1
|
Meca-Lallana JE, Martínez Yélamos S, Eichau S, Llaneza MÁ, Martín Martínez J, Peña Martínez J, Meca Lallana V, Alonso Torres AM, Moral Torres E, Río J, Calles C, Ares Luque A, Ramió-Torrentà L, Marzo Sola ME, Prieto JM, Martínez Ginés ML, Arroyo R, Otano Martínez MÁ, Brieva Ruiz L, Gómez Gutiérrez M, Rodríguez-Antigüedad Zarranz A, Sánchez-Seco VG, Costa-Frossard L, Hernández Pérez MÁ, Landete Pascual L, González Platas M, Oreja-Guevara C. Consensus statement of the Spanish Society of Neurology on the treatment of multiple sclerosis and holistic patient management in 2023. Neurologia 2024; 39:196-208. [PMID: 38237804 DOI: 10.1016/j.nrleng.2024.01.003] [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: 03/09/2023] [Accepted: 06/14/2023] [Indexed: 01/25/2024] Open
Abstract
The last consensus statement of the Spanish Society of Neurology's Demyelinating Diseases Study Group on the treatment of multiple sclerosis (MS) was issued in 2016. Although many of the positions taken remain valid, there have been significant changes in the management and treatment of MS, both due to the approval of new drugs with different action mechanisms and due to the evolution of previously fixed concepts. This has enabled new approaches to specific situations such as pregnancy and vaccination, and the inclusion of new variables in clinical decision-making, such as the early use of high-efficacy disease-modifying therapies (DMT), consideration of the patient's perspective, and the use of such novel technologies as remote monitoring. In the light of these changes, this updated consensus statement, developed according to the Delphi method, seeks to reflect the new paradigm in the management of patients with MS, based on the available scientific evidence and the clinical expertise of the participants. The most significant recommendations are that immunomodulatory DMT be started in patients with radiologically isolated syndrome with persistent radiological activity, that patient perspectives be considered, and that the term "lines of therapy" no longer be used in the classification of DMTs (> 90% consensus). Following diagnosis of MS, the first DMT should be selected according to the presence/absence of factors of poor prognosis (whether epidemiological, clinical, radiological, or biomarkers) for the occurrence of new relapses or progression of disability; high-efficacy DMTs may be considered from disease onset.
Collapse
Affiliation(s)
- J E Meca-Lallana
- Unidad de Neuroinmunología Clínica y CSUR Esclerosis Múltiple, Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca (IMIB-Arrixaca)/Cátedra de Neuroinmunología Clínica y Esclerosis Múltiple, Universidad Católica San Antonio (UCAM), Murcia, Spain.
| | - S Martínez Yélamos
- Unidad de Esclerosis Múltiple «EMxarxa», Servicio de Neurología. H.U. de Bellvitge, IDIBELL, Departament de Ciències Clíniques, Universitat de Barcelona, Barcelona, Spain
| | - S Eichau
- Servicio de Neurología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - M Á Llaneza
- Servicio de Neurología, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | - J Martín Martínez
- Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - V Meca Lallana
- Servicio de Neurología, Hospital Universitario La Princesa, Madrid, Spain
| | - A M Alonso Torres
- Unidad de Esclerosis Múltiple, Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - E Moral Torres
- Servicio de Neurología, Complejo Hospitalario y Universitario Moisès Broggi, Barcelona, Spain
| | - J Río
- Servicio de Neurología, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitario Vall d'Hebrón, Barcelona, Spain
| | - C Calles
- Servicio de Neurología, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - A Ares Luque
- Servicio de Neurología, Complejo Asistencial Universitario de León, León, Spain
| | - L Ramió-Torrentà
- Unitat de Neuroimmunologia i Esclerosi Múltiple Territorial de Girona (UNIEMTG), Hospital Universitari Dr. Josep Trueta y Hospital Santa Caterina. Grupo Neurodegeneració i Neuroinflamació, IDIBGI. Departamento de Ciencias Médicas, Universidad de Girona, Girona, Spain
| | - M E Marzo Sola
- Servicio de Neurología, Hospital San Pedro, Logroño, Spain
| | - J M Prieto
- Servicio de Neurología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - M L Martínez Ginés
- Servicio de Neurología, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - R Arroyo
- Servicio de Neurología, Hospital Universitario Quirón Salud Madrid, Madrid, Spain
| | - M Á Otano Martínez
- Servicio de Neurología, Hospital Universitario de Navarra, Navarra, Spain
| | - L Brieva Ruiz
- Hospital Universitari Arnau de Vilanova, Universitat de Lleida, Lleida, Spain
| | - M Gómez Gutiérrez
- Servicio de Neurología, Hospital San Pedro de Alcántara, Cáceres, Spain
| | | | - V G Sánchez-Seco
- Servicio de Neurología, Hospital Universitario de Toledo, Toledo, Spain
| | - L Costa-Frossard
- CSUR de Esclerosis Múltiple, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - M Á Hernández Pérez
- Unidad de Esclerosis Múltiple, Servicio de Neurología, Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - L Landete Pascual
- Servicio de Neurología, Hospital Universitario Dr. Peset, Valencia, Spain
| | - M González Platas
- Servicio de Neurología, Hospital Universitario de Canarias, La Laguna, Spain
| | - C Oreja-Guevara
- Departamento de Neurología, Hospital Clínico San Carlos, IdISSC, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain
| |
Collapse
|
2
|
Mendo T, Mendo J, Ransijn JM, Gomez I, Gil-Kodaka P, Fernández J, Delgado R, Travezaño A, Arroyo R, Loza K, McCann P, Crowe S, Jones EL, James MA. Assessing discards in an illegal small-scale fishery using fisher-led reporting. Rev Fish Biol Fish 2022; 32:963-974. [PMID: 35370370 PMCID: PMC8958935 DOI: 10.1007/s11160-022-09708-9] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
UNLABELLED About a third of all marine fish in the world are caught in Small-Scale Fisheries (SSF). SSF are increasingly recognised as essential for food security and livelihoods for vulnerable and economically fragile communities globally. Although individual SSF vessels are usually perceived as having little impact on the ecosystem, the cumulative impact of gear type and number of vessels may be substantial. Bottom trawling is a common fishing method that can greatly influence the marine ecosystem by damaging the seafloor and generating high levels of discards. However, appropriate sampling coverage using on-board observer programmes to collect these data from SSF are rare, as they are expensive and pose logistical constraints. A mobile App was used to assess whether self-reporting by fishers could provide reliable fine-scale information on fishing effort and discards over time in an illegal shrimp trawling fishery in northern Peru. Maps depicting the spatial distribution of trawling effort and the proportion of discards from observers and fishers were compared using the Similarity in Means (SIM) Index, which ranges from 0 when spatial patterns differ completely to 1 when spatial patterns are very similar. High levels of agreement between spatio-temporal patterns of effort (SIM Index = 0.81) and discards (0.96) were found between fisher and observer maps. Moreover, far greater spatial coverage was accomplished by fishers, suggesting that self-reporting via an App represents a useful approach to collect reliable fisheries data as an initial step for effective monitoring and management of these fisheries. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11160-022-09708-9.
Collapse
Affiliation(s)
- T. Mendo
- Scottish Oceans Institute, University of St Andrews, East Sands, Fife, KY16 8LB UK
| | - J. Mendo
- Facultad de Pesquería, Universidad Nacional Agraria La Molina, Av. La Molina s/n, Lima, Peru
| | - J. M. Ransijn
- Scottish Oceans Institute, University of St Andrews, East Sands, Fife, KY16 8LB UK
| | - I. Gomez
- Facultad de Pesquería, Universidad Nacional Agraria La Molina, Av. La Molina s/n, Lima, Peru
| | - P. Gil-Kodaka
- Facultad de Pesquería, Universidad Nacional Agraria La Molina, Av. La Molina s/n, Lima, Peru
| | - J. Fernández
- Facultad de Pesquería, Universidad Nacional Agraria La Molina, Av. La Molina s/n, Lima, Peru
| | - R. Delgado
- Facultad de Pesquería, Universidad Nacional Agraria La Molina, Av. La Molina s/n, Lima, Peru
| | - A. Travezaño
- Facultad de Pesquería, Universidad Nacional Agraria La Molina, Av. La Molina s/n, Lima, Peru
| | - R. Arroyo
- Facultad de Pesquería, Universidad Nacional Agraria La Molina, Av. La Molina s/n, Lima, Peru
| | - K. Loza
- Facultad de Pesquería, Universidad Nacional Agraria La Molina, Av. La Molina s/n, Lima, Peru
| | - P. McCann
- IT Services, University of St. Andrews, Walter Bower House, Guardbridge, KY16 0US UK
| | - S. Crowe
- IT Services, University of St. Andrews, Walter Bower House, Guardbridge, KY16 0US UK
| | - E. L. Jones
- Biomathematics and Statistics Scotland, Peter Guthrie Tait Road, Edinburgh, UK
| | - M. A. James
- Scottish Oceans Institute, University of St Andrews, East Sands, Fife, KY16 8LB UK
| |
Collapse
|
3
|
Fernández O, Aladro Y, Arroyo R, Brieva L, Calles-Hernández MC, Carrascal P, Comabella M, Costa-Frossard L, Eichau S, García-Merino JA, Ginestal R, González I, Izquierdo G, Martínez-Ginés ML, Meca-Lallana JE, Mendibe-Bilbao MM, Oterino A, Prieto JM, Río J, Ramió-Torrentà L, Romero-Pinel L, Téllez N, Rodríguez-Antigüedad A. [12th Post-ECTRIMS Meeting: review of the novelties from the 2019 ECTRIMS Congress (I)]. Rev Neurol 2021; 70:379-390. [PMID: 32390131 DOI: 10.33588/rn.7010.2020121] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Like every year, after the ECTRIMS Congress, renowned Spanish neurologists who are experts in multiple sclerosis presented the main novelties in research in this field at the Post-ECTRIMS Meeting. AIM To summarise the content presented at the 12th edition of the Post-ECTRIMS Meeting, which took place in September 2019 in Sevilla and is presented in two parts. DEVELOPMENT This first part addresses the latest studies on vitamin D deficiency and the discrepancies that currently exist regarding its treatment. The advances made in epigenetics allow us to present this approach as a possible biomarker of multiple sclerosis. An account is provided to explain the growing importance of imaging techniques to detect atrophy and other phenomena that occur during the disease, such as changes in iron concentration or remyelination processes, which allow us to further our understanding of the mechanisms of cortical pathology, and the dimensionality of neurodegeneration during its course. Findings related to immunological mechanisms and advances in potential antigen-specific therapies are discussed. The contribution presents the latest studies on the assessment of cognitive impairment and its rehabilitation, which are becoming increasingly important due to the high prevalence of these disorders and the absence of their systematic assessment in clinical practice. Finally, the unmet social and health needs of multiple sclerosis patients in our country are presented, with emphasis on the current deficits in the system of social protection.
Collapse
Affiliation(s)
- O Fernández
- Instituto de Investigación Biomédica de Málaga. IBIMA, Málaga, España
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, España
| | - R Arroyo
- Hospital Quirón, Pozuelo de Alarcón, España
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, España
| | | | | | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, España
| | | | - S Eichau
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
| | - J A García-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, España
| | - R Ginestal
- Fundación Jiménez Díaz, 28040 Madrid, España
| | | | | | | | | | | | - A Oterino
- Hospital Universitario Marqués de Valdecilla, Santander, España
| | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, España
| | - J Río
- Hospitals Vall d'Hebron, 08035 Barcelona, España
| | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 Hospitalet de Ll., España
| | - N Téllez
- Hospital Clínico Universitario, 47005 Valladolid, España
| | | |
Collapse
|
4
|
Fernández O, Montalban X, Aladro Y, Alonso A, Arroyo R, Calles C, Castillo-Triviño T, Comabella M, Costa-Frossard L, Forero L, Ginestal R, Landete L, Llaneza M, Llufriu S, Martínez-Ginés ML, Meca-Lallana J, Mendibe M, Oreja-Guevara C, Oterino A, Prieto JM, Ramió-Torrentà L, Romero-Pinel L, Téllez N, Rodríguez-Antigüedad A. 13th Post-ECTRIMS Meeting: review of the new developments presented at the 2020 ECTRIMS Congress (I). Rev Neurol 2021; 72:397-406. [PMID: 34042168 DOI: 10.33588/rn.7211.2021172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION For more than a decade, following the ECTRIMS Congress, the Post-ECTRIMS Meeting has been held in Spain, where neurologists with expertise in multiple sclerosis (MS) from all over the country meet to review the most relevant latest developments presented at the ECTRIMS congress (on this occasion held together with ACTRIMS). AIM This article, published in two parts, summarises the presentations that took place at the Post-ECTRIMS Meeting, held online on 16 and 17 October 2020. DEVELOPMENT This first part includes the latest results regarding the impact of the environment and lifestyle on risk of MS and its clinical course, and the role of epigenetics and genetic factors on these processes. Findings from preclinical and clinical research on the lymphocyte subtypes identified and the involvement of lymphoid follicles and meningeal involvement in the disease are discussed. Changes in brain structure are addressed at the microscopic and macroscopic levels, including results from high-resolution imaging techniques. The latest advances on biomarkers for the diagnosis and prognosis of MS, and on the involvement of the microbiome in these patients are also reported. Finally, results from patient registries on the impact of COVID-19 in MS patients are outlined. CONCLUSIONS There have been new data on MS risk factors, the impact of MS at the cellular and structural level, the role of the microbiome in the disease, biomarkers, and the relationship between COVID-19 and MS.
