, the correlation of the age vs. maximal left foot loading, forefoot loading and hindfoot loading was observed. In the dynamic, the age and plantar angle of the foot had weak relation. CONCLUSIONS Quantitative parameters defining balance deviations of MS are related to BMI and age in statics and dynamics, therefore should be taken into account during MS imbalance assessment.
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Affiliation(s)
| | | | - Kristina Daunoraviciene
- Vilnius Gediminas Technical University, Department of Biomechanical Engineering, Vilnius, Lithuania
| | - Jolanta Pauk
- Bialystok University of Technology, Białystok, Poland
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Warpechowski J, Jamiołkowska J, Ilnicki M, Michalczuk K, Czarnowska A, Kulikowska J, Kapica-Topczewska K, Kochanowicz J, Kułakowska A. Level of fibrinogen, D-dimers and C-reactive protein, and correlations between these parameters in ischemic and haemorrhagic stroke. Med Og Nauk Zdr 2021. [DOI: 10.26444/monz/142620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Kulczyńska-Przybik A, Dulewicz M, Słowik A, Borawska R, Kułakowska A, Kochanowicz J, Mroczko B. The Clinical Significance of Cerebrospinal Fluid Reticulon 4 (RTN4) Levels in the Differential Diagnosis of Neurodegenerative Diseases. J Clin Med 2021; 10:jcm10225281. [PMID: 34830564 PMCID: PMC8622503 DOI: 10.3390/jcm10225281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022] Open
Abstract
Neurodegenerative diseases (NDs) belong to the top global causes of mortality. Diagnostic approaches to improve early diagnosis and differentiation of these diseases are constantly being sought. Therefore, we aimed to assess the cerebrospinal fluid (CSF) concentrations of Reticulon 4 (RTN4) in patients with neurodegenerative diseases and evaluate the potential clinical usefulness of this protein. RTNs are transmembrane proteins mediating neuroanatomical plasticity and functional recovery after central nervous system injury or diseases. According to our best knowledge, this is the first investigation providing the data concerning the dynamic of CSF RTN4 protein levels in patients with different NDs. Methods: Overall, 77 newly diagnosed patients with neurodegenerative diseases, including Alzheimer’s disease (AD), Parkinson’s disease (PD), and multiple sclerosis (MS), as well as 21 controls, were enrolled in the study. The CSF concentrations of tested proteins were assessed using immunological assays. Results: We revealed significantly higher CSF RTN4A levels in patients with AD, PD, and MS in comparison to the controls. Moreover, the comparative analysis of RTN4 concentration between different neurodegenerative diseases revealed the highest concentration of RTN4A in AD patients and a statistically significant difference between AD vs. PD, and AD vs. MS groups. The increased CSF level of the protein correlated with Tau, and pTau181 proteins in AD as well as in PD patients. Conclusions: Our study presents a previously not identified clinical utility of RTN4 in the differential diagnosis of neurodegenerative diseases.
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Affiliation(s)
- Agnieszka Kulczyńska-Przybik
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland; (M.D.); (R.B.); (B.M.)
- Correspondence:
| | - Maciej Dulewicz
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland; (M.D.); (R.B.); (B.M.)
| | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University, 30-688 Kraków, Poland;
| | - Renata Borawska
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland; (M.D.); (R.B.); (B.M.)
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, 15-269 Bialystok, Poland; (A.K.); (J.K.)
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, 15-269 Bialystok, Poland; (A.K.); (J.K.)
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland; (M.D.); (R.B.); (B.M.)
- Department of Biochemical Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
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Czarnowska A, Kapica-Topczewska K, Zajkowska O, Adamczyk-Sowa M, Kubicka-Bączyk K, Niedziela N, Warmus P, Kalinowska-Łyszczarz A, Kania K, Słowik A, Wnuk M, Marona M, Nowak K, Bartosik-Psujek H, Lech B, Perenc A, Popiel M, Kucharska-Lipowska M, Chorąży M, Tarasiuk J, Mirończuk A, Kochanowicz J, Lasek-Bal A, Puz P, Maciejowska K, Wawrzyniak S, Niezgodzińska-Maciejek A, Pokryszko-Dragan A, Gruszka E, Budrewicz S, Białek M, Zwiernik J, Michałowska A, Nosek K, Zwiernik B, Lewańczyk B, Brola W, Kułakowska A. Symptoms after COVID-19 Infection in Individuals with Multiple Sclerosis in Poland. J Clin Med 2021; 10:jcm10225225. [PMID: 34830507 PMCID: PMC8618380 DOI: 10.3390/jcm10225225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/14/2021] [Accepted: 11/04/2021] [Indexed: 12/13/2022] Open
Abstract
(1) Background: To report and analyze the presence of residual symptoms after SARS-CoV-2 infection among Polish patients with multiple sclerosis (MS) treated with different disease-modifying therapies (DMTs). (2) Methods: The study included 426 individuals with MS treated with DMTs and confirmed SARS-CoV-2 infection from 12 Polish MS centers. The data were collected through to 31 May 2021. The information included demographics, specific MS characteristics, course of SARS-CoV-2 infection, and residual (general and neurological) symptoms lasting more than four and 12 weeks after the initial infection. The results were obtained using maximum likelihood estimates for odds ratio and logistic regression. (3) Results: A total of 44.84% patients with MS reported symptoms lasting between four and 12 weeks after the initial infection; 24.41% people had symptoms that resolved up to 12 weeks, and 20.42% patients had symptoms that lasted over 12 weeks. The most common symptoms were: fatigue, disturbance of concentration, attention, and memory, cognitive complaints, and headache. None of the DMTs were predisposed to the development of residual symptoms after the initial infection. A total of 11.97% of patients had relapse three months prior or after SARS-CoV-2 infection. (4) Conclusion: Almost half of individuals with MS treated with different DMTs had residual symptoms after SARS-CoV-2 infection. None of the DMTs raised the probability of developing post-acute COVID symptoms.
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Affiliation(s)
- Agata Czarnowska
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
- Correspondence: ; Tel.: +48-85-746-83-26; Fax: +48-85-746-86-08
| | - Katarzyna Kapica-Topczewska
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
| | - Olga Zajkowska
- Faculty of Economic Sciences, University of Warsaw, 00-241 Warszawa, Poland;
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (M.A.-S.); (K.K.-B.); (N.N.); (P.W.)
| | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (M.A.-S.); (K.K.-B.); (N.N.); (P.W.)
| | - Natalia Niedziela
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (M.A.-S.); (K.K.-B.); (N.N.); (P.W.)
| | - Paweł Warmus
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (M.A.-S.); (K.K.-B.); (N.N.); (P.W.)
| | - Alicja Kalinowska-Łyszczarz
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, 61-701 Poznań, Poland; (A.K.-Ł.); (K.K.)
| | - Karolina Kania
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, 61-701 Poznań, Poland; (A.K.-Ł.); (K.K.)
| | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University Medical College, University Hospital, 30-688 Krakow, Poland; (A.S.); (M.W.); (M.M.); (K.N.)
| | - Marcin Wnuk
- Department of Neurology, Jagiellonian University Medical College, University Hospital, 30-688 Krakow, Poland; (A.S.); (M.W.); (M.M.); (K.N.)
| | - Monika Marona
- Department of Neurology, Jagiellonian University Medical College, University Hospital, 30-688 Krakow, Poland; (A.S.); (M.W.); (M.M.); (K.N.)
| | - Klaudia Nowak
- Department of Neurology, Jagiellonian University Medical College, University Hospital, 30-688 Krakow, Poland; (A.S.); (M.W.); (M.M.); (K.N.)
