1
|
Alfke H, Schimrigk S. Tumorimitierende Hirnstammläsion bei einer Erwachsenen mit Alexander Krankheit. ROFO-FORTSCHR RONTG 2016; 188:869-70. [DOI: 10.1055/s-0042-108211] [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: 10/21/2022]
|
2
|
Hoffmann F, Kraft A, Heigl F, Mauch E, Koehler J, Harms L, Kümpfel T, Köhler W, Klingel R, Fassbender C, Schimrigk S. [Tryptophan immunoadsorption for multiple sclerosis and neuromyelitis optica: therapy option for acute relapses during pregnancy and breastfeeding]. Nervenarzt 2015; 86:179-86. [PMID: 25604838 DOI: 10.1007/s00115-014-4239-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Approximately 25 % of women with multiple sclerosis (MS) suffer clinically relevant relapses during pregnancy. Almost all disease-modifying drugs are contraindicated in pregnancy. High-dose glucocorticoids have some serious risks, especially within the first trimester. Tryptophan immunoadsorption (IA) provides a safe option to treat MS relapses during pregnancy. OBJECTIVES In this case series we describe for the first time the use of tryptophan IA for MS and neuromyelitis optica (NMO) relapses during pregnancy and breastfeeding. PATIENTS AND METHODS In this study a total of 9 patients were retrospectively analyzed of which 7 patients received IA treatment during pregnancy, 2 during breastfeeding and 4-6 tryptophan IA treatments were performed per patient with the single use tryptophan adsorber. Primary outcome was symptom improvement of the relapse. RESULTS In this study four patients with MS and one with NMO relapse during pregnancy were treated with IA without preceding glucocorticoid pulse therapy. The MS patients showed improvement in the expanded disability status scale (EDSS) by at least one point, the NMO patient showed significant improvement in visual acuity and two pregnant patients with steroid-refractory relapses showed clinically relevant improvement after IA. Of the patients two suffered from steroid-refractory relapses during breastfeeding and relapse symptoms improved in both cases after treatment with IA. All treatments were well tolerated and no serious adverse events occurred. CONCLUSION Tryptophan IA was found to be safe, well-tolerated and effective in the treatment of MS and NMO relapses during pregnancy and breastfeeding, sometimes without preceding glucocorticoid pulse therapy. A binding recommendation is limited without prospective clinical studies.
Collapse
Affiliation(s)
- F Hoffmann
- Klinik für Neurologie, Krankenhaus Martha-Maria Halle-Dölau GmbH, Röntgenstr. 1, 06120, Halle (Saale), Deutschland,
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Schimrigk S, Adibi I, Eberl A, Selka I, Galle J, Schmidt S, Fritz H, Fassbender C, Klingel R, Füchtemann D, Hoffmann F. Immunadsorption zur Eskalation der Schubtherapie bei Multipler Sklerose. Akt Neurol 2012. [DOI: 10.1055/s-0032-1305029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - I. Adibi
- Klinik für Neurologie, Klinikum Lüdenscheid
| | - A. Eberl
- Klinik für Neurologie, Klinikum Lüdenscheid
| | - I. Selka
- Klinik für Neurologie, Klinikum Lüdenscheid
| | - J. Galle
- Klinik für Nephrologie und Dialyseverfahren, Klinikum Lüdenscheid
| | - S. Schmidt
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Krankenhaus Martha-Maria, Halle-Dölau
| | - H. Fritz
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Krankenhaus Martha-Maria, Halle-Dölau
| | | | | | | | - F. Hoffmann
- Klinik für Neurologie, Krankenhaus Martha-Maria, Halle-Dölau
| |
Collapse
|
4
|
Schimrigk S, Adibi I, Eberl A, Selka I, Galle J, Schmidt S, Fritz H, Fassbender C, Klingel R, Füchtemann D, Hoffmann F. Immunadsorption zur Eskalation der Schubtherapie bei Multipler Sklerose. Akt Neurol 2012. [DOI: 10.1055/s-0032-1321387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - I. Adibi
- Klinik für Neurologie, Klinikum Lüdenscheid
| | - A. Eberl
- Klinik für Neurologie, Klinikum Lüdenscheid
| | - I. Selka
- Klinik für Neurologie, Klinikum Lüdenscheid
| | - J. Galle
- Klinik für Nephrologie und Dialyseverfahren, Klinikum Lüdenscheid
| | - S. Schmidt
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Krankenhaus Martha-Maria, Halle-Dölau
| | - H. Fritz
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Krankenhaus Martha-Maria, Halle-Dölau
| | | | | | | | - F. Hoffmann
- Klinik für Neurologie, Krankenhaus Martha-Maria, Halle-Dölau
| |
Collapse
|
5
|
|
6
|