Collapse
Affiliation(s)
- O Fernández
- Hospital Regional Universitario de Málaga, Málaga, España
| | - X Montalban
- Hospital Universitario Vall d'Hebron-CEMCAT, Barcelona, España
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, España
| | - A Alonso
- Hospital Regional Universitario de Málaga, Málaga, España
| | - R Arroyo
- Hospital Universitario Quirónsalud, Madrid, España
| | - C Calles
- Hospital Universitari Son Espases, Palma de Mallorca, España
| | | | - M Comabella
- Hospital Universitario Vall d'Hebron-CEMCAT, Barcelona, España
| | | | - L Forero
- Hospital Universitario Puerta del Mar, 11009 Cádiz, España
| | - R Ginestal
- Hospital Universitario Clínico de Madrid, Madrid, España
| | - L Landete
- Hospital Universitario Doctor Peset, Valencia, España
| | - M Llaneza
- Complejo Hospitalario Universitario de Ferrol, Ferrol, España
| | - S Llufriu
- Hospital Clínic de Barcelona, 08036 Barcelona, España
| | | | - J Meca-Lallana
- Hospital Clínico Universitario Virgen de la Arrixaca. IMIB-Arrixaca, Murcia, España
| | - M Mendibe
- Hospital Universitario de Cruces, Bilbao, España
| | | | - A Oterino
- Hospital Universitario Central de Asturias, Oviedo, España
| | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, España
| | - Ll Ramió-Torrentà
- Hospital Universitari Dr. Josep Trueta, 17007 Girona, España.,Hospital de Santa Caterina-IDIBGI, Salt, España
| | - L Romero-Pinel
- Hospital Universitario de Bellvitge , Hospitalet de Ll., España
| | - N Téllez
- Hospital Clínico Universitario de Valladolid, Valladolid, España
| | | |
Collapse
|
5
|
Fernández O, Montalban X, Aladro Y, Alonso A, Arroyo R, Calles C, Castillo-Triviño T, Comabella M, Costa-Frossard L, Forero L, Ginestal R, Landete L, Llaneza M, Llufriu S, Martínez-Ginés ML, Meca-Lallana J, Mendibe M, Oreja-Guevara C, Oterino A, Prieto JM, Ramió-Torrentà L, Romero-Pinel L, Téllez N, Rodríguez-Antigüedad A. 13th Post-ECTRIMS Meeting: review of the new developments presented at the 2020 ECTRIMS Congress (II). Rev Neurol 2021; 72:433-442. [PMID: 34109999 DOI: 10.33588/rn.7212.2021173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION For more than a decade, after the ECTRIMS Congress, Spain has hosted the Post-ECTRIMS meeting, where neurologists with expertise in multiple sclerosis (MS) meet to review the new developments presented at the ECTRIMS. AIM This article, published in two parts, summarises the presentations of the post-ECTRIMS meeting, held online on 16 and 17 October 2020. DEVELOPMENT This second part highlights the importance of gender and age in understanding the pathology of the disease and optimising its management. The advances made in paediatric MS, from a neuropsychological and neuroimaging point of view, are presented. In turn, special attention is paid to the findings that contribute to a more personalised approach to therapy and to choosing the best treatment strategy (pharmacological and non-pharmacological) for each patient. Similarly, results related to possible strategies to promote remyelination are addressed. Although there are no major advances in the treatment of progressive forms, some quantitative methods for the classification of these patients are highlighted. In addition, the study also includes results on potential tools for assessment and treatment of cognitive deficits, and some relevant aspects observed in the spectrum of neuromyelitis optica disorders. Finally, the results of the papers considered as breaking news at the ECTRIMS-ACTRIMS are detailed. CONCLUSIONS Most of the advances presented were related to the knowledge of paediatric MS, remyelination strategies and cognitive assessment in MS.
Collapse
Affiliation(s)
- O Fernández
- Hospital Regional Universitario de Málaga, Málaga, España
| | - X Montalban
- Hospital Universitario Vall d'Hebron-CEMCAT, Barcelona, España
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, España
| | - A Alonso
- Hospital Regional Universitario de Málaga, Málaga, España
| | - R Arroyo
- Hospital Universitario Quirónsalud, Madrid, España
| | - C Calles
- Hospital Universitari Son Espases, Palma de Mallorca, España
| | | | - M Comabella
- Hospital Universitario Vall d'Hebron-CEMCAT, Barcelona, España
| | | | - L Forero
- Hospital Universitario Puerta del Mar, 11009 Cádiz, España
| | - R Ginestal
- Hospital Universitario Clínico de Madrid, Madrid, España
| | - L Landete
- Hospital Universitario Doctor Peset, Valencia, España
| | - M Llaneza
- Complejo Hospitalario Universitario de Ferrol, Ferrol, España
| | - S Llufriu
- Hospital Clínic de Barcelona, 08036 Barcelona, España
| | | | - J Meca-Lallana
- Hospital Clínico Universitario Virgen de la Arrixaca. IMIB-Arrixaca, Murcia, España
| | - M Mendibe
- Hospital Universitario de Cruces, Bilbao, España
| | | | - A Oterino
- Hospital Universitario Central de Asturias, Oviedo, España
| | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, España
| | - Ll Ramió-Torrentà
- Hospital Universitari Dr. Josep Trueta, 17007 Girona, España.,Hospital de Santa Caterina-IDIBGI, Salt, España
| | - L Romero-Pinel
- Hospital Universitario de Bellvitge , Hospitalet de Ll., España
| | - N Téllez
- Hospital Clínico Universitario de Valladolid, Valladolid, España
| | | |
Collapse
|
6
|
Fernández O, Aladro Y, Arroyo R, Brieva L, Calles-Hernández MC, Carrascal P, Comabella M, Costa-Frossard L, Eichau S, García-Merino JA, Ginestal R, González I, Izquierdo G, Martínez-Ginés ML, Meca-Lallana JE, Mendibe-Bilbao MM, Oterino A, Prieto JM, Río J, Ramió-Torrentà L, Romero-Pinel L, Téllez N, Rodríguez-Antigüedad A. 12th Post-ECTRIMS Meeting: review of the novelties from the 2019 ECTRIMS Congress (II). Rev Neurol 2020; 70:417-429. [PMID: 32436209 DOI: 10.33588/rn.7011.2020122] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Like every year, after the ECTRIMS Congress, renowned Spanish neurologists who are experts in multiple sclerosis presented the main novelties in research in this field at the Post-ECTRIMS Meeting. AIM To summarise the content presented at the 12th edition of the Post-ECTRIMS Meeting, which took place in September 2019 in Sevilla and is presented in two parts. DEVELOPMENT In this second part, the most recent evidence on the use of disease-modifying treatments during pregnancy is presented. Details are provided concerning the results of phase 3 clinical trials conducted to evaluate the efficacy and safety of two potential disease-modifying treatments for relapsing-remitting multiple sclerosis: ponesimod and ofatumumab. For the progressive forms, both available disease modifying treatments and others still in the research phase are reviewed. In the field of stem cell therapies, the article includes the results of the only clinical trial carried out to date comparing patients with relapsing-remitting multiple sclerosis treated with autologous haematopoietic stem cell transplantation and those treated with disease-modifying therapies. There are no important developments as regards symptomatic treatments, although the European Academy of Neurology has published a guide on palliative care. The various sources of information that collect pharmacovigilance data in the post-marketing setting are reviewed. CONCLUSIONS Patients diagnosed in recent years tend to have less severe multiple sclerosis, probably due to the fact that it is diagnosed in its milder stages together with the steady increase in the number of treatments available.
Collapse
Affiliation(s)
- O Fernández
- Instituto de Investigación Biomédica de Málaga. IBIMA, Málaga, España
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, España
| | - R Arroyo
- Hospital Quirón, Pozuelo de Alarcón, España
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, España
| | | | | | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, España
| | | | - S Eichau
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
| | - J A García-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, España
| | - R Ginestal
- Fundación Jiménez Díaz, 28040 Madrid, España
| | | | | | | | | | | | - A Oterino
- Hospital Universitario Marqués de Valdecilla, Santander, España
| | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, España
| | - J Río
- Hospitals Vall d'Hebron, 08035 Barcelona, España
| | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 Hospitalet de Ll., España
| | - N Téllez
- Hospital Clínico Universitario, 47005 Valladolid, España
| | | |
Collapse
|
7
|
Alves A, Alonso R, Cuevas A, Margarida AM, Pereira C A, Jannes E C, J. Krieger E, Arroyo R, Schreier L, Corral P, Bañares G V, Araujo M, Asenjo S, Stoll M, Dell'Oca N, Reyes X, Ressia A, Campo R, Merchan A, Magaña-Torres Teresa M, Vasques-Cardenas N A, Mata P, Santos R, Bourbon M. Molecular Aspects Of Homozygous Familial Hypercholesterolemia In Ibero-American Countries. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.654] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
8
|
Fernandez O, Tintore M, Saiz A, Calles-Hernandez MC, Comabella M, Ramio-Torrenta L, Oterino A, Izquierdo G, Tellez N, Garcia-Merino JA, Brieva L, Arnal-Garcia C, Aladro Y, Mendibe-Bilbao MM, Meca-Lallana JE, Romero-Pinel L, Martinez-Gines ML, Arroyo R, Oreja-Guevara C, Costa-Frossard L, Carrascal P, Rodriguez-Antiguedad A. Review of the novelties presented at the 2018 ECTRIMS Congress: 11th Post-ECTRIMS Meeting (II). Rev Neurol 2019; 68:468-479. [PMID: 31132136 DOI: 10.33588/rn.6811.2019121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The Post-ECTRIMS Meeting was held for the eleventh consecutive year in October 2018 in Madrid, with the aim of analysing the advances made in multiple sclerosis that were highlighted at the latest ECTRIMS annual congress. Based on the issues discussed at this meeting, attended by the nation's foremost opinion leaders on multiple sclerosis, two review articles are presented. This second part includes the growing body of evidence confirming the safety of exposure to disease-modifying treatments in women planning a pregnancy, and the beneficial effect of breastfeeding, provided that the disease is not very active. It addresses data showing how the application of the 2017 McDonald criteria in the paediatric population has significantly improved diagnosis compared to the previous criteria. With regard to progressive multiple sclerosis, the results of neuroprotective drugs are inconclusive, but biomarkers are proposed to improve the evaluation of the therapeutic response. Studies on myelin repair treatments suggest that remyelination in multiple sclerosis is possible. Likewise, there are favourable indications for haematopoietic stem cell transplantation, provided that patients are selected appropriately. On the other hand, we also conduct a review of the similarities and differences of the recommendations in the new clinical practice guidelines. Finally, the positive results of cognitive and motor rehabilitation with the use of new technologies point to the systematic incorporation of these tools in the treatment of the disease in the near future.
Collapse
Affiliation(s)
- O Fernandez
- Hospital Regional Universitario de Malaga, Malaga, Espana
| | - M Tintore
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - A Saiz
- Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana
| | | | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | | | - A Oterino
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | | | - N Tellez
- Hospital Clinico Universitario, 47005 Valladolid, Espana
| | - J A Garcia-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, Espana
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, Espana
| | - C Arnal-Garcia
- Hospital Universitario Virgen de las Nieves, 18013 Granada, Espana
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, Espana
| | | | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 Hospitalet de Ll., Espana
| | | | - R Arroyo
- Hospital Quiron, Pozuelo de Alarcon, Espana
| | | | | | | | | |
Collapse
|
9
|
Fernandez O, Tintore M, Saiz A, Calles-Hernandez MC, Comabella M, Ramio-Torrenta L, Oterino A, Izquierdo G, Tellez N, Garcia-Merino JA, Brieva L, Arnal-Garcia C, Aladro Y, Mendibe-Bilbao MM, Meca-Lallana JE, Romero-Pinel L, Martinez-Gines ML, Arroyo R, Oreja-Guevara C, Costa-Frossard L, Carrascal P, Rodriguez-Antiguedad A. [Review of the novelties presented at the 2018 ECTRIMS Congress: 11th Post-ECTRIMS Meeting (I)]. Rev Neurol 2019; 68:431-441. [PMID: 31070235 DOI: 10.33588/rn.6810.2019120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The Post-ECTRIMS Meeting is an emblematic event in Spain which seeks to review and disseminate the main advances in multiple sclerosis presented at the ECTRIMS annual congress. In October 2018, the eleventh Post-ECTRIMS meeting was held in Madrid and was attended by the country's leading experts in multiple sclerosis. As a result of this meeting, we present two articles which outline the most interesting novelties discussed there. This first part includes the latest results obtained regarding the influence of modifiable and non-modifiable risk factors in multiple sclerosis, with emphasis on the progress made in the field of genetics, where the discovery of genes associated with multiple sclerosis has increased exponentially. The complexity of the immune system is addressed and some contributions are made on autoimmunity mechanisms, in which bidirectional relations are observed between immune cells and cells residing in the central nervous system, such as microglial cells and astrocytes. Biomarkers, both in serum and cerebrospinal fluid as well as in imaging, are gaining more and more attention due to their current and, above all, potential role in the diagnosis and prognosis of the disease and in the evaluation of the efficacy of treatments. Finally, the observations made regarding changes in structural and functional connectivity in patients and their relationship with clinical alterations are presented.