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszów, Poland;
| | - Beata Lech
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, 35-301 Rzeszów, Poland; (B.L.); (A.P.); (M.P.)
| | - Adam Perenc
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, 35-301 Rzeszów, Poland; (B.L.); (A.P.); (M.P.)
| | - Małgorzata Popiel
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, 35-301 Rzeszów, Poland; (B.L.); (A.P.); (M.P.)
| | | | - Monika Chorąży
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
| | - Anna Mirończuk
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
| | - Anetta Lasek-Bal
- Department of Neurology, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland; (A.L.-B.); (P.P.); (K.M.)
| | - Przemysław Puz
- Department of Neurology, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland; (A.L.-B.); (P.P.); (K.M.)
| | - Katarzyna Maciejowska
- Department of Neurology, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland; (A.L.-B.); (P.P.); (K.M.)
| | - Sławomir Wawrzyniak
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Independent Public Healthcare Centre, 85-681 Bydgoszcz, Poland; (S.W.); (A.N.-M.)
| | - Anna Niezgodzińska-Maciejek
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Independent Public Healthcare Centre, 85-681 Bydgoszcz, Poland; (S.W.); (A.N.-M.)
| | - Anna Pokryszko-Dragan
- Department of Neurology, Wroclaw Medical University, 50-367 Wroclaw, Poland; (A.P.-D.); (E.G.); (S.B.)
| | - Ewa Gruszka
- Department of Neurology, Wroclaw Medical University, 50-367 Wroclaw, Poland; (A.P.-D.); (E.G.); (S.B.)
| | - Sławomir Budrewicz
- Department of Neurology, Wroclaw Medical University, 50-367 Wroclaw, Poland; (A.P.-D.); (E.G.); (S.B.)
| | - Marta Białek
- Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, 41-902 Bytom, Poland;
| | - Jacek Zwiernik
- Neurology Ward, Provincial Specialist Hospital, 10-561 Olsztyn, Poland; (J.Z.); (A.M.)
- Department of Neurology, University of Warmia and Mazury, 10-719 Olsztyn, Poland;
| | - Anna Michałowska
- Neurology Ward, Provincial Specialist Hospital, 10-561 Olsztyn, Poland; (J.Z.); (A.M.)
| | - Krzysztof Nosek
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, 10-719 Olsztyn, Poland;
| | - Beata Zwiernik
- Department of Neurology, University of Warmia and Mazury, 10-719 Olsztyn, Poland;
- Clinic of Neurology, University of Warmia and Mazury, 10-719 Olsztyn, Poland
| | - Bożena Lewańczyk
- Neurology Ward, Provincial Integrated Hospital, 82-300 Elbląg, Poland;
| | - Waldemar Brola
- Department of Neurology, Specialist Hospital in Końskie, Collegium Medicum, Jan Kochanowski University Kielce, 26-200 Końskie, Poland;
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland; (K.K.-T.); (M.C.); (J.T.); (A.M.); (J.K.); (A.K.)
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Kulikowska J, Kulczyńska-Przybik A, Mroczko B, Kułakowska A. The Significance of COVID-19 Immunological Status in Severe Neurological Complications and Multiple Sclerosis-A Literature Review. Int J Mol Sci 2021; 22:5894. [PMID: 34072715 PMCID: PMC8199258 DOI: 10.3390/ijms22115894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2/Coronavirus 2019 (COVID-19) is responsible for the pandemic, which started in December 2019. In addition to the typical respiratory symptoms, this virus also causes other severe complications, including neurological ones. In diagnostics, serological and polymerase chain reaction tests are useful not only in detecting past infections but can also predict the response to vaccination. It is now believed that an immune mechanism rather than direct viral neuroinvasion is responsible for neurological symptoms. For this reason, it is important to assess the presence of antibodies not only in the serum but also in the cerebrospinal fluid (CSF), especially in the case of neuro-COVID. A particular group of patients are people with multiple sclerosis (MS) whose disease-modifying drugs weaken the immune system and lead to an unpredictable serological response to SARS-CoV-2 infection. Based on available data, the article summarizes the current serological information concerning COVID-19 in CSF in patients with severe neurological complications and in those with MS.
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Affiliation(s)
- Joanna Kulikowska
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland;
| | - Agnieszka Kulczyńska-Przybik
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland; (A.K.-P.); (B.M.)
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland; (A.K.-P.); (B.M.)