Khil L, Flachenecker P, Zettl UK, Elias W, Freidel M, Haas J, Pitschnau-Michel D, Schimrigk S, Rieckmann P. Patientenversorgung bei Multipler Sklerose: Vergleich der Basisdaten verschiedener Versorgungsstrukturen im Deutschen MS-Register. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238764] [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: 10/20/2022]
|
7
|
Stuke K, Flachenecker P, Zettl U, Elias W, Freidel M, Haas J, Pitschnau-Michel D, Schimrigk S, Rieckmann P. MS-Register in Deutschland 2008: Symptomatik der MS. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086850] [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: 10/21/2022]
|
8
|
Hellwig K, Brune N, Haghikia A, Müller T, Schimrigk S, Schwödiauer V, Gold R. Reproductive counselling, treatment and course of pregnancy in 73 German MS patients. Acta Neurol Scand 2008; 118:24-8. [PMID: 18205883 DOI: 10.1111/j.1600-0404.2007.00978.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [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: 11/29/2022]
Abstract
Multiple sclerosis (MS) often affects women during the reproductive years of their life. During this period, issues such as choice of immunomodulatory treatment, seeking advice from specialists, relapse-induced steroid application before, during or after pregnancy in combination with breastfeeding gain importance. The objective was to investigate these issues retrospectively using a questionnaire among 73 MS patients with a total of 88 pregnancies. Eighty per cent of the participants consulted their neurologists before and 60% during pregnancy. The annual relapse rate decreased during pregnancy and significantly increased during the first 3 months after delivery. Immunomodulatory treatment was stopped due to desired pregnancy for a mean of 4 years. Fourteen of the MS patients received intravenous immunoglobulin treatment post-natal. Ninety per cent of the study subjects started breastfeeding. However, nearly 30% ablactated, as they received steroids due to a relapse. Weight and height of the full-term children of singleton pregnancies from MS patients were significantly lower compared with the ones of age-matched healthy controls. Our results confirm the known reduced relapse rate during pregnancy, which is followed by an increased relapse rate after delivery. They shed light on the epidemiology of childbirth in patients with MS.
Collapse
Affiliation(s)
- K Hellwig
- Department of Neurology, St Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | | | | | | | | | | | | |
Collapse
|
9
|
|
10
|
Flachenecker P, Zettl UK, Stuke K, Elias W, Freidel M, Haas J, Pette M, Pitschnau-Michel D, Schimrigk S, Rieckmann P. MS-Register in Deutschland – Ergebnisse 2005/2006. Akt Neurol 2007. [DOI: 10.1055/s-2007-987983] [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: 10/21/2022]
|
11
|
Meyer C, Schröder A, Fischer M, Schimrigk S, Schlegel U, Chan A, Gold R. Plasmapherese in der eskalierenden Schubtherapie der Multiplen Sklerose: offene Nachbeobachtung. Akt Neurol 2007. [DOI: 10.1055/s-2007-987988] [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: 10/21/2022]
|
12
|
Hellwig K, Haghikia A, Schimrigk S, Gold R. Kinderwunsch und Multiple Sklerose Einstellungs- und Verschreibungsverhalten deutschsprachiger Neurologen. Akt Neurol 2007. [DOI: 10.1055/s-2007-987766] [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: 10/21/2022]
|
13
|
Haghikia A, Hellwig K, Fischer M, Brune N, Schimrigk S, Chan A, Gold R. Natalizumab (Tysabri®) neun Monate nach der Zulassung im klinischen Alltag: neutralisierende Antikörper und klinische Daten. Akt Neurol 2007. [DOI: 10.1055/s-2007-988005] [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: 10/21/2022]
|
14
|
Zipp F, Hartung HP, Hillert J, Schimrigk S, Trebst C, Stangel M, Infante-Duarte C, Jakobs P, Wolf C, Sandbrink R, Pohl C, Filippi M. Blockade of chemokine signaling in patients with multiple sclerosis. Neurology 2006; 67:1880-3. [PMID: 17130431 DOI: 10.1212/01.wnl.0000244420.68037.86] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [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: 11/15/2022] Open
Abstract
We assessed the safety and efficacy of orally administered CC chemokine receptor 1 (CCR1) antagonist in 105 patients with relapsing/remitting MS (RRMS) in a 16-week, randomized, double-blind, placebo-controlled trial. The primary endpoint was the cumulative number of newly active lesions on serial MRI scans. Other MRI, immunologic, and clinical outcomes were also explored. No significant treatment difference was observed for any tested MRI variable. CCR1 does not contribute to initial leukocyte infiltration in RRMS.