Collapse
Affiliation(s)
- O Fernandez
- Hospital Regional Universitario de Malaga, Malaga, Espana
| | - M Tintore
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - A Saiz
- Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana
| | | | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | | | - A Oterino
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | | | - N Tellez
- Hospital Clinico Universitario, 47005 Valladolid, Espana
| | - J A Garcia-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, Espana
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, Espana
| | - C Arnal-Garcia
- Hospital Universitario Virgen de las Nieves, 18013 Granada, Espana
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, Espana
| | | | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 Hospitalet de Ll., Espana
| | | | - R Arroyo
- Hospital Quiron, Pozuelo de Alarcon, Espana
| | | | | | | | | |
Collapse
|
10
|
Pérez-Pérez S, Domínguez-Mozo MI, García-Martínez MÁ, Aladro Y, Martínez-Ginés M, García-Domínguez JM, López de Silanes C, Casanova I, Ortega-Madueño I, López-Lozano L, Torrejón MJ, Arroyo R, Álvarez-Lafuente R. Study of the possible link of 25-hydroxyvitamin D with Epstein-Barr virus and human herpesvirus 6 in patients with multiple sclerosis. Eur J Neurol 2018; 25:1446-1453. [PMID: 29996002 DOI: 10.1111/ene.13749] [Citation(s) in RCA: 15] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/10/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND PURPOSE Although the causes of multiple sclerosis (MS) remain partially unknown, environmental and genetic factors are thought to play a role in its aetiopathogenesis. Hypovitaminosis D, Epstein-Barr virus (EBV) and human herpesvirus 6 (HHV-6) infections have been described as possible MS triggers. Our aim was to analyse the possible link between 25-hydroxyvitamin D [25(OH)D] and viruses in patients with MS. METHODS We included 482 patients with MS in a 2-year study. Serum samples were collected to analyse 25(OH)D levels and, according to sample availability, antibody titres against EBV and HHV-6 by enzyme-linked immunosorbent assay. DNA was extracted from blood in order to analyse EBV and HHV-6 viral load by quantitative real-time polymerase chain reaction and to genotype MS-related single nucleotide polymorphisms (rs3135388, rs2248359 and rs12368653) when possible. RESULTS The 25(OH)D levels were significantly higher in the first semester of the year than in the second. Carriers of the risk allele rs2248359-C showed lower 25(OH)D levels than non-carriers. For EBV, viral load was significantly higher when 25(OH)D levels were low, demonstrating an inverse correlation between 25(OH)D levels and EBV load. CONCLUSIONS The 25(OH)D levels could be involved in the regulation of EBV replication/reactivation in patients with MS.
Collapse
Affiliation(s)
- S Pérez-Pérez
- Grupo Investigación EM, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid
| | - M I Domínguez-Mozo
- Grupo Investigación EM, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid
| | - M Á García-Martínez
- Grupo Investigación EM, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid
| | - Y Aladro
- Servicio Neurología, Hospital Universitario Getafe, Getafe
| | - M Martínez-Ginés
- Servicio Neurología, Hospital General Universitario Gregorio Marañón, Madrid
| | | | | | - I Casanova
- Servicio Neurología, Hospital Universitario Torrejón, Torrejón de Ardoz
| | - I Ortega-Madueño
- Servicio Análisis Clínicos, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid
| | - L López-Lozano
- Servicio Análisis Clínicos, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid
| | - M J Torrejón
- Servicio Análisis Clínicos, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid
| | - R Arroyo
- Servicio Neurología, Hospital Universitario Quironsalud Madrid, Madrid, Spain
| | - R Álvarez-Lafuente
- Grupo Investigación EM, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid
| |
Collapse
|
11
|
Fernandez O, Tintore M, Saiz A, Calles-Hernandez MC, Comabella M, Ramio-Torrenta L, Oterino A, Izquierdo G, Tellez N, Garcia-Merino JA, Brieva L, Arnal-Garcia C, Aladro Y, Mendibe-Bilbao MM, Meca-Lallana JE, Romero-Pinel L, Ginestal R, Martinez-Gines ML, Arroyo R, Rodriguez-Antiguedad A. [Review of the novelties from the 2017 ECTRIMS Congress, presented at the 10th Post-ECTRIMS Meeting (II)]. Rev Neurol 2018; 67:50-62. [PMID: 29971758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The Post-ECTRIMS Meeting is an emblematic event in the field of multiple sclerosis in Spain. Its chief aim is bring together the country's leading specialist neurologists to analyse the main advances made in multiple sclerosis and to review the most important topics addressed at the ECTRIMS Congress. The tenth Post-ECTRIMS Meeting was held in November 2017. Over the years this event has firmly established itself as an important meeting point where experts from all over the country get together to foster communication, establish synergies and promote and enhance research ultimately aimed at improving the prognosis and quality of life of patients with multiple sclerosis. This second part addresses the different strategies for the management of patients in advanced stages of the disease and the safety of therapy in multiple sclerosis. Likewise, attention is also drawn to the areas that require further scientific and clinical evidence. In this edition, particular importance is given to multiple sclerosis in the paediatric population and ageing in the disease. At the same time emphasis is placed on the need to conduct collaborative studies and to foster greater awareness among specialists regarding the detection and management of the comorbidities in multiple sclerosis.
Collapse
Affiliation(s)
- O Fernandez
- Hospital Regional Universitario de Malaga, Malaga, Espana
| | - M Tintore
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - A Saiz
- Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana
| | | | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | | | - A Oterino
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | - G Izquierdo
- Hospital Universitario Virgen Macarena, 41003 Sevilla, Espana
| | - N Tellez
- Hospital Clinico Universitario, 47005 Valladolid, Espana
| | - J A Garcia-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, Espana
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, Espana
| | - C Arnal-Garcia
- Hospital Universitario Virgen de las Nieves, 18013 Granada, Espana
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, Espana
| | | | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 L'Hospitalet de Llobregat, Espana
| | - R Ginestal
- Fundacion Jimenez Diaz, 28040 Madrid, Espana
| | | | - R Arroyo
- Hospital Quiron, Pozuelo de Alarcon, Espana
- Complejo Hospitalario Ruber, Madrid, Espana
| | | |
Collapse
|
12
|
Fernandez O, Tintore M, Saiz A, Calles-Hernandez MC, Comabella M, Ramio-Torrenta L, Oterino A, Izquierdo G, Tellez N, Garcia-Merino JA, Brieva L, Arnal-Garcia C, Aladro Y, Mendibe-Bilbao MM, Meca-Lallana JE, Romero-Pinel L, Ginestal R, Martinez-Gines ML, Arroyo R, Rodriguez-Antiguedad A. [Review of the novelties from the 2017 ECTRIMS Congress, presented at the 10th Post-ECTRIMS Meeting (I)]. Rev Neurol 2018; 67:15-27. [PMID: 29923596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The Post-ECTRIMS Meeting is an emblematic event in the field of multiple sclerosis in Spain. Its chief aim is bring together the country's leading specialist neurologists to analyse the main advances made in multiple sclerosis and to review the most important topics addressed at the ECTRIMS Congress. The tenth Post-ECTRIMS Meeting was held in November 2017. Over the years this event has firmly established itself as an important meeting point where experts from all over the country get together to foster communication, establish synergies and promote and enhance research ultimately aimed at improving the prognosis and quality of life of patients with multiple sclerosis. This first part reports on the publication of the new European and American clinical guidelines on the use of disease-modifying treatments and the new diagnostic criteria. It also discusses the strategies for following up patients treated with disease-modifying therapies, reviews cerebral atrophy and biomarkers of neurodegeneration and neuroinflammation, and analyses the role of neuroglia in pathogenesis and treatment. The study examines the natural history of the disease, with the evidence provided by registers, and we anticipate the future thanks to the progress being made in genetics and immunology.
Collapse
Affiliation(s)
- O Fernandez
- Hospital Regional Universitario de Malaga, Malaga, Espana
| | - M Tintore
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - A Saiz
- Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana
| | | | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | | | - A Oterino
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | - G Izquierdo
- Hospital Universitario Virgen Macarena, 41003 Sevilla, Espana
| | - N Tellez
- Hospital Clinico Universitario, 47005 Valladolid, Espana
| | - J A Garcia-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, Espana
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, Espana
| | - C Arnal-Garcia
- Hospital Universitario Virgen de las Nieves, 18013 Granada, Espana
| | - Y Aladro
- Hospital Universitario de Getafe, 28905 Getafe, Espana
| | | | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 L'Hospitalet de Llobregat, Espana
| | - R Ginestal
- Fundacion Jimenez Diaz, 28040 Madrid, Espana
| | | | - R Arroyo
- Hospital Quiron, Pozuelo de Alarcon, Espana
- Complejo Hospitalario Ruber, Madrid, Espana
| | | |
Collapse
|
13
|
Ramió-Torrentà L, Álvarez-Cermeño J, Arroyo R, Casanova-Estruch B, Fernández O, García-Merino J, Hernández M, Izquierdo G, Martínez-Yélamos S, Meca J, Moral E, Olascoaga J, Prieto J, Saiz A. A guide to treating gait impairment with prolonged-release fampridine (Fampyra ® ) in patients with multiple sclerosis. Neurología (English Edition) 2018. [DOI: 10.1016/j.nrleng.2015.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
14
|
Herreros-Villanueva M, Durán-Sanchón S, Martín A, Pérez-Palacios R, Vila-Navarro E, Marcuello M, Díaz-Centeno M, Cubiella J, Diez M, Bujanda L, Lanas A, Jover R, Hernández V, Quintero E, Lozano J, Martínez I, Castells A, Gironella M, Arroyo R. Plasma miRNAs signature validation for early detection of colorectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy149.017] [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: 11/14/2022] Open
|
15
|
Arroyo R, Martín-González A, Echaide M, Jain A, Brondyk W, Rosenbaum J, Moreno-Herrero F, Pérez-Gil J. Supramolecular Assembly of Human Pulmonary Surfactant Protein SP-D. J Mol Biol 2018; 430:1495-1509. [DOI: 10.1016/j.jmb.2018.03.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/26/2018] [Accepted: 03/26/2018] [Indexed: 11/15/2022]
|
16
|
Alari-Pahissa E, Moreira A, Zabalza A, Alvarez-Lafuente R, Munteis E, Vera A, Arroyo R, Alvarez-Cermeño JC, Villar LM, López-Botet M, Martínez-Rodríguez JE. Low cytomegalovirus seroprevalence in early multiple sclerosis: a case for the 'hygiene hypothesis'? Eur J Neurol 2018. [PMID: 29528545 DOI: 10.1111/ene.13622] [Citation(s) in RCA: 15] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND PURPOSE Cytomegalovirus (CMV) infection has recently been associated with a lower multiple sclerosis (MS) susceptibility, although it remains controversial whether it has a protective role or is merely an epiphenomenon related to westernization and early-life viral infections. We aimed to evaluate whether CMV serostatus may differ in patients with early MS as compared with patients with non-early MS, analyzing the putative association of this virus with MS clinical course and humoral immune responses against other herpesviruses. METHODS Multicentric analysis was undertaken of 310 patients with MS (early MS, disease duration ≤5 years, n = 127) and controls (n = 155), evaluating specific humoral responses to CMV, Epstein-Barr virus and human herpesvirus-6, as well as T-cell and natural killer (NK)-cell immunophenotypes. RESULTS Cytomegalovirus seroprevalence in early MS was lower than in non-early MS or controls (P < 0.01), being independently associated with disease duration (odds ratio, 1.04; 95% confidence interval, 1.01-1.08, P < 0.05). CMV+ patients with MS displayed increased proportions of differentiated T-cells (CD27-CD28-, CD57+, LILRB1+) and NKG2C+ NK-cells, which were associated with a lower disability in early MS (P < 0.05). CMV+ patients with early MS had an age-related decline in serum anti-EBNA-1 antibodies (P < 0.01), but no CMV-related differences in anti-human herpesvirus-6 humoral responses. CONCLUSIONS Low CMV seroprevalence was observed in patients with early MS. Modification of MS risk attributed to CMV might be related to the induction of differentiated T-cell and NK-cell subsets and/or modulation of Epstein-Barr virus-specific immune responses at early stages of the disease.