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland;
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Czarnowska A, Brola W, Zajkowska O, Rusek S, Adamczyk-Sowa M, Kubicka-Bączyk K, Kalinowska-Łyszczarz A, Kania K, Słowik A, Wnuk M, Marona M, Podlecka-Piętowska A, Nojszewska M, Zakrzewska-Pniewska B, Jasińska E, Gołuch K, Lech B, Noga M, Perenc A, Popiel M, Lasek-Bal A, Puz P, Maciejowska K, Kucharska-Lipowska M, Lipowski M, Kapica-Topczewska K, Chorąży M, Tarasiuk J, Kochanowicz J, Kulikowska J, Wawrzyniak S, Niezgodzińska-Maciejek A, Pokryszko-Dragan A, Gruszka E, Budrewicz S, Białek M, Kurkowska-Jastrzębska I, Kurowska K, Stępień A, Włodek A, Ptasznik V, Pawełczyk M, Sobolewski P, Lejmel H, Strzalińska K, Maciejowski M, Tutaj A, Zwiernik J, Litwin A, Lewańczyk B, Paprocka I, Zwiernik B, Pawlos A, Borysowicz A, Narożnik A, Michałowska A, Nosek K, Fudala M, Milewska-Jędrzejczak M, Kułakowska A, Bartosik-Psujek H. Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease-modifying therapies - the Polish experience. Neurol Neurochir Pol 2021; 55:212-222. [PMID: 33856686 DOI: 10.5603/pjnns.a2021.0031] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The aim of this study was to report the course and outcome of SARS-CoV-2 infection in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs) in Poland. A major concern for neurologists worldwide is the course and outcome of SARS-CoV-2 infection in patients with MS treated with different DMTs. Although initial studies do not suggest an unfavourable course of infection in this group of patients, the data is limited. MATERIALS AND METHODS This study included 396 MS patients treated with DMTs and confirmed SARS-CoV-2 infection from 28 Polish MS centres. Information concerning patient demographics, comorbidities, clinical course of MS, current DMT use, as well as symptoms of SARS-CoV-2 infection, need for pharmacotherapy, oxygen therapy, and/or hospitalisation, and short-term outcomes was collected up to 30 January 2021. Additional data about COVID-19 cases in the general population in Poland was obtained from official reports of the Polish Ministry of Health. RESULTS There were 114 males (28.8%) and 282 females (71.2%). The median age was 39 years (IQR 13). The great majority of patients with MS exhibited relapsing-remitting course (372 patients; 93.9%). The median EDSS was 2 (SD 1.38), and the mean disease duration was 8.95 (IQR 8) years. Most of the MS patients were treated with dimethyl fumarate (164; 41.41%). Other DMTs were less frequently used: interferon beta (82; 20.70%), glatiramer acetate (42; 10.60%), natalizumab (35;8.84%), teriflunomide (25; 6.31%), ocrelizumab (20; 5.05%), fingolimod (16; 4.04), cladribine (5; 1.26%), mitoxantrone (3; 0.76%), ozanimod (3; 0.76%), and alemtuzumab (1; 0.25%). The overall hospitalisation rate due to COVID-19 in the cohort was 6.81% (27 patients). Only one patient (0.3%) died due to SARS-CoV-2 infection, and three (0.76%) patients were treated with mechanical ventilation; 106 (26.8%) patients had at least one comorbid condition. There were no significant differences in the severity of SARS-CoV-2 infection regarding patient age, duration of the disease, degree of disability (EDSS), lymphocyte count, or type of DMT used. CONCLUSIONS AND CLINICAL IMPLICATIONS Most MS patients included in this study had a favourable course of SARS-CoV-2 infection. The hospitalisation rate and the mortality rate were not higher in the MS cohort compared to the general Polish population. Continued multicentre data collection is needed to increase the understanding of SARS-CoV-2 infection impact on the course of MS in patients treated with DMTs.
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Affiliation(s)
| | - Waldemar Brola
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Olga Zajkowska
- Faculty of Economic Sciences, University of Warsaw, Poland
| | - Stanisław Rusek
- Department of Neurology, Specialist Hospital Ludwika Rydygiera in Krakow, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Alicja Kalinowska-Łyszczarz
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poland
| | - Karolina Kania
- Department of Neurology, Poznan University of Medical Sciences, Poland
| | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Marcin Wnuk
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Monika Marona
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | | | | | | | - Elżbieta Jasińska
- Collegium Medicum UJK, and Clinical Center, RESMEDICA, Kielce, Poland
| | | | - Beata Lech
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland
| | - Magdalena Noga
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland
| | - Adam Perenc
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland
| | - Małgorzata Popiel
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland
| | - Anetta Lasek-Bal
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Przemysław Puz
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Katarzyna Maciejowska
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | | | - Michał Lipowski
- Department of Urology, Specialist Hospital in Końskie, Poland
| | | | | | | | | | | | - Sławomir Wawrzyniak
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Independent Public Healthcare Centre, Bydgoszcz, Poland
| | - Anna Niezgodzińska-Maciejek
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Independent Public Healthcare Centre, Bydgoszcz, Poland
| | | | - Ewa Gruszka
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Marta Białek
- Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, Poland
| | | | - Katarzyna Kurowska
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland
| | - Agata Włodek
- Department of Neurology, Masovian Voivodeship Hospital in Siedlce, Poland
| | | | | | - Piotr Sobolewski
- Department of Neurology and Stroke Unit in Sandomierz, Collegium Medicum, Jan Kochanowski University in Kielce
| | - Henryka Lejmel
- Department of Neurology, The Regional Hospital in Suwalki, Poland
| | | | | | - Andrzej Tutaj
- Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland
| | - Jacek Zwiernik
- Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland; Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland
| | - Anna Litwin
- Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland
| | | | | | - Beata Zwiernik
- Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland; Clinic of Neurology, University of Warmia and Mazury, Olsztyn, Poland
| | - Aleksandra Pawlos
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | - Andrzej Borysowicz
- Department of Neurology, Specialist Hospital Dr Tytus Chałubiński Radom, Poland
| | - Anna Narożnik
- Department of Neurology, Specialist Hospital Dr Tytus Chałubiński Radom, Poland
| | | | - Krzysztof Nosek
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | - Małgorzata Fudala
- Department of Neurology, Regional Hospital in Skarżysko-Kamienna, Poland
| | | | | | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Poland
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Chorazy M, Wawrusiewicz-Kurylonek N, Adamska-Patruno E, Czarnowska A, Zajkowska O, Kapica-Topczewska K, Posmyk R, Kretowski AJ, Kochanowicz J, Kułakowska A. Variants of Novel Immunomodulatory Fc Receptor Like 5 Gene Are Associated With Multiple Sclerosis Susceptibility in the Polish Population. Front Neurol 2021; 12:631134. [PMID: 33889124 PMCID: PMC8055847 DOI: 10.3389/fneur.2021.631134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Abstract
Fc receptors have been shown to play a role in several autoimmune diseases. We aimed to test, for the first time, whether some of the single nucleotide variants in the FCRL5 gene were associated with multiple sclerosis (MS) susceptibility and clinical manifestations in the Polish population. The case-control study included 94 individuals with MS and 160 healthy subjects. We genotyped two single nucleotide variants of the FCRL5 gene: rs2012199 and rs6679793. The age of onset, disease duration, and clinical condition of the MS subjects were analyzed. For statistical analysis, we used the chi-squared test confirmed with Fisher's exact test. We observed the significant differences in the distribution of investigated FCRL5 genotypes between MS subjects and healthy controls. The CC and CT genotypes, as well as the C allele of rs2012199, were significantly more common in the MS subjects, as were genotypes AA and AG, and allele A of rs6679793. We noted that decreased MS susceptibility was associated with the T allele rs2012199 (OR = 0.37, p = 0.0002) and G allele rs6679793 (OR = 0.6, p = 0.02). Our results support the role of the FCRL5 locus in MS predisposition and extend the evidence of its influence on autoimmunity.