Collapse
Affiliation(s)
- F Zipp
- Institute of Neuroimmunology, Neuroscience Research Center, NWFZ 2680, Charité, 10098 Berlin, Germany.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Schimrigk S, Brune N, Hellwig K, Lukas C, Bellenberg B, Rieks M, Hoffmann V, Pöhlau D, Przuntek H. Oral fumaric acid esters for the treatment of active multiple sclerosis: an open-label, baseline-controlled pilot study. Eur J Neurol 2006; 13:604-10. [PMID: 16796584 DOI: 10.1111/j.1468-1331.2006.01292.x] [Citation(s) in RCA: 154] [Impact Index Per Article: 8.6] [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: 11/27/2022]
Abstract
An exploratory, prospective, open-label study of fumaric acid esters (FAE, Fumaderm(R)) was conducted in patients with relapsing-remitting multiple sclerosis (RRMS). The study consisted of the following four phases: 6-week baseline, 18-week treatment (target dose of 720 mg/day), 4-week washout, and a second 48-week treatment phase (target dose of 360 mg/day). Ten patients with an Expanded Disability Status Scale (EDSS) score of 2.0-6.0 and at least one gadolinium-enhancing (Gd+) lesion on T1-weighted magnetic resonance imaging (MRI) brain scans participated in the study. Safety was assessed by adverse events (AEs), blood chemistry/hematology, electrocardiogram, and urinalysis. The primary efficacy outcomes were number and volume of Gd+ lesions. Other clinical outcomes included EDSS score, ambulation index (AI), and nine-hole peg test (9-HPT). Effects of FAE on intracellular cytokine profiles, T-cell apoptosis, and soluble adhesion molecules were also assessed. Three patients withdrew during the first 3 weeks of the study because of side effects, non-compliance, and follow-up loss. The most common AEs were gastrointestinal symptoms and flushing; all AEs were reported as mild and reversible. FAE produced significant reductions from baseline in number (P < 0.05) and volume (P < 0.01) of Gd+ lesions after 18 weeks of treatment; this effect persisted during the second treatment phase at half the target dose after the 4-week washout period. EDSS scores, AI, and 9-HPT remained stable or slightly improved from baseline in all patients. Measures of T-cell function demonstrated alterations in cytokines and circulating tumor necrosis factor. The results of this exploratory study suggest that further studies of FAE in patients with MS are warranted.