Collapse
Affiliation(s)
- E Alari-Pahissa
- Neurology Department, Hospital del Mar Medical Research Institute (IMIM), Barcelona
| | - A Moreira
- Neurology Department, Universitat Autònoma de Barcelona, Hospital del Mar Medical Research Institute (IMIM), Barcelona
| | - A Zabalza
- Neurology Department, Hospital del Mar Medical Research Institute (IMIM), Barcelona
| | - R Alvarez-Lafuente
- Neurology Service, Instituto de Investigación Sanitaria del Hospital Clínico de San Carlos, Madrid
| | - E Munteis
- Neurology Department, Hospital del Mar Medical Research Institute (IMIM), Barcelona
| | - A Vera
- Neurology Department, Hospital del Mar Medical Research Institute (IMIM), Barcelona
| | - R Arroyo
- Neurology Service, Hospital Universitario Quirónsaluld, Madrid
| | | | - L M Villar
- Immunology Department, Hospital Universitario Ramón y Cajal, Madrid
| | - M López-Botet
- Immunology Unit, University Pompeu Fabra, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | | |
Collapse
|
17
|
Fernandez O, Oterino A, Oreja-Guevara C, Prieto JM, Mendibe-Bilbao MM, Garcia-Merino JA, Ramio-Torrenta L, Ginestal R, Meca-Lallana JE, Romero-Pinel L, Munoz D, Oliva-Nacarino P, Calles-Hernandez MC, Izquierdo G, Martinez-Gines ML, Saiz A, Comabella M, Casanova-Estruch B, Brieva L, Arroyo R, Rodriguez-Antiguedad A. Review of the novelties from the 32nd ECTRIMS Congress, 2016, presented at the 9th Post-ECTRIMS Meeting (II). Rev Neurol 2017; 65:75-84. [PMID: 28675259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
For the ninth year in a row the Post-ECTRIMS Meeting has been held in Madrid (Spain) with the aim of presenting and discussing the hottest issues debated at the ECTRIMS Congress by renowned specialists in multiple sclerosis in our country. One outcome of this scientific activity, endorsed by the Spanish Neurology Society, is this review article, which is published in two parts. This second part reflects the current controversy over the management of multiple sclerosis, especially as regards the progressive forms and their differential diagnosis. The work presents the latest advances in remyelination, where the use of the micropillar technique in laboratory stands out, and in neuroprotection, which is reviewed through a study of the optic nerve. Anti-CD20 antibodies are a very promising development and we find ourselves before a new mechanism of action and therapeutic target in cells to which little attention has been paid to date. Another notable fact is the high correlation between the levels of neurofilaments in cerebrospinal fluid and in serum, which could make it possible to avoid the use of cerebrospinal fluid as a biological sample in future studies of biomarkers. The review also provides a preview of the advances in clinical research, which will converge in clinical practice in the future, thereby conditioning the steps that should be taken in the therapeutic management of multiple sclerosis.
Collapse
Affiliation(s)
- O Fernandez
- Hospital Regional Universitario de Malaga, Malaga, Espana
| | - A Oterino
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | | | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Espana
| | | | - J A Garcia-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, Espana
| | | | - R Ginestal
- Fundacion Jimenez Diaz, 28040 Madrid, Espana
| | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 L'Hospitalet de Llobregat, Espana
| | - D Munoz
- Hospital Alvaro Cunqueiro, Vigo, Espana
| | - P Oliva-Nacarino
- Hospital Universitario Central de Asturias, 33006 Oviedo, Espana
| | | | - G Izquierdo
- Hospital Universitario Virgen Macarena, 41003 Sevilla, Espana
| | | | - A Saiz
- Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana
| | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | | | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, Espana
| | - R Arroyo
- Hospital Quiron, Pozuelo de Alarcon, Espana
| | | |
Collapse
|
18
|
Mas A, Martínez A, de las Heras V, Bartolomé M, de la Concha EG, Arroyo R, Urcelay E. The 795CT polymorphism in osteopontin gene is not associated with multiple sclerosis in a Spanish population. Mult Scler 2017; 13:250-2. [PMID: 17439891 DOI: 10.1177/1352458506070944] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Multiple sclerosis (MS) is an inflammatory disease affecting the central nervous system. The dysregulation of the cytokine network is an important component of its pathogenesis. One of the cytokines produced by activated T-cells is osteopontin (OPN). OPN enhances the production of the pro-inflammatory cytokines, interleukin-12 and interferon-gamma, while reducing interleukin-10 levels. Therefore, OPN is considered a pro-inflammatory cytokine, and could play a key role in MS pathogenesis. The OPN gene contains several common polymorphisms, distributed in two main haplotypes, which may modulate its production or activity. A total of 326 MS patients and 484 healthy controls were typed for 795CT OPN polymorphism. In order to perform a familial study, 51 progenitor pairs were also included. No difference was found in the case-control or family study. This negative finding is inconsistent with a previous haplotype study in an Italian population, where the haplotype associated carried the low-frequency allele in position 795. In a Japanese population, a similar study yielded no association with this polymorphism. In conclusion, our data suggest that the 795 polymorphism does not play an etiological role per se and the haplotype structure may differ from one population to another. Multiple Sclerosis 2007; 13: 250–252. http://msj.sagepub.com
Collapse
Affiliation(s)
- A Mas
- Department of Immunology, Hospital Clínico San Carlos, C Prof Martín Lagos, s/n 28040, Madrid, Spain
| | | | | | | | | | | | | |
Collapse
|
19
|
Sánchez-Muniz F, Arroyo R, Sánchez-Montero J, Cuesta C. In vitro digestibility study of thermal oxidized palm oleins Estudio de la digestibilidad in vitro de oleínas de palma termooxidadas. FOOD SCI TECHNOL INT 2016. [DOI: 10.1177/108201320000600603] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Information on digestibility and absorption of oils and fats used for frying is under debate. To get knowledge on this, unused palm olein (9.27 ± 0.10% w/w polar content), used frying palm olein with a moderate degree of alteration (14.81 ± 0.90% w/w polar content) and highly altered used frying palm olein (26.36 ± 0.30% w/w polar content) and their respective nonpolar and polar fractions were studied. Samples were analyzed by high-performance size-exclusion chromatography before and after a 20-min in vitro incubation with pancreatic lipase. Formation of monoacylglycerols and free fatty acids reflected no relevant differences between unused and moderately altered oleins, whereas the most altered olein was hydrolyzed to a much lesser degree. The presence of oligomers (dimers and polymers of triacylglycerols) negatively affected the hydrolysis of triacylglycerol monomers in whole oleins. The hydrolysis of these monomers in the isolated nonpolar and polar fractions ranked between 60.2% and 78.5%. Oligomers were efficiently hydrolyzed by pancreatic lipase in whole un used and moderately altered oleins but not in the most altered one. Polymers from isolated polar fractions were poorly hydrolyzed or not hydrolyzed at all. These data suggest that whole oleins contained some compounds that increase susceptibility of oligomers to enzymatic hydrolysis and that such compounds were not present in the polar fraction.
Collapse
Affiliation(s)
- F.J. Sánchez-Muniz
- Departamento de Nutrición y Bromatología I (Nutrición), Sección Lípidos, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - R. Arroyo
- Departamento de Nutrición y Bromatología I (Nutrición), Sección Lípidos, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - J.M. Sánchez-Montero
- Departamento de Química Orgánica y Farmaceútica, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - C. Cuesta
- Instituto de Nutrición y Bromatología (CSIC-UCM), Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
| |
Collapse
|
20
|
Cristóbal F, Gómez-Ullate R, Cristóbal I, Arcocha A, Arroyo R. Hearing Results in the Second Stage of Open Mastoidectomy: A Comparison of the Different Techniques. Otolaryngol Head Neck Surg 2016; 122:748-51. [PMID: 10793359 DOI: 10.1016/s0194-5998(00)70209-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: The goal of this study was to compare the hearing results obtained through different hearing-restoration techniques in open-cavity mastoidectomy. METHODS AND MATERIAL: A total of 116 ears operated on during the second stage of open mastoidectomy were studied. The hearing gain was registered as the difference between preoperative and 1-year postoperative conversational frequency means (500, 1000, 2000 Hz). High-pitched frequencies (4000 Hz) were used equally. Two groups of studies were carried out: in one study the stapes was intact, and in the other the stapes arch was absent. The columella techniques we examined, from a hearing point of view, are total and partial ossicular replacement prostheses, ossiculoplasty, cartilage with or without perichondrium, and the myringostapediopexy. RESULTS AND CONCLUSIONS: In the group of patients in whom the stapes was intact, the differences in high-pitched frequencies found between the different techniques were negligible, but the differences were quite significant in conversational frequencies, where the partial ossicular replacement prosthesis turned out to be the technique with the worst results. In ears in which only the footplate was present, the total ossicular replacement prosthesis gave better results than any other technique, both in conversational frequencies and in 4000-Hz frequency.
Collapse
Affiliation(s)
- F Cristóbal
- ENT Department, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | | | | |
Collapse
|
21
|
Rio J, Rovira A, Blanco Y, Sainz A, Perkal H, Robles R, Ramio-Torrenta L, Diaz RM, Arroyo R, Urbaneja P, Fernandez O, Garcia-Merino JA, Reyes MP, Oreja-Guevara C, Prieto JM, Izquierdo G, Olascoaga J, Alvarez-Cermeno JC, Simon E, Pujal B, Comabella M, Montalban X. [Response to treatment with interferon beta in patients with multiple sclerosis. Validation of the Rio Score]. Rev Neurol 2016; 63:145-150. [PMID: 27439483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Different criteria have been proposed for the response to treatment with interferon beta, and the Rio Score is one of the most widely used. The aim of this study was to validate the usefulness of the Rio Score in an independent cohort. PATIENTS AND METHODS A multi-centre, prospective, longitudinal study was conducted on patients with relapsing-remitting multiple sclerosis treated with interferon beta. The patients were classified according to the presence of attacks, active lesions (new in T2 or gadolinium enhancing lesions) in magnetic resonance imaging, a confirmed increase in disability or combinations of these variables (attacks, increase on the Expanded Disability Status Scale and active lesions) after one year's treatment. Regression analysis was used in order to identify the response-predicting variables after a three-year follow-up. RESULTS The sample consisted of 249 patients with relapsing-remitting multiple sclerosis. The logistic model confirmed that the presence of two (odds ratio = 6.6; CI 95% = 2.7-16.1; p < 0.0001) or three (odds ratio = 8.5; CI 95% = 1.6-46; p < 0.01) positive variables during the first year of treatment were indicative of a significant risk of activity (attacks or progression) in the next two years. CONCLUSIONS The usefulness of the Rio Score is confirmed, in an independent cohort, as a means of identifying patients with a higher risk of developing clinical activity or progression of disability during treatment with interferon beta.
Collapse
Affiliation(s)
- J Rio
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - A Rovira
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - Y Blanco
- Hospital Clinic de Barcelona, 08036 Barcelona, Espana
| | - A Sainz
- Hospital Clinic de Barcelona, 08036 Barcelona, Espana
| | - H Perkal
- Hospital Universitari Dr. Josep Trueta, 17007 Girona, Espana
| | - R Robles
- Hospital Universitari Dr. Josep Trueta, 17007 Girona, Espana
| | | | - R M Diaz
- Hospital Universitari Son Espases, Palma de Mallorca, Espana
| | - R Arroyo
- Hospital Clinico San Carlos, 28040 Madrid, Espana
| | - P Urbaneja
- Hospital Regional Universitario Carlos Haya, Malaga, Espana
| | - O Fernandez
- Hospital Regional Universitario Carlos Haya, Malaga, Espana
| | | | - M P Reyes
- Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Espana
| | - C Oreja-Guevara
- UAM. Universidad Autonoma de Madrid. Hospital Universitario La Paz, 28046 Madrid, Espana
| | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Espana
| | - G Izquierdo
- Hospital Universitario Virgen Macarena, 41003 Sevilla, Espana
| | - J Olascoaga
- Hospital Donostia, 20014 San Sebastian, Espana
| | | | - E Simon
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - B Pujal
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - X Montalban
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| |
Collapse
|
22
|
Fernández O, Arroyo R, Martínez-Yélamos S, Marco M, Merino JAG, Muñoz D, Merino E, Roque A. Long-Term Adherence to IFN Beta-1a Treatment when Using RebiSmart® Device in Patients with Relapsing-Remitting Multiple Sclerosis. PLoS One 2016; 11:e0160313. [PMID: 27526201 PMCID: PMC4985132 DOI: 10.1371/journal.pone.0160313] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 01/11/2016] [Accepted: 07/18/2016] [Indexed: 12/26/2022] Open
Abstract
The effectiveness of disease-modifying drugs in the treatment of multiple sclerosis is associated with adherence. RebiSmart® electronic device provides useful information about adherence to the treatment with subcutaneous (sc) interferon (IFN) β-1a (Rebif®). The aim of the study was to determine long-term adherence to this treatment in patients with relapsing-remitting multiple sclerosis (RRMS). This retrospective multicentre observational study analysed 258 patients with RRMS who were receiving sc IFN β-1a (Rebif®) treatment by using RebiSmart® until replacement (36 months maximum lifetime) or treatment discontinuation. Adherence was calculated with data (injection dosage, time, and date) automatically recorded by RebiSmart®. Patients in the study had a mean age of 41 years with a female proportion of 68%. Mean EDSS score at start of treatment was 1.8 (95% CI, 1.6-1.9). Overall adherence was 92.6% (95% CI, 90.6-94.5%). A total of 30.2% of patients achieved an adherence rate of 100%, 80.6% at least 90%, and only 13.2% of patients showed a suboptimal adherence (<80%). A total of 59.9% of subjects were relapse-free after treatment initiation. Among 106 subjects (41.1%) who experienced, on average, 1.4 relapses, the majority were mild (40.6%) or moderate (47.2%). Having experienced relapses from the beginning of the treatment was the only variable significantly related to achieving an adherence of at least 80% (OR = 3.06, 1.28-7.31). Results of this study indicate that sc IFN β-1a administration facilitated by RebiSmart® could lead to high rates of adherence to a prescribed dose regimen over 36 months.