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Affiliation(s)
- Monika Chorazy
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Natalia Wawrusiewicz-Kurylonek
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.,Department of Clinical Genetics, Medical University of Bialystok, Bialystok, Poland
| | | | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Olga Zajkowska
- Faculty of Economic Sciences, University of Warsaw, Warsaw, Poland
| | | | - Renata Posmyk
- Department of Clinical Genetics, Medical University of Bialystok, Bialystok, Poland
| | - Adam Jacek Kretowski
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.,Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
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Moniuszko-Malinowska A, Guziejko K, Czarnowska A, Kułakowska A, Zajkowska O, Pancewicz S, Świerzbińska R, Dunaj J, Czupryna P, Róg-Makal M, Zajkowska J. Assessment of anti-HSV antibodies in patients with facial palsy in the course of neuroborreliosis. Int J Clin Pract 2021; 75:e13749. [PMID: 33128311 DOI: 10.1111/ijcp.13749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 09/23/2020] [Indexed: 11/27/2022] Open
Abstract
AIM There are many causes of facial nerve palsy. The most common causes are neuroborreliosis (NB), idiopathic paralysis or Herpes simplex virus (HSV) reactivation. The aim of this study was to characterize patients with facial palsy in the course of NB and to determine whether HSV-1 reactivation takes place during the acute phase of NB. METHODS A retrospective analysis of 66 patients with facial nerve palsy was performed. In 38 patients, facial palsy was caused by Borrelia burgdorferi sl infection. Immunological tests for HSV-1, tick-borne encephalitis virus and B burgdorferi sl in serum and cerebrospinal fluid (CSF) were performed. RESULTS In this analysis, 55.2% of NB patients had right nerve palsy and 21% bilateral palsy; 15.8% of patients had erythema migrans (EM). Lymphocytic meningitis was diagnosed in 92% of patients and Bannwarth's syndrome was diagnosed in 47% of patients. IgM anti-HSV-1 antibodies were detected in four patients with NB and two patients with facial nerve palsy of other origin. IgM anti-HSV-1 antibodies were detected in the CSF of three patients (7.9%) with NB, and one of them had bilateral VII paresis and EM simultaneously. Treatment with ceftriaxone or doxycycline led to complete recovery. CONCLUSIONS Neuroborreliosis should always be considered as a cause of peripheral facial nerve palsy. Peripheral facial nerve palsy is a significant symptom in the course of NB, especially in patients accompanied by meningitis. Pathomechanism of facial nerve paresis has not been well explained so far and may depend on two independent mechanisms in NB, including HSV-1 reactivation.
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Affiliation(s)
- Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland
| | - Katarzyna Guziejko
- Department of Lung Diseases and Tuberculosis, Medical University of Bialystok, Bialystok, Poland
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Olga Zajkowska
- Faculty of Economic Sciences, University of Warsaw, Warsaw, Poland
| | - Sławomir Pancewicz
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland
| | - Renata Świerzbińska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland
| | - Justyna Dunaj
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland
| | - Piotr Czupryna
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland
| | - Magdalena Róg-Makal
- Department of Invasive Cardiology, Medical University in Białystok, Białystok, Poland
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland
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Kapica-Topczewska K, Collin F, Tarasiuk J, Czarnowska A, Chorąży M, Mirończuk A, Kochanowicz J, Kułakowska A. Assessment of Disability Progression Independent of Relapse and Brain MRI Activity in Patients with Multiple Sclerosis in Poland. J Clin Med 2021; 10:jcm10040868. [PMID: 33669799 PMCID: PMC7923173 DOI: 10.3390/jcm10040868] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/10/2021] [Accepted: 02/14/2021] [Indexed: 12/16/2022] Open
Abstract
The aim of the study was to verify the association of clinical relapses and brain activity with disability progression in relapsing/remitting multiple sclerosis patients receiving disease-modifying treatments in Poland. Disability progression was defined as relapse-associated worsening (RAW), progression independent of relapse activity (PIRA), and progression independent of relapses and brain MRI Activity (PIRMA). Data from the Therapeutic Program Monitoring System were analyzed. Three panels of patients were identified: R0, no relapse during treatment, and R1 and R2 with the occurrence of relapse during the first and the second year of treatment, respectively. In the R0 panel, we detected 4.6% PIRA patients at 24 months (p < 0.001, 5.0% at 36 months, 5.6% at 48 months, 6.1% at 60 months). When restricting this panel to patients without brain MRI activity, we detected 3.0% PIRMA patients at 12 months, 4.5% at 24 months, and varying from 5.3% to 6.2% between 36 and 60 months of treatment, respectively. In the R1 panel, RAW was detected in 15.6% patients at 12 months and, in the absence of further relapses, 9.7% at 24 months and 6.8% at 36 months of treatment. The R2 group was associated with RAW significantly more frequently at 24 months compared to the R1 at 12 months (20.7%; p < 0.05), but without a statistical difference later on. In our work, we confirmed that disability progression was independent of relapses and brain MRI activity.
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Affiliation(s)
- Katarzyna Kapica-Topczewska
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
- Correspondence: ; Tel.: +48-85-7468326
| | - François Collin
- Independent Statistical Consultant, 40-668 Katowice, Poland;
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
| | - Anna Mirończuk
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland; (J.T.); (A.C.); (M.C.); (A.M.); (J.K.); (A.K.)
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Nojszewska M, Kalinowska A, Adamczyk-Sowa M, Kułakowska A, Bartosik-Psujek H. COVID-19 mRNA vaccines (Pfizer-BioNTech and Moderna) in patients with multiple sclerosis: a statement by a working group convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society. Neurol Neurochir Pol 2021; 55:8-11. [PMID: 33555604 DOI: 10.5603/pjnns.a2021.0016] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/25/2021] [Indexed: 11/25/2022]
Abstract
A working group convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society has developed a statement with regard to the currently available mRNA vaccines (Pfizer-BioNTech and Moderna) preventing novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) infection, which causes Coronavirus disease 2019 (COVID-19), in patients with multiple sclerosis (MS). This statement has been based on the literature available as of 15 January, 2021. The guidance will be updated as new data emerges. All data regarding the above-mentioned vaccines comes from clinical trials which have been reviewed, published and approved by the regulatory authorities [1, 2]. In the current manuscript, whenever a SARS-CoV-2 vaccine is discussed, it refers to mRNA vaccines only.
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Affiliation(s)
- Monika Nojszewska
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | - Alicja Kalinowska
- Poznan University of Medical Sciences, Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan, Poland.
| | - Monika Adamczyk-Sowa
- Department of Neurology, Zabrze; Medical University of Silesia, Katowice, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Poland
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Kulczynska‐Przybik A, Kułakowska A, Tarasiuk J, Dulewicz M, Kurzyna P, Borawska R, Kochanowicz J, Mroczko B. The significance of reticulon4A as a potential indicator of neurodegeneration. Alzheimers Dement 2020. [DOI: 10.1002/alz.042619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Piktel E, Suprewicz Ł, Depciuch J, Cieśluk M, Chmielewska S, Durnaś B, Król G, Wollny T, Deptuła P, Kochanowicz J, Kułakowska A, Fiedoruk K, Maximenko A, Parlińska-Wojtan M, Bucki R. Rod-shaped gold nanoparticles exert potent candidacidal activity and decrease the adhesion of fungal cells. Nanomedicine (Lond) 2020; 15:2733-2752. [PMID: 33090058 DOI: 10.2217/nnm-2020-0324] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: To investigate the fungicidal activity of rod-shaped gold nanoparticles (AuR NPs) against Candida strains isolated from hematooncological patients and representative strains of filamentous fungi. Methods: Colony-counting assays, colorimetric and fluorometric methods and atomic force microscopy were employed. Results: AuR NPs were characterized by their potent fungicidal activity against all tested isolates, regardless of the species or drug susceptibility, at concentrations that are nontoxic to the host cells. The membrane-permeabilizing properties of AuR NPs and induction of reactive oxygen species were recognized as crucial for fungicidal activity. Conclusions: The results provide a rationale for the development of nonspherical Au NPs as effective antifungals or drug-delivery carriers to improve therapy for fungal infections.