Collapse
Affiliation(s)
- S Schimrigk
- Department of Neurology, St. Josef Hospital, Ruhr Universität Bochum, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Hoffmann V, Kuhn W, Schimrigk S, Islamova S, Hellwig K, Lukas C, Brune N, Pöhlau D, Przuntek H, Müller T. Repeat intrathecal triamcinolone acetonide application is beneficial in progressive MS patients. Eur J Neurol 2006; 13:72-6. [PMID: 16420395 DOI: 10.1111/j.1468-1331.2006.01145.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [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: 12/01/2022]
Abstract
Available immunomodulatory and conventional steroid treatment regimens provide a limited symptomatic benefit for patients with progressive multiple sclerosis (MS). We performed an open trial on the short-term efficacy of repeated intrathecal application of the sustained release steroid triamcinolone acetonide (TCA) in 27 progressive MS patients. Six TCA administrations, performed every third day, reduced the Expanded Disability Status Scale (EDSS) score [initial: 5.4+/-1.3, 3-7.5 (mean+/-SD, range); end: 4.9+/-1.1; 2.5-6.5; P<0.001] and significantly increased the walking distance and speed in particular after the fourth TCA injection. Concomitantly serially determined cerebrospinal fluid (CSF) markers of cell injury, neuron-specific enolase, total tau-protein, S-100, and beta-amyloid did not significantly change within the interval of TCA treatment. No serious side effects appeared. We conclude that repeat intrathecal injection of 40 mg TCA provides a substantial benefit in progressive MS patients with predominant spinal symptoms and does not alter CSF markers of neuronal cell injury.
Collapse
Affiliation(s)
- V Hoffmann
- Department of Neurology, Kamillus-Klinik, Asbach, and Department of Neurology, St Josef-Hospital, Ruhr-University, Bochum, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Flachenecker P, Zettl U, Stuke K, Elias W, Haas J, Pette M, Pitschnau-Michel D, Schimrigk S, Rieckmann P. MS-Register in Deutschland – modifizierter Basisdatensatz und Rekrutierung neuer Zentren. Akt Neurol 2006. [DOI: 10.1055/s-2006-953213] [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: 10/20/2022]
|
18
|
Maug S, Kaeder M, Schwenkreis P, Stückle K, Haupts M, Ahle G, Hellwig K, Schimrigk S. Mitoxantron bei Multipler Sklerose – Abbruchgründe und Folgetherapien. Akt Neurol 2006. [DOI: 10.1055/s-2006-953212] [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: 10/20/2022]
|
19
|
Flachenecker P, Zettl U, Götze U, Hennig M, Bertram J, Daumer M, Elias W, Eulitz M, Haas J, Hollweck R, Neiss A, Pette M, Pitschnau-Michel D, Schimrigk S, Rieckmann P. MS-Register in Deutschland - weitere Analysen und Ausweitung des Projektes. Akt Neurol 2005. [DOI: 10.1055/s-2005-919585] [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: 10/26/2022]
|
20
|
Deschauer M, Hudson G, Buttmann M, Schimrigk S, Busse K, Chinnery P, Zierz S. SANDO-Syndrom bei Patienten mit CPEO und multiplen Deletionen der mtDNA. Akt Neurol 2005. [DOI: 10.1055/s-2005-919444] [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: 10/26/2022]
|
21
|
Flachenecker P, Zettl UK, Götze U, Haas J, Schimrigk S, Elias W, Pette M, Eulitz M, Hennig M, Bertram J, Hollweck R, Neiss A, Daumer M, Pitschnau-Michel D, Rieckmann P. MS-Register in Deutschland — Design und erste Ergebnisse der Pilotphase. Nervenarzt 2005; 76:967-75. [PMID: 15806419 DOI: 10.1007/s00115-005-1907-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In the summer of 2001, a nationwide epidemiological multiple sclerosis (MS) register was initiated under the auspices of the German MS Society (DMSG). This project aimed at collecting epidemiological data on the number of patients with MS, course of the disease, and their social situation in Germany. During the 2-year pilot phase, five MS centers with various regional differences and treatment methods participated, leading to a representative selection of patients. In December 2003, standardised data sets of 3,458 MS patients were available for evaluation. After examining the quality of the data, 3,223 sets remained for further analysis. The demographics were similar to those obtained from other epidemiological studies: 72% of the patients were female, mean age was 42.9+/-11.2 years, mean disease duration 12.6+/-8.7 years, and 64% suffered from the relapsing-remitting form of the disease. The median EDSS was 3.0, and 69% of patients had an EDSS </=4.0. The great effect of this disorder was underscored by the fact that one third of the patients had prematurely retired due to MS. After successful completion of the pilot phase, the MS register will provide reliable data and thus serve as an important tool to improve the overall situation of MS patients in Germany.