Collapse
Affiliation(s)
- O. Fernández
- Hospitales Universitarios Regional de Málaga y Virgen de la Victoria, Universidad de Málaga, IBIMA
| | - R. Arroyo
- Hospital U. Clínico San Carlos, Madrid
| | | | - M. Marco
- Corporació Sanitaria Parc Taulí, Barcelona
| | | | | | | | | | | |
Collapse
|
23
|
Fernandez O, Rodriguez-Antiguedad A, Olascoaga J, Oreja-Guevara C, Prieto JM, Mendibe-Bilbao MM, Garcia-Merino JA, Ramio-Torrenta L, Ginestal R, Meca-Lallana JE, Romero-Pinel L, Munoz D, Saiz A, Calles-Hernandez MC, Izquierdo G, Villar LM, Oliva-Nacarino P, Arnal-Garcia C, Comabella M, Brieva L, Arroyo R, Montalban X. Review of the novelties from the 31st ECTRIMS Congress, 2015, presented at the 8th Post-ECTRIMS meeting. Rev Neurol 2016; 62:559-569. [PMID: 27270678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Renowned national specialists in multiple sclerosis (MS) met, for the eighth year in a row, to give details of the latest novelties presented at the last ECTRIMS Congress 2015, which are included in this review. One of the highlights at this Congress was the new classification of the phenotypes of MS. Both the diagnostic criteria of the neuromyelitis optica spectrum and the problems involved in the differential diagnosis derived from the lack of definition of the radiological spectrum were reviewed. The microbiota comes to the fore as a possible factor determining the disease, together with extrinsic factors such as tobacco, salt ingestion or vitamin D deficiency. Advances made in immunomodulation are driving the progress being made in the treatment of MS. Ocrelizumab is the first treatment with positive results in the primarily progressive forms and tocilizumab, a drug product for rheumatoid arthritis, stands out as a potential candidate for the treatment of neuromyelitis optica. Certain antibiotics and vitamins could also play a role in the treatment of MS. In this edition of the Congress special attention was paid to personalised therapy. To date, 11 drugs have been approved for use in Europe. There is a need for therapeutic algorithms that help us to choose the best treatment for each patient. Likewise, we need to be able to identify, in the early stages of the disease, the risk of developing disability, so as to be able to design therapeutic strategies. To do so, molecular biomarkers and other predictive tools are required. The problems that still exist in software technology in magnetic resonance hinder its application in daily clinical practice.
Collapse
Affiliation(s)
- O Fernandez
- Fundacion IMABIS, Hospital Universitario Carlos Haya, 29190 Malaga, Espana
| | | | - J Olascoaga
- Hospital Donostia, 20014 San Sebastian, Espana
| | | | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Espana
| | | | - J A Garcia-Merino
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, Espana
| | | | - R Ginestal
- Fundacion Jimenez Diaz, 28040 Madrid, Espana
| | | | - L Romero-Pinel
- Hospital General Universitari de Bellvitge, 08907 L'Hospitalet de Llobregat, Espana
| | - D Munoz
- Hospital Alvaro Cunqueiro, Vigo, Espana
| | - A Saiz
- Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana
| | | | - G Izquierdo
- Hospital Universitario Virgen Macarena, 41003 Sevilla, Espana
| | | | - P Oliva-Nacarino
- Hospital Universitario Central de Asturias, 33006 Oviedo, Espana
| | - C Arnal-Garcia
- Hospital Universitario Virgen de las Nieves, 18013 Granada, Espana
| | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - Ll Brieva
- Hospital Arnau de Vilanova, 25198 Lleida, Espana
| | - R Arroyo
- Hospital Quiron, Pozuelo de Alarcon, Espana
| | - X Montalban
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| |
Collapse
|
24
|
Domínguez-Mozo MI, García-Montojo M, Arias-Leal A, García-Martínez Á, Santiago JL, Casanova I, Galán V, Arroyo R, Fernández-Arquero M, Alvarez-Lafuente R. Monitoring the John Cunningham virus throughout natalizumab treatment in multiple sclerosis patients. Eur J Neurol 2015; 23:182-9. [DOI: 10.1111/ene.12834] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 08/04/2015] [Indexed: 12/21/2022]
Affiliation(s)
- M. I. Domínguez-Mozo
- Department of Neurology; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Hospital Clínico San Carlos; Madrid Spain
| | - M. García-Montojo
- Department of Neurology; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Hospital Clínico San Carlos; Madrid Spain
| | - A. Arias-Leal
- Department of Neurology; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Hospital Clínico San Carlos; Madrid Spain
| | - Á. García-Martínez
- Department of Neurology; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Hospital Clínico San Carlos; Madrid Spain
| | - J. L. Santiago
- Department of Immunology; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Hospital Clínico San Carlos; Madrid Spain
| | - I. Casanova
- Department of Neurology; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Hospital Clínico San Carlos; Madrid Spain
| | - V. Galán
- Department of Neurology; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Hospital Clínico San Carlos; Madrid Spain
| | - R. Arroyo
- Department of Neurology; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Hospital Clínico San Carlos; Madrid Spain
| | - M. Fernández-Arquero
- Department of Immunology; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Hospital Clínico San Carlos; Madrid Spain
| | - R. Alvarez-Lafuente
- Department of Neurology; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Hospital Clínico San Carlos; Madrid Spain
| |
Collapse
|
25
|
Fernandez O, Alvarez-Cermeno JC, Arroyo R, Brieva L, Calles-Hernandez MC, Casanova-Estruch B, Comabella M, Garcia-Merino JA, Ginestal R, Izquierdo G, Meca-Lallana JE, Mendibe-Bilbao MM, Montalban X, Munoz-Garcia D, Olascoaga J, Oliva-Nacarino P, Oreja-Guevara C, Ramio-Torrenta L, Romero-Pinel L, Rodriguez-Antiguedad A, Saiz A, Tintore M, Grupo Post-Ectrims GPE. Review of the novelties from the 2014 ECTRIMS-ACTRIMS Joint Congress, presented at the 7th Post-ECTRIMS Meeting (II). Rev Neurol 2015; 61:271-283. [PMID: 26350778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
For the seventh year in a row the Post-ECTRIMS Meeting has been held in Madrid (Spain). Renowned specialists in multiple sclerosis and national leaders in this area have gathered once again to discuss the novelties presented at the 2014 ECTRIM-ACTRIMS World Congress. That meeting gave rise to this review, which is published in two parts. This second part shows that immunological phenomena are increasingly more present in the pathogenesis of the disease, and that the interaction between inflammation and neurodegeneration is becoming more apparent. Metabolic, mitochondrial dysfunction and oxidative stress phenomena are also involved in axonal degeneration and the experimental models open up the way to promising new therapeutic approaches for regenerative strategies. Although ambitious, inducible neural progenitor cells have become a promising alternative to the conventional treatments with stem cells, and the identification of new genetic variants of susceptibility to multiple sclerosis opens up the way to the discovery of new drugs. Reconsidering the value of old drugs and procedures would be another alternative therapeutic development.
Collapse
Affiliation(s)
- O Fernandez
- Fundacion IMABIS, Hospital Universitario Carlos Haya, 29190 Malaga, Espana
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Fernandez O, Alvarez-Cermeno JC, Arroyo R, Brieva L, Calles-Hernandez MC, Casanova-Estruch B, Comabella M, Garcia-Merino JA, Ginestal R, Izquierdo G, Meca-Lallana JE, Mendibe-Bilbao MM, Montalban X, Munoz-Garcia D, Olascoaga J, Oliva-Nacarino P, Oreja-Guevara C, Ramio-Torrenta L, Romero-Pinel L, Rodriguez-Antiguedad A, Saiz A, Tintore M, Grupo Post-Ectrims GPE. [Review of the novelties from the 2014 ECTRIMS-ACTRIMS Joint Congress, presented at the 7th Post-ECTRIMS meeting (I)]. Rev Neurol 2015; 61:215-224. [PMID: 26308843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
For the seventh year in a row the Post-ECTRIMS Meeting has been held in Madrid (Spain). Renowned specialists in multiple sclerosis and national leaders in this area have gathered once again to discuss the novelties presented at the 2014 ECTRIM-ACTRIMS World Congress. That meeting gave rise to this review, which will be published in two parts. One of the main conclusions in this first part is the deeper understanding of the genetic component of multiple sclerosis that we are acquiring, although it is still insufficient unless we bear in mind its interaction with the environmental risk factors of the disease or the impact of comorbidity and healthy habits on the patients' susceptibility and prognosis. In this respect, the authors insist on the fact that, in clinical practice, the cognitive and psychiatric disorders remain under-diagnosed and are rarely taken into account in clinical research. Yet, although scarce, the evidence we have points to the possible benefits of disease-modifying drugs and alternatives to treatment with selective serotonin reuptake inhibitors. Addressing the sub-populations in multiple sclerosis and variants of the disease enhances the importance of an early accurate diagnosis in order to offer patients a safer and more personalised prognosis and treatment. Paediatric multiple sclerosis is ideal for studying the risk factors of the disease but, given its low prevalence, the use of prospective studies raises a number of doubts and there is a preference for conducting collaborative studies.
Collapse
Affiliation(s)
- O Fernandez
- Fundacion IMABIS, Hospital Universitario Carlos Haya, 29190 Malaga, Espana
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Kappos L, Mehling M, Arroyo R, Izquierdo G, Selmaj K, Curovic-Perisic V, Keil A, Bijarnia M, Singh A, von Rosenstiel P. Randomized trial of vaccination in fingolimod-treated patients with multiple sclerosis. Neurology 2015; 84:872-9. [DOI: 10.1212/wnl.0000000000001302] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
28
|
Abstract
The use of culture-dependent and -independent techniques to study the human milk microbiota and microbiome has revealed a complex ecosystem with a much greater diversity than previously anticipated. The potential role of the milk microbiome appears to have implications not only for short- and long-term infant health but also for mammary health. In fact, mammary disbiosis, which may be triggered by a variety of host, microbial and medical factors, often leads to acute, subacute or subclinical mastitis, a condition that represents the first medical cause for undesired weaning. Multiresistance to antibiotics, together with formation of biofilms and mechanisms for evasion of the host immune response, is a common feature among the bacterial agents involved. This explains why this condition uses to be elusive to antibiotic therapy and why the development of new strategies for mastitis management based on probiotics is particularly appealing. In fact, selected lactobacilli strains isolated from breast milk have already shown a high efficacy for treatment.
Collapse
Affiliation(s)
- L Fernández
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain Probisearch SL, C/ Santiago Grisolía 2, 28760 Tres Cantos, Spain
| | - R Arroyo
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain
| | - I Espinosa
- Probisearch SL, C/ Santiago Grisolía 2, 28760 Tres Cantos, Spain
| | - M Marín
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain
| | - E Jiménez
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain
| | - J M Rodríguez
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain Probisearch SL, C/ Santiago Grisolía 2, 28760 Tres Cantos, Spain
| |
Collapse
|
29
|
Bisbe E, Moltó L, Arroyo R, Muniesa J, Tejero M. Randomized trial comparing ferric carboxymaltose vs oral ferrous glycine sulphate for postoperative anaemia after total knee arthroplasty. Br J Anaesth 2014; 113:402-9. [DOI: 10.1093/bja/aeu092] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
30
|
Espiño M, Abraira V, Arroyo R, Bau L, Cámara C, Campos-Ruiz L, Casanova B, Espejo C, Fernández O, García-Merino A, García-Sánchez MI, Gómez M, Gosis A, Izquierdo G, Meca J, Montalban X, Morandeira F, Olascoaga J, Prada A, Quintana E, Ramió-Torrentà L, Rodríguez-Antigüedad A, Salgado G, Santiago JL, Sarasola E, Simó-Castelló M, Alvarez-Cermeño JC, Villar LM. Assessment of the reproducibility of oligoclonal IgM band detection for its application in daily clinical practice. Clin Chim Acta 2014; 438:67-9. [PMID: 25110815 DOI: 10.1016/j.cca.2014.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 06/27/2014] [Revised: 07/18/2014] [Accepted: 08/03/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND The presence of oligoclonal IgM bands (OCMB) in cerebrospinal fluid (CSF) is an unfavourable prognostic marker in multiple sclerosis. There is no commercial test to investigate OCMB status. However, a sensitive and specific isoelectrofocusing (IEF) and western blot method was described. We aimed to study the inter-centre reproducibility of this technique, a necessary condition for a reliable test to be incorporated into clinical practice. METHODS The presence of OCMB was analysed by IEF and western blot with prior reduction of pentameric IgM. We assayed the reproducibility of this test in a blinded multicentre study performed in 13 university hospitals. Paired-CSF and serum samples from 52 neurological patients were assayed at every centre. RESULTS Global analysis rendered a concordance of 89.8% with a kappa value of 0.71. CONCLUSION These data indicate that OCMB detection by means of IEF and western blot with IgM reduction shows a good interlaboratory reproducibility and thus can be used in daily clinical setting.