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Affiliation(s)
- Ewelina Piktel
- Department of Medical Microbiology & Nanobiomedical Engineering, Medical University of Białystok, PL-15222 Białystok, Poland
| | - Łukasz Suprewicz
- Department of Medical Microbiology & Nanobiomedical Engineering, Medical University of Białystok, PL-15222 Białystok, Poland
| | - Joanna Depciuch
- Institute of Nuclear Physics Polish Academy of Sciences, PL-31342 Krakow, Poland
| | - Mateusz Cieśluk
- Department of Medical Microbiology & Nanobiomedical Engineering, Medical University of Białystok, PL-15222 Białystok, Poland
| | - Sylwia Chmielewska
- Department of Medical Microbiology & Nanobiomedical Engineering, Medical University of Białystok, PL-15222 Białystok, Poland
| | - Bonita Durnaś
- Department of Microbiology & Immunology, Institute of Medical Sciences, Collegium Medicum, Jan Kochanowski University in Kielce, PL-25317 Kielce, Poland
| | - Grzegorz Król
- Department of Microbiology & Immunology, Institute of Medical Sciences, Collegium Medicum, Jan Kochanowski University in Kielce, PL-25317 Kielce, Poland
| | - Tomasz Wollny
- Holy Cross Cancer Center in Kielce, PL-25734 Kielce, Poland
| | - Piotr Deptuła
- Department of Medical Microbiology & Nanobiomedical Engineering, Medical University of Białystok, PL-15222 Białystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Białystok, PL-15276 Białystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, PL-15276 Białystok, Poland
| | - Krzysztof Fiedoruk
- Department of Medical Microbiology & Nanobiomedical Engineering, Medical University of Białystok, PL-15222 Białystok, Poland
| | - Alexey Maximenko
- SOLARIS National Synchrotron Radiation Centre, Jagiellonian University, PL-30392 Krakow, Poland
| | | | - Robert Bucki
- Department of Medical Microbiology & Nanobiomedical Engineering, Medical University of Białystok, PL-15222 Białystok, Poland
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Sąsiadek M, Hartel M, Siger M, Katulska K, Majos A, Kluczewska E, Bartosik-Psujek H, Kułakowska A, Słowik A, Steinborn B, Adamczyk-Sowa M, Kalinowska A, Krzystanek E, Bonek R, Serafin Z, Sławek J, Nowacki P, Stępień A, Jóżwiak S, Rejdak K, Selmaj K, Walecki J. Recommendations of the Polish Medical Society of Radiology and the Polish Society of Neurology for a protocol concerning routinely used magnetic resonance imaging in patients with multiple sclerosis. Neurol Neurochir Pol 2020; 54:410-415. [PMID: 33085075 DOI: 10.5603/pjnns.a2020.0084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 11/25/2022]
Abstract
Magnetic resonance imaging (MRI) is a widely used method for the diagnosis of multiple sclerosis that is essential for the detection and follow-up of the disease. OBJECTIVE: The Polish Medical Society of Radiology (PLTR) and the Polish Society of Neurology (PTN) present the second version of their recommendations for investigations routinely conducted in magnetic resonance imaging departments in patients with multiple sclerosis. This version includes new data and practical comments for electroradiology technologists and radiologists. The recommended protocol aims to improve the MRI procedure and, most importantly, to standardise the method of conducting scans in all MRI departments. This is crucial for the initial diagnostics necessary for establishing a diagnosis, as well as for MS patient monitoring, which directly translates into significant clinical decisions. INTRODUCTION: Multiple sclerosis (MS) is a chronic immune mediated inflammatory demyelinating disease of the central nervous system (CNS), the aetiology of which is still unknown. The nature of the disease lies in a CNS destruction process disseminated in time (DIT) and space (DIS). MRI detects focal lesions in the white and grey matter with high sensitivity (although with significantly lower specificity in the latter). It is also the best tool to assess brain atrophy in patients with MS in terms of grey matter volume (GMV) and white matter volume (WMV) as well as local atrophy (by measuring the volume of thalamus, corpus callosum, subcortical nuclei, and hippocampus) as parameters that correlate with disability progression and cognitive dysfunctions. Progress in MR techniques, as well as advances in postprocessing the obtained data, has driven the dynamic development of computer programs that allow for a more repeatable assessment of brain atrophy in both cross-sectional and longitudinal studies. MR imaging is unquestionably the best diagnostic tool available to follow up the course of the disease and support clinicians in choosing the most appropriate treatment strategy for their MS patient. However, to diagnose and follow up MS patients on the basis of MRI in accordance with the latest standards, the MRI study must adhere to certain quality criteria. Such criteria are the subject of this paper.