Collapse
Affiliation(s)
- M Espiño
- Department of Immunology, Hospital Universitario Ramón y Cajal, Ctra de Colmenar Viejo km 9.100, 28034 Madrid, IRYCIS, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - V Abraira
- Department of Biostatistics, Hospital Universitario Ramón y Cajal, Ctra de Colmenar Viejo km 9.100, 28034 Madrid, IRYCIS, Spain
| | - R Arroyo
- Department of Neurology, Hospital Clínico San Carlos, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - L Bau
- Department of Neurology, Hospital Universitari de Bellvitge, Av. Granvia s/n, Hospitalet de Llobregat, Barcelona, Spain
| | - C Cámara
- Department of Immunology, Hospital San Pedro de Alcántara, Avenida Pablo Naranjo s/n, 10003 Cáceres, Spain
| | - L Campos-Ruiz
- Department of Neurology, Hospital Universitario Puerta de Hierro, Calle Manuel de Falla, 1, 28222 Majadahonda, Madrid, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - B Casanova
- Department of Neurology, Hospital Universitari La Fe, Avinguda Fernando Abril Martorell, 46026 Valencia, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - C Espejo
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - O Fernández
- Department of Neurology, Hospital Regional Universitario, Avda Carlos Haya, s/n, 29010 Málaga, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - A García-Merino
- Department of Neurology, Hospital Universitario Puerta de Hierro, Calle Manuel de Falla, 1, 28222 Majadahonda, Madrid, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - M I García-Sánchez
- Department of Neurology, Hospital Universitario Virgen Macarena, Avd. Dr. Fedriani, 3, 41007 Sevilla, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - M Gómez
- Department of Neurology, Hospital San Pedro de Alcántara, Avenida Pablo Naranjo s/n, 10003 Cáceres, Spain
| | - A Gosis
- Red Española de Esclerosis Múltiple (REEM), Spain; Immunology, Hospital Regional Universitario, Avda Carlos Haya, s/n, 29010 Málaga, Spain
| | - G Izquierdo
- Department of Neurology, Hospital Universitario Virgen Macarena, Avd. Dr. Fedriani, 3, 41007 Sevilla, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - J Meca
- Department of Neurology, Hospital Universitario Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - X Montalban
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - F Morandeira
- Immunology, Hospital Universitari de Bellvitge, Av. Granvia s/n, Hospitalet de Llobregat, Barcelona, Spain
| | - J Olascoaga
- Department of Neurology, Hospital Universitario Donostia, P° Dr. Beguiristain, 107-111, 20014 San Sebastián, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - A Prada
- Red Española de Esclerosis Múltiple (REEM), Spain; Department of Neurology, Hospital Universitario Donostia, P° Dr. Beguiristain, 107-111, 20014 San Sebastián, Spain
| | - E Quintana
- Unitat de Neuroimmunologia i Esclerosi Múltiple, Hospital Universitari Dr. Josep Trueta, Institut d'Investigació Biomèdica de Girona (IDIBGI), Avenida França, s/n, 17007 Girona, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - Ll Ramió-Torrentà
- Unitat de Neuroimmunologia i Esclerosi Múltiple, Hospital Universitari Dr. Josep Trueta, Institut d'Investigació Biomèdica de Girona (IDIBGI), Avenida França, s/n, 17007 Girona, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - A Rodríguez-Antigüedad
- Department of Neurology, Hospital Universitario Basurto, Av de Montevideo, 18, 48013 Bilbao, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - G Salgado
- Immunology, Hospital Universitario Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - J L Santiago
- Department of Neurology, Hospital Clínico San Carlos, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - E Sarasola
- Department of Neurology, Hospital Universitario Basurto, Av de Montevideo, 18, 48013 Bilbao, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - M Simó-Castelló
- Department of Neurology, Hospital Universitari La Fe, Avinguda Fernando Abril Martorell, 46026 Valencia, Spain; Red Española de Esclerosis Múltiple (REEM), Spain
| | - J C Alvarez-Cermeño
- Red Española de Esclerosis Múltiple (REEM), Spain; Department of Neurology, Hospital Universitario Ramón y Cajal, Ctra de Colmenar Viejo km 9.100, 28034 Madrid, IRYCIS, Spain
| | - L M Villar
- Department of Immunology, Hospital Universitario Ramón y Cajal, Ctra de Colmenar Viejo km 9.100, 28034 Madrid, IRYCIS, Spain; Red Española de Esclerosis Múltiple (REEM), Spain.
| |
Collapse
|
31
|
Mases A, Sabaté S, Guilera N, Sadurní M, Arroyo R, Fau M, Rojo A, Castillo J, Bover J, Sierra P, Canet J. Preoperative estimated glomerular filtration rate and the risk of major adverse cardiovascular and cerebrovascular events in non-cardiac surgery. Br J Anaesth 2014; 113:644-51. [PMID: 24928634 DOI: 10.1093/bja/aeu134] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Chronic kidney disease is an independent predictor of perioperative cardiovascular morbidity and mortality. We analysed the preoperative estimated glomerular filtration rate (eGFR) as a risk factor for perioperative major adverse cardiovascular and cerebrovascular events (MACCE) in non-cardiac surgery. METHODS In a post hoc analysis of the ANESCARDIOCAT database, patients were classified into six stages of eGFR calculated with the abbreviated Modification of Diet in Renal Disease Study and the Chronic Kidney Disease Epidemiology Collaboration equations: >90 (1), 60-89.9 (2), 45-59.9 (3a), 30-44.9 (3b), 15-29.9 (4), and <15 (5) ml min(-1) 1.73 m(-2). We analysed differences in MACCE, length of hospital stay, and all-cause mortality between eGFR stages. RESULTS The eGFR was available in 2323 patients. Perioperative MACCE occurred in 4.5% of patients and cardiac-related mortality was 0.5%. Five hundred and forty-three (23.4%) patients had an eGFR of <60 ml min(-1) 1.73 m(-2) and 127 (5.4%) had an eGFR below 45 ml min(-1) 1.73 m(-2). Logistic regression analysis showed that MACCE increased with eGFR impairment (P<0.001), with a marked increase from stage 3b onwards (odds ratio 1.8 vs 3.9 in 3a and 3b, respectively, P=0.047). All-cause mortality was not related to eGFR (P=0.071), but increased substantially between stages 3b and 4. The length of stay correlated with eGFR (P<0.001). CONCLUSIONS Perioperative MACCE increase with declining eGFR, primarily when <45 ml min(-1) 1.73 m(-2). We recommend the use of preoperative eGFR for cardiovascular risk assessment.
Collapse
Affiliation(s)
- A Mases
- Department of Anaesthesiology, Parc de Salut Mar, Pg. Marítim 25-29, 08003 Barcelona, Spain
| | - S Sabaté
- Department of Anaesthesiology and
| | - N Guilera
- Department of Anaesthesiology, Hospital de Sabadell, Sabadell, Spain
| | - M Sadurní
- Department of Anaesthesiology, Parc de Salut Mar, Pg. Marítim 25-29, 08003 Barcelona, Spain
| | - R Arroyo
- Department of Anaesthesiology, Parc de Salut Mar, Pg. Marítim 25-29, 08003 Barcelona, Spain
| | - M Fau
- Department of Anaesthesiology, Parc de Salut Mar, Pg. Marítim 25-29, 08003 Barcelona, Spain Department of Anaesthesiology, Vivantes Klinikum Hellersdorf, Berlin, Germany
| | - A Rojo
- Department of Anaesthesiology, Parc de Salut Mar, Pg. Marítim 25-29, 08003 Barcelona, Spain Department of Anaesthesiology, Centre Hospitalier Saint Palais, Sant Palais, France
| | - J Castillo
- Department of Anaesthesiology, Parc de Salut Mar, Pg. Marítim 25-29, 08003 Barcelona, Spain
| | - J Bover
- Department of Nephrology, Fundació Puigvert (IUNA), Barcelona, Spain
| | - P Sierra
- Department of Anaesthesiology and
| | - J Canet
- Department of Anaesthesiology, Hospital Germans Trias i Pujol, Badalona, Spain
| | | |
Collapse
|
32
|
Alenda R, Álvarez-Lafuente R, Costa-Frossard L, Arroyo R, Mirete S, Álvarez-Cermeño JC, Villar LM. Identification of the major HHV-6 antigen recognized by cerebrospinal fluid IgG in multiple sclerosis. Eur J Neurol 2014; 21:1096-1101. [PMID: 24724742 DOI: 10.1111/ene.12435] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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: 12/19/2013] [Accepted: 03/06/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Different data show an association between human herpesvirus 6 (HHV-6) and multiple sclerosis (MS). Intrathecal anti-HHV-6 immunoglobulin G (IgG) was detected in MS patients, but the antigen recognized by cerebrospinal fluid (CSF) IgG has not been characterized yet. Our objective was to identify the HHV-6 antigens recognized by IgG present in the CSF of patients with MS. METHODS Cerebrospinal fluid IgG of 15 MS patients and eight patients with other neurological diseases was purified on protein G Sepharose columns. Purified IgG from every patient was linked to a CNBr-activated Sepharose 4B column. Fifty micrograms of viral extract was applied to each column. Bound proteins were eluted and analysed by SDS-PAGE and silver staining. The viral protein was characterized by mass spectrometry. RESULTS A protein of 150 kD was eluted from CSF IgG columns of three of eight patients with primary progressive MS and one of seven with relapsing-remitting MS. After digestion and mass spectrometry analysis 10 peptides were found with 100% homology with the major capsid protein of the HHV-6A. DISCUSSION These findings confirm the presence of anti-HHV-6 IgG in CSF of MS patients, particularly in progressive forms, and identify major capsid protein as the major antigen recognized by CSF IgG from MS patients.
Collapse
Affiliation(s)
- R Alenda
- MS Unit, Departments of Immunology and Neurology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.,Red Española de Esclerosis Múltiple, Madrid, Spain
| | - R Álvarez-Lafuente
- Red Española de Esclerosis Múltiple, Madrid, Spain.,Department of Neurology, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - L Costa-Frossard
- MS Unit, Departments of Immunology and Neurology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.,Red Española de Esclerosis Múltiple, Madrid, Spain
| | - R Arroyo
- Red Española de Esclerosis Múltiple, Madrid, Spain.,Department of Neurology, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - S Mirete
- MS Unit, Departments of Immunology and Neurology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
| | - J C Álvarez-Cermeño
- MS Unit, Departments of Immunology and Neurology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.,Red Española de Esclerosis Múltiple, Madrid, Spain.,Department of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - L M Villar
- MS Unit, Departments of Immunology and Neurology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.,Red Española de Esclerosis Múltiple, Madrid, Spain
| |
Collapse
|
33
|
Fernández O, García-Merino JA, Arroyo R, Álvarez-Cermeño JC, Izquierdo G, Saiz A, Olascoaga J, Rodríguez-Antigüedad A, Prieto JM, Oreja-Guevara C, Hernández MA, Moral E, Meca J, Montalbán X. Spanish consensus on the use of natalizumab (Tysabri®)-2013. Neurologia 2013; 30:302-14. [PMID: 24360652 DOI: 10.1016/j.nrl.2013.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 09/25/2013] [Accepted: 10/13/2013] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Natalizumab treatment has been shown to be very efficacious in clinical trials and very effective in clinical practice in patients with relapsing-remitting multiple sclerosis, by reducing relapses, slowing disease progression, and improving magnetic resonance imaging patterns. However, the drug has also been associated with a risk of progressive multifocal leukoencephalopathy (PML). The first consensus statement on natalizumab use, published in 2011, has been updated to include new data on diagnostic procedures, monitoring for patients undergoing treatment, PML management, and other topics of interest including the management of patients discontinuing natalizumab. MATERIAL AND METHODS This updated version followed the method used in the first consensus. A group of Spanish experts in multiple sclerosis (the authors of the present document) reviewed all currently available literature on natalizumab and identified the relevant topics would need updating based on their clinical experience. The initial draft passed through review cycles until the final version was completed. RESULTS AND CONCLUSIONS Studies in clinical practice have demonstrated that changing to natalizumab is more effective than switching between immunomodulators. They favour early treatment with natalizumab rather than using natalizumab in a later stage as a rescue therapy. Although the drug is very effective, its potential adverse effects need to be considered, with particular attention to the patient's likelihood of developing PML. The neurologist should carefully explain the risks and benefits of the treatment, comparing them to the risks of multiple sclerosis in terms the patient can understand. Before treatment is started, laboratory tests and magnetic resonance images should be available to permit proper follow-up. The risk of PML should be stratified as high, medium, or low according to presence or absence of anti-JC virus antibodies, history of immunosuppressive therapy, and treatment duration. Although the presence of anti-JC virus antibodies is a significant finding, it should not be considered an absolute contraindication for natalizumab. This update provides general recommendations, but neurologists must use their clinical expertise to provide personalised follow-up for each patient.
Collapse
Affiliation(s)
- O Fernández
- Instituto de Neurociencias Clínicas, Servicio de Neurología, Hospital Regional Universitario Carlos Haya, Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud, Málaga, España.
| | - J A García-Merino
- Servicio de Neurología, Hospital Universitario Puerta de Hierro, Madrid, España
| | - R Arroyo
- Servicio de Neurología, Hospital Clínico Universitario San Carlos, Madrid, España
| | - J C Álvarez-Cermeño
- Servicio de Neurología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - G Izquierdo
- Servicio de Neurología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - A Saiz
- Servicio de Neurología, Hospital Clinic, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Barcelona, España
| | - J Olascoaga
- Servicio de Neurología, Hospital Universitario de Donostia, San Sebastián, España
| | | | - J M Prieto
- Servicio de Neurología, Hospital Clínico Universitario Santiago de Compostela, Santiago de Compostela, España
| | - C Oreja-Guevara
- Servicio de Neurología, Hospital Clínico Universitario San Carlos, Madrid, España
| | - M A Hernández
- Servicio de Neurología, Hospital Universitario Ntra. Sra. de la Candelaria, Tenerife, España
| | - E Moral
- Servicio de Neurología, Hospital de Sant Joan Despí Moisès Broggi, Barcelona, España
| | - J Meca
- Servicio de Neurología, Hospital Universitario Virgen de la Arrixaca, Murcia, España
| | - X Montalbán
- Centre d'Esclerosi Múltiple de Catalunya (CEMCAT), Hospital Universitari Vall d'Hebron, Barcelona, España
| |
Collapse
|
34
|
Morales F, Viniegra M, Arroyo R, Córdoba G, Zepeda TA. CO oxidation over CuO/ZrO2 catalysts: effect of loading and incorporation procedure of CuO. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/143307510x12639910071872] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- F. Morales
- Departamento de Química, Universidad Autónoma Metropolitana– Iztapalapa, 09340 México, DF, Mexico
| | - M. Viniegra
- Departamento de Química, Universidad Autónoma Metropolitana– Iztapalapa, 09340 México, DF, Mexico
| | - R. Arroyo
- Departamento de Química, Universidad Autónoma Metropolitana– Iztapalapa, 09340 México, DF, Mexico
| | - G. Córdoba
- Departamento de Química, Universidad Autónoma Metropolitana– Iztapalapa, 09340 México, DF, Mexico
| | - T. A. Zepeda
- Centro de Nanociencias y Nanotecnología UNAM, Km. 107 Carretera Tijuana-Ensenada, CP 22800, Ensenada, BC, Mexico
| |
Collapse
|
35
|
Dominguez-Mozo MI, Garcia-Montojo M, López-Cavanillas M, De Las Heras V, Garcia-Martinez A, Arias-Leal AM, Casanova I, Urcelay E, Arroyo R, Alvarez-Lafuente R. Toll-like receptor-9 in Spanish multiple sclerosis patients: an association with the gender. Eur J Neurol 2013; 21:537-40. [PMID: 23731219 DOI: 10.1111/ene.12209] [Citation(s) in RCA: 11] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 04/30/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Toll-like receptor-9 (TLR9) is a potent inducer of innate immune system triggered by infection with viruses, some of them previously related to multiple sclerosis (MS). The aim of this study was to analyze the possible association of two TLR9 single nucleotide polymorphisms (SNPs; rs352162 and rs187084) with susceptibility to MS. METHODS Two independent cohorts of MS patients and controls were included: 574 clinically definite relapsing-remitting MS patients (367 females) and 807 healthy controls (418 females) for the first cohort; and 366 relapsing-remitting MS patients (238 females) and 224 healthy controls (160 females) for the second cohort. Genotyping was performed by TaqMan assays. RESULTS The AT haplotype was found to be significantly higher in women than in men (P = 0.013 and P = 0.044). CONCLUSIONS Here two possible genetic markers are proposed that could be also associated with the differences observed in the clinical course of MS in both genders. Further studies with larger cohorts should be performed to confirm these results.
Collapse
Affiliation(s)
- M I Dominguez-Mozo
- Servicio de Neurología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Lopez de Lapuente A, Alloza I, Goertsches R, Zettl UK, Urcelay E, Arroyo R, Comabella M, Montalban X, Antigüedad A, Vandenbroeck K. Analysis of the IL28RA locus as genetic risk factor for multiple sclerosis. J Neuroimmunol 2012; 245:98-101. [PMID: 22386267 DOI: 10.1016/j.jneuroim.2012.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 01/24/2012] [Accepted: 02/06/2012] [Indexed: 01/07/2023]
Abstract
Recently, we reported an association between a SNP in IL28RA and MS. Here, we performed a fine-mapping of the IL28RA locus by genotyping 10 haplotype-tagging SNPs in a Basque-Spanish population. In addition, based on shared genetic risk loci between autoimmune diseases, a psoriasis-associated SNP located at this locus, rs4649203, was genotyped in four independent populations, comprising a total of 2582 cases and 2614 controls. We did not find any consistent association between IL28RA and MS in these populations, suggesting that, although it may play a role in other autoimmune diseases, this gene is unlikely of general relevance to MS pathogenesis.
Collapse
|
37
|
Cantó E, Reverter F, Morcillo-Suárez C, Matesanz F, Fernández O, Izquierdo G, Vandenbroeck K, Rodríguez-Antigüedad A, Urcelay E, Arroyo R, Otaegui D, Olascoaga J, Saiz A, Navarro A, Sanchez A, Domínguez C, Caminero A, Horga A, Tintoré M, Montalban X, Comabella M. Chitinase 3-like 1 plasma levels are increased in patients with progressive forms of multiple sclerosis. Mult Scler 2011; 18:983-90. [DOI: 10.1177/1352458511433063] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Chitinase 3-like 1 (CHI3L1) is upregulated in a wide variety of inflammatory conditions. Recent studies have pointed to a role of CHI3L1 in multiple sclerosis (MS) pathogenesis. Objective: The objective of this study was to investigate the role of plasma CHI3L1 in MS clinical course and disease activity and to evaluate the effect of interferon-beta (IFNβ) treatment on protein levels. Methods: Plasma CHI3L1 levels were determined by ELISA in 57 healthy controls (HC), 220 untreated MS patients [66 primary progressive MS patients (PPMS), 30 secondary progressive MS patients (SPMS), and 124 relapsing–remitting MS patients (RRMS), 94 during clinical remission and 30 during relapse], and 32 MS patients receiving IFNβ treatment. A polymorphism of the CHI3L1 gene, rs4950928, was genotyped in 3274 MS patients and 3483 HC. Results: Plasma CHI3L1 levels were significantly increased in patients with progressive forms of MS compared with RRMS patients and HC. CHI3L1 levels were similar between RRMS patients in relapse and remission. A trend towards decreased CHI3L1 levels was observed in IFNβ-treated patients. Allele C of rs4950928 was significantly associated with PPMS patients and with higher plasma CHI3L1 levels. Conclusions: These findings point to a role of CHI3L1 in patients with progressive forms of MS, particularly in those with PPMS.
Collapse
Affiliation(s)
- E Cantó
- Centre d’Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d’Hebron (HUVH), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F Reverter
- Departament d’Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - C Morcillo-Suárez
- Institute of Evolutionary Biology (UPF-CSIC), PRBB, Barcelona, Spain
- National Institute for Bioinformatics, Universitat Pompeu Fabra, Barcelona, Spain
| | - F Matesanz
- Instituto de Parasitología y Biomedicina López Neyra, Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - O Fernández
- Servicio de Neurología, Instituto de Neurociencias Clínicas, Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - G Izquierdo
- Unidad de Esclerosis Múltiple, Hospital Virgen Macarena, Sevilla, Spain
| | - K Vandenbroeck
- Neurogenomiks Group, Universidad del País Vasco (UPV/EHU), Leioa, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | | | - E Urcelay
- Servicio de Inmunología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - R Arroyo
- Unidad de Esclerosis Múltiple. Servicio de Neurología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - D Otaegui
- Multiple Sclerosis Unit, Biodonostia Institute, San Sebastián, Spain
| | - J Olascoaga
- Multiple Sclerosis Unit, Biodonostia Institute, San Sebastián, Spain
| | - A Saiz
- Service of Neurology, Hospital Clinic and Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
| | - A Navarro
- National Institute for Bioinformatics, Universitat Pompeu Fabra, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - A Sanchez
- Unitat d’Estadística i Bioinformàtica, Institut de Recerca, HUVH, Barcelona, Spain
| | - C Domínguez
- Molecular Biology and Biochemistry Research Center for Nanomedicine, Hospital Universitari Vall d’Hebron (HUVH), Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - A Caminero
- Centre d’Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d’Hebron (HUVH), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Horga
- Centre d’Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d’Hebron (HUVH), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Tintoré
- Centre d’Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d’Hebron (HUVH), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - X Montalban
- Centre d’Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d’Hebron (HUVH), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Comabella
- Centre d’Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d’Hebron (HUVH), Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
38
|
Fernández O, García-Merino JA, Arroyo R, Álvarez-Cermeño JC, Arbizu T, Izquierdo G, Saiz A, Olascoaga J, Rodríguez-Antigüedad A, Prieto JM, Oreja-Guevara C, Hernández MA, Montalbán X. Spanish consensus on the use of natalizumab (Tysabri(®))--2011. Neurologia 2011; 27:432-41. [PMID: 22078648 DOI: 10.1016/j.nrl.2011.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Accepted: 09/05/2011] [Indexed: 10/15/2022] Open
Abstract
INTRODUCTION Natalizumab is very effective at reducing relapses and delaying disease progression in patients with relapsing-remitting multiple sclerosis (RRMS). However, treatment has also been associated with a risk of progressive multifocal leukoencephalopathy (PML). The aim of this article is to provide a consensus view on the assessment and stratification of these risks, and to improve the management of natalizumab-treated patients. DEVELOPMENT At an initial meeting of experts on multiple sclerosis (the authors of this consensus), the relevant topics of the consensus were determined and assigned for further elaboration. Topics included how to establish benefit and risk in general, stratification for risk of PML, informing patients of benefits/risks, and how to monitor patients during treatment and after discontinuing treatment. During the drafting phase, all available information published or presented at international meetings was reviewed. After a series of review sessions and meetings, the final draft was produced. CONCLUSIONS Although natalizumab is a very effective drug, its use needs to be considered carefully in view of possible adverse effects and the risk of PML in particular. The neurologist should carefully explain the risks and benefits of treatment in terms the patient can best understand. Before starting treatment, baseline laboratory tests and magnetic resonance imaging (MRI) should be available for future comparisons in the event of suspected PML. The risk of PML should be stratified into high, medium and low risk groups according to presence or absence of anti-JC virus antibodies, prior immunosuppressive therapy, and treatment duration. The follow-up, and frequency of MRI scans in particular, should depend on the risk group to which patient belongs. As our understanding of the risk factors for PML develops, it should be possible to offer patients increasingly individualised therapy. This is a consensus that establishes general recommendations, but neurologists must use their clinical expertise to monitor patients individually.
Collapse
Affiliation(s)
- O Fernández
- Servicio de Neurología, Instituto de Neurociencias Clínicas, Hospital Regional Universitario Carlos Haya, IMABIS, Málaga, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Abraira V, Alvarez-Cermeño J, Arroyo R, Cámara C, Casanova B, Cubillo S, de Andrés C, Espejo C, Fernández O, Ferrer J, Figueredo M, García-Merino A, García-Sánchez M, García-Trujillo J, Gómez M, González-Oria C, Gosis A, Izquierdo G, Jímenez J, López-Trascasa M, Montalbán X, Moreno M, Muñoz D, Nuñez V, Muriel A, Navarro J, Olascoaga J, Oreja-Guevara C, Prada A, Ramil E, Ramo-Tello C, Rodríguez C, Rodríguez E, Rodríguez-Frías F, Rodríguez-Antigüedad A, Rodríguez-Molina J, Ruiz E, Saiz A, Sarasola E, Simó M, Yagüe J, Villar L. Utility of oligoclonal IgG band detection for MS diagnosis in daily clinical practice. J Immunol Methods 2011; 371:170-3. [DOI: 10.1016/j.jim.2011.06.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 06/06/2011] [Accepted: 06/08/2011] [Indexed: 11/29/2022]
|
40
|
Conrad M, Gorman A, Schilinger J, Sullivan S, Upcroft J, Gonzalez J, Fiori PL, Arroyo R, Ravel J, Secor WE, Carlton J. P4-S3.07 Population genomics of Trichomonas vaginalis reveals a globally distributed two-phylotype population structure. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.522] [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: 11/03/2022]
|
41
|
Garcia-Montojo M, De Las Heras V, Dominguez-Mozo M, Bartolome M, Garcia-Martinez MA, Arroyo R, Alvarez-Lafuente R. Human herpesvirus 6 and effectiveness of interferon beta 1b in multiple sclerosis patients. Eur J Neurol 2011; 18:1027-35. [DOI: 10.1111/j.1468-1331.2011.03410.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
42
|
Hernández-Clares R, Di Capua D, Bartolomé M, de las Heras V, Arroyo R. Balo's concentric sclerosis. Neurología (English Edition) 2011. [DOI: 10.1016/s2173-5808(11)70027-x] [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: 11/28/2022] Open
|
43
|
Fernández-Bergés D, Bertomeu-Gonzalez V, Sánchez PL, Cruz-Fernandez JM, Arroyo R, Barriales Álvarez V, Carrasco Sánchez FJ, Dalli E, Castro Beiras A, Kaski JC. Clinical scores and patient risk stratification in non-ST elevation acute coronary syndrome. Int J Cardiol 2010; 146:219-24. [PMID: 20439123 DOI: 10.1016/j.ijcard.2010.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 01/07/2010] [Accepted: 04/03/2010] [Indexed: 12/22/2022]
Abstract
BACKGROUND Risk stratification of patients with unstable angina or non-ST-segment elevation myocardial infarction (UA/NSTEMI) is problematic given the heterogeneous presentation of the condition. This study was undertaken to compare, in UA/NSTEMI patients, the prognostic value of two clinical risk scores (RS) (i.e. Thrombolysis in Myocardial Infarction (TIMI) and physician's risk assessment (PRA)) and to assess whether serum biomarkers can increase the prognostic accuracy of these RS. METHODS We prospectively assessed 610 consecutive UA/NSTEMI patients, 217 (36%) UA and 393 (64%) NSTEMI. In all patients RS, high sensitivity C-reactive protein, CD40 ligand, IL6, IL10, IL18, E-selectin, P-selectin, white blood cell count, neopterin, myeloperoxidase, fibrinogen and NT proBNP were assessed at study entry. The primary study endpoint was death and non-fatal MI at 30 and 360 days of follow-up. RESULTS At 1 year, 54 patients (8.9%) had reached the primary study endpoint (26 suffered a cardiac death (4.3%) and 34 (5.6%) a non-fatal MI). For both RS, the study endpoint occurred more commonly in patients at a "higher risk" compared to those classified as being at a "lower risk". Moreover, TIMI and PRA RS had similar discriminatory accuracy. TIMI RS, however, was a better predictor of events than PRA at both 30- and 360-day follow-up. The inflammatory biomarkers assessed in the study did not improve significantly the predictive value of RS. CONCLUSIONS Our study suggests both that TIMI RS is a better marker of risk than PRA RS and inflammatory biomarkers do not increase the predictive value of these clinical risk scores.