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Affiliation(s)
- Marek Sąsiadek
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Poland
| | | | | | - Katarzyna Katulska
- Department of Neuroradiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Poland
| | - Ewa Kluczewska
- Department and Institute of Medical Radiology and Radiodiagnostics in Zabrze, Medical University of Silesia in Katowice, Poland
| | | | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Poland
| | - Agnieszka Słowik
- Jagiellonian University Medical College, Department of Neurology, Krakow, Poland; University Hospital in Krakow, Poland
| | - Barbara Steinborn
- Department of Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Alicja Kalinowska
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poland
| | - Ewa Krzystanek
- Department of Neurology, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Robert Bonek
- Department of Neurology and Clinical Neuroimmunology, Regional Specialist Hospital, Grudziądz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | | | - Przemysław Nowacki
- Department of Neurology, Pomeranian Medical University, Szczecin, Poland
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland
| | - Sergiusz Jóżwiak
- Department of Pediatric Neurology, Warsaw Medical University, Warsaw, Poland
| | - Konrad Rejdak
- Department of Neurology; Medical University of Lublin, Poland
| | - Krzysztof Selmaj
- Department of Neurology, Laboratory of Neuroimmunology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | - Jerzy Walecki
- Department of Radiology, Medical Centre for Postgraduate Education, Warsaw, Poland
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Kapica-Topczewska K, Collin F, Tarasiuk J, Czarnowska A, Chorąży M, Mirończuk A, Kochanowicz J, Kułakowska A. John Cunningham Virus Status, Seroconversion Rate, and the Risk of Progressive Multifocal Leukoencephalopathy in Polish John Cunningham Virus-Seronegative Patients with Relapsing-Remitting Multiple Sclerosis. Eur Neurol 2020; 83:487-492. [PMID: 33027785 DOI: 10.1159/000510849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 08/07/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Presence of anti-JC-virus antibodies (JCVAbs) is associated with the increased risk of natalizumab (NAT)-related progressive multifocal leukoencephalopathy (PML). Little is known about seroconversion rate and time to seroconversion in relapsing-remitting multiple sclerosis (RRMS) patients treated with NAT in Poland. The aim of the study was to assess the true risk of PML, seroconversion rate, and time to seroconversion in all JCVAb-negative RRMS patients treated with NAT in Poland. METHODS Demographic and clinical data of all Polish RRMS patients treated with NAT reimbursed by National Health Fund (NFZ) were prospectively collected in electronic files using the Therapeutic Programme Monitoring System provided by NFZ. The assessment of JCVAb presence (without collection of JCVAb index value) in serum (Unilabs, STRATIFY JCV: anti-JCV antibody ELISA) was done at the beginning of therapy and then repeated every 6 months. The maximum follow-up time was 4 years. In Poland, since 2013, according to the NFZ drug program guidance, only patients with negative JCVAb test have started treatment with NAT. RESULTS In all Polish multiple sclerosis centers, 210 negative JCVAb RRMS patients with at least 9 (±3) months of observation (146 females, 64 males, and the median age at baseline: 33 years) were included in the study. During the follow-up period, JCVAb status changed from negative to positive in 34 patients (16.2%). For half of the patients, the seroconversion was diagnosed 1 year after starting NAT treatment. In 4 patients (1.9%) during follow-up, JCVAb status changed again from positive to negative. In Poland, before establishment of NFZ drug program, 4 cases of PML in patients treated with NAT in clinical trials were diagnosed. In the NFZ drug program, since 2013, no patient treated with NAT has been diagnosed with PML. CONCLUSIONS NAT therapy in JCV-seronegative RRMS patients is safe and results in the absence of PML cases. In Poland, JCV seroconversion rate is similar to that observed in other European countries.
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Affiliation(s)
| | - Francois Collin
- Independent Statistical Consultant, François COLLIN, Katowice, Poland
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Anna Mirończuk
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
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Cieśluk M, Pogoda K, Deptuła P, Werel P, Kułakowska A, Kochanowicz J, Mariak Z, Łysoń T, Reszeć J, Bucki R. Nanomechanics and Histopathology as Diagnostic Tools to Characterize Freshly Removed Human Brain Tumors. Int J Nanomedicine 2020; 15:7509-7521. [PMID: 33116485 PMCID: PMC7547774 DOI: 10.2147/ijn.s270147] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/18/2020] [Indexed: 12/28/2022] Open
Abstract
Background The tissue-mechanics environment plays a crucial role in human brain physiological development and the pathogenesis of different diseases, especially cancer. Assessment of alterations in brain mechanical properties during cancer progression might provide important information about possible tissue abnormalities with clinical relevance. Methods With atomic force microscopy (AFM), the stiffness of freshly removed human brain tumor tissue was determined on various regions of the sample and compared to the stiffness of healthy human brain tissue that was removed during neurosurgery to gain access to tumor mass. An advantage of indentation measurement using AFM is the small volume of tissue required and high resolution at the single-cell level. Results Our results showed great heterogeneity of stiffness within metastatic cancer or primary high-grade gliomas compared to healthy tissue. That effect was not clearly visible in lower-grade tumors like meningioma. Conclusion Collected data indicate that AFM might serve as a diagnostic tool in the assessment of human brain tissue stiffness in the process of recognizing tumors.
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Affiliation(s)
- Mateusz Cieśluk
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok PL-15222, Poland
| | - Katarzyna Pogoda
- Institute of Nuclear Physics, Polish Academy of Sciences, Krakow PL-31342, Poland
| | - Piotr Deptuła
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok PL-15222, Poland
| | - Paulina Werel
- Department of Neurology, Medical University of Bialystok, Bialystok PL-15276, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok PL-15276, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Bialystok PL-15276, Poland
| | - Zenon Mariak
- Department of Neurosurgery, Medical University of Bialystok, Bialystok PL-15276, Poland
| | - Tomasz Łysoń
- Department of Neurosurgery, Medical University of Bialystok, Bialystok PL-15276, Poland
| | - Joanna Reszeć
- Department of Pathology, Medical University of Bialystok, Bialystok PL-15269, Poland
| | - Robert Bucki
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok PL-15222, Poland
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Kapica-Topczewska K, Tarasiuk J, Chorąży M, Czarnowska A, Brola W, Szczepański M, Kochanowicz J, Kułakowska A. The epidemiology of comorbidities among multiple sclerosis patients in northeastern Poland. Mult Scler Relat Disord 2020; 41:102051. [DOI: 10.1016/j.msard.2020.102051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 11/30/2022]
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Sąsiadek M, Hartel M, Siger M, Katulska K, Majos A, Kluczewska E, Bartosik-Psujek H, Kułakowska A, Słowik A, Steinborn B, Adamczyk-Sowa M, Kalinowska A, Krzystanek E, Bonek R, Serafin Z, Sławek J, Nowacki P, Stępień A, Jóżwiak S, Rejdak K, Selmaj K, Walecki J. Recommendations of the Polish Medical Society of Radiology and the Polish Society of Neurology for the routinely used magnetic resonance imaging protocol in patients with multiple sclerosis. Pol J Radiol 2020; 85:e272-e276. [PMID: 32612727 PMCID: PMC7315047 DOI: 10.5114/pjr.2020.96010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/13/2020] [Indexed: 11/30/2022] Open
Abstract
Magnetic resonance imaging (MRI) is a widely used method for the diagnosis of multiple sclerosis (MS) that is essential for the detection and follow-up of the disease. The Polish Medical Society of Radiology (PLTR) and the Polish Society of Neurology (PTN) present the second version of the recommendations for examinations routinely conducted in magnetic resonance imaging departments in patients with MS, which include new data and practical comments for electroradiology technicians and radiologists. The recommended protocol aims to improve the MRI procedure and, most importantly, to standardise the method of conducting scans in all MRI departments. This is crucial for the initial diagnostics that are necessary to establish a diagnosis as well as monitor patients with MS, which directly translates into significant clinical decisions. MS is a chronic idiopathic inflammatory demyelinating disease of the central nervous system (CNS), the aetiology of which is still unknown. The nature of the disease lies in the CNS destruction process disseminated in time and space. MRI detects focal lesions in the white and grey matter with high sensitivity (with significantly less specificity in the latter). It is also the best tool to assess brain atrophy in patients with MS in terms of grey matter volume and white matter volume as well as local atrophy (by measuring the volume of thalamus, corpus callosum, subcortical nuclei, hippocampus) as parameters that correlate with disability progression and cognitive dysfunctions. Progress in magnetic resonance techniques, as well as the abilities of postprocessing the obtained data, has become the basis for the dynamic development of computer programs that allow for a more repeatable assessment of brain atrophy in both cross-sectional and longitudinal studies. MRI is unquestionably the best diagnostic tool used to follow up the course of the disease and to treat patients with MS. However, to diagnose and follow up the patients with MS on the basis of MRI in accordance with the latest standards, an MRI study must meet certain quality criteria, which are the subject of this paper.
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Affiliation(s)
- Marek Sąsiadek
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Małgorzata Siger
- Department of Neurology, Medical University of Lodz, Lodz, Poland
| | - Katarzyna Katulska
- Department of Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Lodz, Poland
| | - Ewa Kluczewska
- Department and Institute of Medical Radiology and Radiodiagnostics in Zabrze, Medical University of Silesia in Katowice, Poland
| | | | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University Medical College, University Hospital in Krakow, Krakow, Poland
| | - Barbara Steinborn
- Department of Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Alicja Kalinowska
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Krzystanek
- Department of Neurology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Robert Bonek
- Department of Neurology and Clinical Neuroimmunology, Regional Specialist Hospital, Grudziądz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Jarosław Sławek
- Department of Neurology, St. Adalbert Hospital, “Copernicus” Ltd., Gdańsk, Poland
| | - Przemysław Nowacki
- Department of Neurology, Pomeranian Medical University, Szczecin, Poland
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland
| | - Sergiusz Jóżwiak
- Department of Paediatric Neurology, Warsaw Medical University, Warsaw, Poland
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Krzysztof Selmaj
- Department of Neurology, Laboratory of Neuroimmunology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | - Jerzy Walecki
- Department of Radiology, Medical Centre for Postgraduate Education, Warsaw, Poland
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Kapica-Topczewska K, Collin F, Tarasiuk J, Chorąży M, Czarnowska A, Kwaśniewski M, Brola W, Bartosik-Psujek H, Adamczyk-Sowa M, Kochanowicz J, Kułakowska A. Clinical and epidemiological characteristics of multiple sclerosis patients receiving disease-modifying treatment in Poland. Neurol Neurochir Pol 2020; 54:161-168. [PMID: 32219813 DOI: 10.5603/pjnns.a2020.0020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/19/2019] [Accepted: 11/24/2019] [Indexed: 11/25/2022]
Abstract
AIM OF STUDY The aim of this study was to collect and analyse data on relapsing-remitting multiple sclerosis (RRMS) patients receiving disease-modifying therapies (DMTs) in Poland. MATERIAL AND METHODS This observational, multicentre study with prospective data collection included RRMS patients receiving DMTs reimbursed by the National Health Fund (NFZ) in Poland, monitored by the Therapeutic Programme Monitoring System (SMPT). Demographic profiles, disability status, and treatment modalities were analysed. RESULTS Data from 11,632 RRMS patients was collected (from 15,368 new prescriptions), including 10,649 patients in the first-line and 983 in the second-line therapeutic programme of DMTs. The proportion of females to males was 2.39 in the first-line and 1.91 in the second-line. The mean age at DMTs start was 36.6 years in the first-line and 35.1 in the second-line. The median time from the first symptoms to MS diagnosis was 7.4 months, and from MS diagnosis to treatment it was 18.48 months. A total of 43.4% of MS patients started DMT during the 12 months following diagnosis. There was a positive correlation between the duration from MS diagnosis to the start of DMT and a higher initial EDSS value [correlation 0.296 (p < 0.001)]. About 10% of patients stopped DMTs. In Poland, about one third of all MS patients are treated in both lines, and the choice of first-line treatment depends on the region of the country. CONCLUSIONS In Poland there is a need to increase MS patient access to DMTs by improving the organisation of drug programmes.
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Affiliation(s)
- Katarzyna Kapica-Topczewska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland, Skłodowskiej-Curie 24 A, 15-275 Białystok, Poland.
| | - Francois Collin
- Centre for Bioinformatics and Data Analysis, Medical University of Bialystok, Bialystok, Poland, Ul.J. Waszyngtona 13 A, 15-269 Białystok, Poland
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland, Skłodowskiej-Curie 24 A, 15-275 Białystok, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland, Skłodowskiej-Curie 24 A, 15-275 Białystok, Poland
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland, Skłodowskiej-Curie 24 A, 15-275 Białystok, Poland
| | - Mirosław Kwaśniewski
- Centre for Bioinformatics and Data Analysis, Medical University of Bialystok, Bialystok, Poland, Ul.J. Waszyngtona 13 A, 15-269 Białystok, Poland
| | - Waldemar Brola
- The Faculty of Medicine and Health Sciences, Institute of Physiotherapy, Jan Kochanowski University, Kielce, Poland, Al. IX Wieków Kielc 19A, 25-317 Kielce, Poland
| | - Halina Bartosik-Psujek
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Medical Faculty, University of Rzeszow, Rzeszów, Poland, Lwowska 60, 35-301 Rzeszów, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology in Zabrze, Medical University of Silesia, Zabrze, Poland, 3-go Maja St. 13-15,, 41-800 Zabrze, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland, Skłodowskiej-Curie 24 A, 15-275 Białystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland, Skłodowskiej-Curie 24 A, 15-275 Białystok, Poland
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Kalinowska A, Kułakowska A, Adamczyk-Sowa M, Czajkowski K, Kurowska K, Pietrzak B, Radziszewski P, Rejdak K, Bartosik-Psujek H. Recommendations for neurological, obstetrical and gynaecological care in women with multiple sclerosis: a statement by a working group convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society. Neurol Neurochir Pol 2020; 54:125-137. [PMID: 32083716 DOI: 10.5603/pjnns.a2020.0015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/13/2019] [Accepted: 11/18/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Multiple sclerosis (MS) is the most common non-traumatic neurological cause of disability in young adults, affecting women 1-3 times more often than men. Several specific challenges arise from the fact that young women diagnosed with MS often have to make decisions related to treatment and family planning at the same time. These issues are connected with fertility, the impact of pregnancy on disease course, the choice of pregnancy timing, and the optimal mode of disease-modifying therapy in the context of a planned pregnancy, contraception, urological complaints, and sexual dysfunction. STATE OF THE ART While MS does not in itself adversely affect fertility, pregnancy or childbirth, pregnancy needs to be carefully planned. This requires the interdisciplinary co-operation of a neurologist, gynaecologist and psychologist. Data on the impact of disease-modifying drugs on foetal development are very limited, and none of these drugs is 100% safe during pregnancy. In the second and third trimesters, MS relapse rate decreases. Unfortunately, it increases within the first 3-6 months after delivery. Adequate disease control should be achieved before pregnancy, as relapse rate in the period of two years preceding pregnancy is one of the strongest predictive factors for post-partum relapses. CLINICAL IMPLICATIONS The following is a statement by a working group of experts in neurology, gynaecology, obstetrics and urology, convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society, addressing the issues that are specific to the female MS population. The aim of this statement is to provide guidance in pregnancy planning and disease management, both during pregnancy and post-partum. FUTURE DIRECTIONS This statement reflects expert opinion and is not intended to be read as guidelines. It rather provides up-to-date information on how to optimise care of female MS patients of childbearing age.