Collapse
Affiliation(s)
- D Fernández-Bergés
- Investigation Unit Don Benito-Villanueva, Fundesalud-Hospital Don Benito-Villanueva, Plaza de Conquistadores 49, Villanueva de la Serena, Badajoz, Spain.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Sánchez Muniz FJ, Cuesta C, Garrido-Polonio MC, Arroyo R. Fritura de patatas en aceite de girasol. Estudio comparativo del grado de alteración del aceite de la freidora y del extraído de las patatas. Grasas y Aceites 2010. [DOI: 10.3989/gya.1994.v45.i5.1016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
45
|
Fernández O, Fernández V, Arbizu T, Izquierdo G, Bosca I, Arroyo R, García Merino JA, de Ramón E. Characteristics of multiple sclerosis at onset and delay of diagnosis and treatment in Spain (the Novo Study). J Neurol 2010; 257:1500-7. [PMID: 20383518 DOI: 10.1007/s00415-010-5560-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 03/08/2010] [Accepted: 03/25/2010] [Indexed: 11/25/2022]
Abstract
Multiple sclerosis (MS) is a disease supposedly of autoimmune origin, with reactivity directed against myelin antigens. From the neuropathological point of view, MS produces inflammation, demyelination and axonal and neuronal degeneration. Inflammatory phenomena are predominant in the initial phase of the disease, followed later by neurodegenerative processes. Over the last decade, early treatment, during the most inflammatory phase of the disease, has been considered the best strategy to treat MS. Accordingly, we decided to determine the periods of delay between the first symptoms and the time to the first medical visit, the time to referral to a specialised MS unit, the delay in undertaking clinical and paraclinical tests, the diagnostic criteria used and the overall delay in diagnosis and treatment. The median time from onset of first symptoms to the first visit to a physician was 19.2 months, which represented the greatest delay. The median time between this initial medical consultation and the confirmation of the diagnosis by a specialised MS unit was 5.7 months, and the overall time from symptom onset to diagnosis was 24.9 months (2.08 years). The median time between onset of the first symptoms and the decision to give the first treatment was 2 years. The most important delay was that from symptom onset to the first medical visit, with the other delays being less. Thus, it is during this initial period that greater effort is required in order to reduce the time to diagnosis, by increasing awareness of the problem of MS among the general population and primary care physicians.
Collapse
Affiliation(s)
- O Fernández
- Hospital Regional Universitario Carlos Haya, Málaga, Spain.
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Martínez A, Varadé J, Márquez A, Cénit MC, Espino L, Perdigones N, Santiago JL, Fernández-Arquero M, de la Calle H, Arroyo R, Mendoza JL, Fernández-Gutiérrez B, de la Concha EG, Urcelay E. Association of the STAT4 gene with increased susceptibility for some immune-mediated diseases. ACTA ACUST UNITED AC 2010; 58:2598-602. [PMID: 18759272 DOI: 10.1002/art.23792] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The STAT4 gene encodes a transcription factor involved in the signaling pathways of several cytokines, including interleukin-12 (IL-12), the type I interferons, and IL-23. Recently, the association of a STAT4 haplotype marked by rs7574865 with rheumatoid arthritis (RA) and systemic lupus erythematosus was reported. The aim of this study was to investigate the role of this STAT4 tagging polymorphism in other immune-mediated diseases. METHODS The study group comprised 2,776 consecutively recruited Spanish individuals: 575 with RA, 440 with multiple sclerosis, 700 with inflammatory bowel disease, 311 with type 1 diabetes, and 723 ethnically matched healthy control subjects. The STAT4 polymorphism rs7574865 was genotyped using a predesigned TaqMan assay. Allele and genotype frequencies in patients and control subjects were compared by chi-square test. RESULTS The association of STAT4 polymorphism rs7574865 with RA was validated in patients of Spanish origin (for T versus G, P = 1.2 x 10(-6), odds ratio [OR] 1.59, 95% confidence interval [95% CI] 1.31-1.92), and the association was described for the first time in both clinical forms of inflammatory bowel disease, Crohn's disease and ulcerative colitis (for T versus G, P = 0.006, OR 1.29, 95% CI 1.07-1.55), and in type 1 diabetes mellitus (for T versus G, P = 0.008, OR 1.36, 95% CI 1.07-1.71). In contrast, the genotypic distribution of this polymorphism showed no difference between patients with multiple sclerosis and healthy control subjects (for T versus G, P = 0.83, OR 1.02, 95% CI 0.82-1.28). CONCLUSION The STAT4 gene is emerging as a novel common risk factor for diverse complex diseases.
Collapse
Affiliation(s)
- A Martínez
- Hospital Clínico San Carlos, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Cénit MC, Alcina A, Márquez A, Mendoza JL, Díaz-Rubio M, de las Heras V, Izquierdo G, Arroyo R, Fernández O, de la Concha EG, Matesanz F, Urcelay E. STAT3 locus in inflammatory bowel disease and multiple sclerosis susceptibility. Genes Immun 2010; 11:264-8. [PMID: 20200543 DOI: 10.1038/gene.2010.10] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
STAT3 (signal transducer and activator of transcription 3) signaling is a critical component of Th17-dependent autoimmune processes. Genome-wide association studies (GWAS) have revealed the role of the STAT3 gene in inflammatory bowel disease (IBD) susceptibility, although confirmation in clinical subphenotypes is warranted. Mice with targeted deletion of Stat3 in T cells are resistant to experimental autoimmune encephalomyelitis, which is a multiple sclerosis (MS) model. Moreover, increased phosphorylated STAT3 was reported in T cells of patients evolving from clinically isolated syndrome to defined MS and in relapsing patients. These evidences led us to analyze the role of STAT3 in Crohn's disease (CD), ulcerative colitis (UC) and MS risk. Polymorphisms in the STAT3 region (rs3809758/rs744166/rs1026916/rs12948909) were genotyped and the inferred haplotypes were subsequently analyzed in 860 IBD and 1540 MS Spanish patients and 1720 ethnically matched controls. The haplotype conformed by the risk alleles of each polymorphism was significantly associated with both clinical phenotypes of IBD (CD: P=0.005, odds ratio 1.25, 95% confidence interval 1.06-1.46; and UC: P=0.002, odds ratio 1.19, 95% confidence interval 1.02-1.38). No evidence of association was detected for MS. The originally described association of IBD with STAT3 polymorphisms is corroborated for the two clinical phenotypes, CD and UC, in an independent population. A major role of this gene in MS seems unlikely.
Collapse
Affiliation(s)
- M C Cénit
- Immunology Department, Hospital Clínico S Carlos, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Carvajal-Gamez B, Arroyo R, Lira R, López-Camarillo C, Alvarez-Sánchez ME. Identification of two novel Trichomonas vaginalis eif-5a genes. Infect Genet Evol 2010; 10:284-91. [PMID: 20060503 DOI: 10.1016/j.meegid.2009.12.008] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Revised: 12/17/2009] [Accepted: 12/25/2009] [Indexed: 11/19/2022]
Abstract
The eukaryotic translation initiation factor 5A (eIF-5A) is highly conserved and is the only protein that is known to contain the unique and essential amino acid residue hypusine. Synthesis of hypusine is essential for the function of eIF5A in eukaryotic cell proliferation and survival. In this study, we identified two novel eukaryotic translation initiation factor 5A (eIF-5A) genes in Trichomonas vaginalis. The tveif-5a1 and tveif-5a2 putative genes were localized in different contigs, both containing ORFs encoding proteins of 168 amino acids that share high sequence identity with eIF-5A sequences from other eukaryotic organisms. A phylogenetic tree constructed with TveIF-5A1 and TveIF-5A2 from T. vaginalis and 13 other eIF-5A sequences of eukaryotic and archaebacterial origin revealed that both trichomonal TveIF-5As show the highest degree of similarity to bacteria. Using an anti-TveIF-5A antibody, we detected two protein bands and spots of 19 and 20kDa with isoelectric points (pI) of 5.2 and 5.5, respectively, by one and two-dimensional Western blot assays. In addition, we used reverse transcription polymerase chain reaction (RT-PCR) to demonstrate that both of these tveif-5a genes are expressed in T. vaginalis. Immunofluorescence assays showed that the TveIF-5A protein was dispersed throughout the parasite cytoplasm. In conclusion, T. vaginalis has two eif-5a genes, and both genes are expressed as highly conserved proteins of 19kDa, which are localized in the cytoplasm of this parasite.
Collapse
Affiliation(s)
- B Carvajal-Gamez
- Posgrado en Ciencias Genómicas, Universidad Autónoma de la Ciudad de México (UACM). San Lorenzo # 290, Col. Del Valle, CP 03100 Mexico City, Mexico
| | | | | | | | | |
Collapse
|
49
|
Martínez A, Perdigones N, Cénit MC, Espino L, Varadé J, Lamas JR, Santiago JL, Fernández-Arquero M, de la Calle H, Arroyo R, de la Concha EG, Fernández-Gutiérrez B, Urcelay E. Chromosomal region 16p13: further evidence of increased predisposition to immune diseases. Ann Rheum Dis 2010; 69:309-11. [PMID: 19221398 DOI: 10.1136/ard.2008.098376] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Genome-wide studies have identified the chromosomal region 16p13 in the susceptibility to type 1 diabetes (T1D) and multiple sclerosis (MS). This region includes the CLEC16A/KIAA0350 gene and an adjacent gene, MHC2TA (MHC class II transactivator), previously associated with susceptibility to MS and rheumatoid arthritis (RA). The role of CLEC16A polymorphisms in the pathogenesis of T1D, MS and RA and its relationship with the association reported with a MHC2TA haplotype were investigated. METHODS CLEC16A (rs2903692/rs6498169/rs11074956) polymorphisms were analysed in 435 patients with MS, 316 with T1D and 600 with RA and in 550 ethnically matched controls. The MHC2TA rs3087456G/rs4774C risk haplotype was studied in an independent RA cohort. RESULTS rs2903692 conferred a protective effect on patients with T1D, MS and RA. The described association of rs6498169 with MS was replicated in MS and RA cohorts. The effect of the MHC2TA rs3087456G/rs4774C haplotype on RA susceptibility was confirmed, and the haplotype was found to be in negative linkage disequilibrium with the CLEC16A rs2903692A/rs6498169A haplotype. CONCLUSIONS Associations of CLEC16A polymorphisms with T1D and MS were successfully replicated in a Spanish population. A novel association of rs6498169 with a predisposition to RA was described which is consistent with previous MHC2TA results. These data provide evidence for the influence of variants within this chromosomal region on the development of complex diseases.
Collapse
Affiliation(s)
- A Martínez
- Immunology Department, Hospital Universitario Clínico San Carlos, Martin Lagos s/n, 28040 Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Garcia-Montojo M, Dominguez-Mozo MI, De Las Heras V, Bartolome M, Garcia-Martinez A, Arroyo R, Alvarez-Lafuente R. Neutralizing antibodies, MxA expression and MMP-9/TIMP-1 ratio as markers of bioavailability of interferon-beta treatment in multiple sclerosis patients: a two-year follow-up study. Eur J Neurol 2009; 17:470-8. [DOI: 10.1111/j.1468-1331.2009.02890.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|