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Affiliation(s)
- Alicja Kalinowska
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan Univerisity of Medical Sciences, 49, Przybyszewskiego st., 60-355 Poznan, Poland.
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Zabrze; Medical University of Silesia, Katowice, Poland
| | - Krzysztof Czajkowski
- II Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | | | - Bronisława Pietrzak
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Piotr Radziszewski
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Poland
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Poland
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Wawrusiewicz-Kurylonek N, Gościk J, Chorąży M, Siewko K, Posmyk R, Zajkowska A, Citko A, Maciulewski R, Szelachowska M, Myśliwiec J, Jastrzębska I, Kułakowska A, Kochanowicz J, Krętowski AJ. The interferon-induced helicase C domain-containing protein 1 gene variant (rs1990760) as an autoimmune-based pathology susceptibility factor. Immunobiology 2020; 225:151864. [DOI: 10.1016/j.imbio.2019.10.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 10/17/2019] [Accepted: 10/29/2019] [Indexed: 12/18/2022]
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Kułak-Bejda A, Waszkiewicz N, Galińska-Skok B, Zajkowska A, Kułakowska A, Kochanowicz J. Primarily depression manifestation of Wilson's disease-Case report. Clin Neurol Neurosurg 2019; 190:105651. [PMID: 31896489 DOI: 10.1016/j.clineuro.2019.105651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 10/22/2019] [Accepted: 12/25/2019] [Indexed: 12/01/2022]
Abstract
Wilson's disease is an inherited autosomal-recessive disorder of biliary copper excretion. It is characterized by hepatic, neurological and ophthalmic manifestations related to the accumulation of copper in the liver, the lenticular nuclei of brain and cornea. The authors present the case of a 29-year-old female with primarily depression manifestation of Wilson's disease. The patient also reported agitation, difficulties with concentration, slowdown of speech, and stuttering. In magnetic resonance imaging, in putamen, the globus pallidus, claustrum, the heads of caudate nucleus and thalamus areas demonstrated the increased signal in T2. A high copper content was obtained in daily urine collection and reduced level in serum. Similarly, ceruloplasmin level was decreased. Despite the antidepressant treatment with venlafaxine, no improvement was observed. Within a week of psychomotor slowdown, symptoms such as Parkinson's syndrome appeared. Due to the rapid progression of the disease symptoms, the patient was referred for further treatment at a specialistic center. After six month, despite the treatment, the progress of disease was so advanced that patient was transferred to the hospice. Two weeks later patient died. Wilson's disease might be consider in differential diagnosis of depression in young patients, especially if they present additional extrapyramidal symptoms and unspecific changes in magnetic resonance imaging.
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Affiliation(s)
- A Kułak-Bejda
- Medical University of Białystok, Department of Psychiatry, Choroszcz, Poland.
| | - N Waszkiewicz
- Medical University of Białystok, Department of Psychiatry, Choroszcz, Poland.
| | - B Galińska-Skok
- Medical University of Białystok, Department of Psychiatry, Choroszcz, Poland.
| | - A Zajkowska
- Medical University of Białystok, Department of Neurology, Białystok, Poland.
| | - A Kułakowska
- Medical University of Białystok, Department of Neurology, Białystok, Poland.
| | - J Kochanowicz
- Medical University of Białystok, Department of Neurology, Białystok, Poland.
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Sajdak J, Stępień D, Werel P, Czarnowska A, Kapica-Topczewska K, Kułakowska A. Does obesity increase the risk of stroke? Med Og Nauk Zdr 2019. [DOI: 10.26444/monz/114153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Kapica-Topczewska K, Tarasiuk J, Collin F, Brola W, Chorąży M, Czarnowska A, Kwaśniewski M, Bartosik-Psujek H, Adamczyk-Sowa M, Kochanowicz J, Kułakowska A. The effectiveness of interferon beta versus glatiramer acetate and natalizumab versus fingolimod in a Polish real-world population. PLoS One 2019; 14:e0223863. [PMID: 31647829 PMCID: PMC6812766 DOI: 10.1371/journal.pone.0223863] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 09/30/2019] [Indexed: 12/22/2022] Open
Abstract
Objective The aim of the study was to assess the effectiveness of disease-modifying therapies (DMTs) in relapsing-remitting multiple sclerosis (RRMS) patients treated in MS centres in Poland. Methods Demographic and clinical data of all Polish RRMS patients receiving DMTs were prospectively collected from 2014 to 2018 in electronic files using the Therapeutic Program Monitoring System (SMPT). Results The study included 10,764 RRMS patients treated with DMTs in first-line and 1,042 in second-line programmes. IFNβ more effectively lengthened the times to the first relapse, disability progression, and brain MRI activity than GA. After 2 and 4 years of follow-up, more patients on IFNβ showed no evidence of disease activity (NEDA-3) in comparison to GA (66.3% and 44.3% vs 55.2% and 33.2%, respectively; p<0.001). NAT more effectively reduced brain MRI activity than FTY (p = 0.001). More patients under NAT had NEDA-3 after 2 and 4 years of follow-up compared to FTY (66.2% and 42.1% vs 52.1% and 29.5%, respectively; p = 0.03). In adjusted analysis, a higher baseline Expanded Disability Status Score (EDSS) was a predictor of relapse (p<0.001) and NEDA-3 failure (p = 0.003). Conclusion IFNβ compared to GA and NAT compared to FTY more effectively reduced disease activity in a Polish population of RRMS patients.
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Affiliation(s)
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Francois Collin
- Centre for Bioinformatics and Data Analysis, Medical University of Bialystok, Bialystok, Poland
| | - Waldemar Brola
- The Faculty of Medicine and Health Sciences, Institute of Physiotherapy, Jan Kochanowski University, Kielce, Poland
| | - Monika Chorąży
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Mirosław Kwaśniewski
- Centre for Bioinformatics and Data Analysis, Medical University of Bialystok, Bialystok, Poland
| | - Halina Bartosik-Psujek
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Medical Faculty, University of Rzeszow, Rzeszów, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
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