Collapse
|
22
|
Fangerau T, Schimrigk S, Haupts M, Kaeder M, Ahle G, Brune N, Klinkenberg K, Kotterba S, Möhring M, Sindern E. Diagnosis of multiple sclerosis: comparison of the Poser criteria and the new McDonald criteria. Acta Neurol Scand 2004; 109:385-9. [PMID: 15147460 DOI: 10.1111/j.1600-0404.2004.00246.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [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: 11/28/2022]
Abstract
OBJECTIVES A confident and accurate diagnosis of multiple sclerosis (MS) is important, but a specific diagnostic test for the disease does not exist. The traditional diagnostic criteria of Poser et al. were published in 1983, and recently, McDonald et al. recommended new criteria for the diagnosis of MS. PATIENTS AND METHODS In this study these two diagnostic schemes were compared by prospectively applying both of them to 76 patients with clinical features suggesting a new diagnosis of MS. RESULTS Using the Poser criteria, 29 patients (38%) were classified as clinically definite and 35 patients (46%) as laboratory definite MS. According to the new McDonald criteria, MS was diagnosed in 39 (52%) patients, 37 patients (48%) had 'possible MS'. All patients with a clinically definite MS with the Poser criteria were also given the diagnosis of MS as recommended by McDonald et al. Of those 35 patients with laboratory definite MS according to Poser et al., four patients could be classified as having MS with the McDonald criteria, 89% of them had 'possible MS'. Conversely, 75% of the 39 patients, who fulfilled the new McDonald criteria for MS were assigned to the category of clinically definite MS according to the Poser criteria, and 83% of the patients with a 'possible MS' using the McDonald criteria, had a laboratory definite MS with the Poser criteria. CONCLUSION MS according to the McDonald criteria was diagnosed more often than 'clinically definite MS' according to Poser et al., but combining the categories of clinically and laboratory definite MS, the diagnosis of MS could clearly be established more frequently using the Poser criteria.
Collapse
Affiliation(s)
- T Fangerau
- BG-Kliniken Bergmannsheil Bochum, Bochum, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Flachenecker P, Hennig M, Götze U, Bertram J, Daumer M, Elias W, Eulitz M, Haas J, Hollweck R, Neiss A, Pette M, Pitschnau-Michel D, Schimrigk S, Schröder G, Schröder M, Steinmayr M, Zettl UK, Rieckmann P. Pilotphase eines epidemiologischen MS-Registers unter Federführung der Deutschen-Multiple-Sklerose-Gesellschaft (DMSG) - Ergebnisse der externen Qualitätsprüfung. Akt Neurol 2004. [DOI: 10.1055/s-2004-833108] [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: 10/28/2022]
|
24
|
Fangerau T, Schimrigk S, Haupts M, Kaeder M, Ahle G, Brune N, Klinkenberg K, Kotterba S, Möhring M, Sindern E. Diagnosis of multiple sclerosis: comparison of the Poser criteria and the new McDonald criteria. Acta Neurol Scand 2003. [DOI: 10.1046/j.1600-0404.2003.00246.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: 11/20/2022]
|
25
|
Miterski B, Böhringer S, Klein W, Sindern E, Haupts M, Schimrigk S, Epplen JT. Inhibitors in the NFkappaB cascade comprise prime candidate genes predisposing to multiple sclerosis, especially in selected combinations. Genes Immun 2002; 3:211-9. [PMID: 12058256 DOI: 10.1038/sj.gene.6363846] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2001] [Revised: 12/04/2001] [Accepted: 12/12/2001] [Indexed: 11/09/2022]
Abstract
Multiple sclerosis (MS) is an autoimmune disease displaying different clinical courses. In this multifactorial disease complex environmental as well as genetic predisposition factors contribute to the disease manifestation. Following the candidate gene approach we analysed several genes of the NFkappaB cascade, which are prime candidates for MS because of their involvement in almost all immunological reactions. MS association was excluded for the NFKB1 and NFKB3 genes, which show remarkably low degrees of polymorphism. The genes of NFkappaB inhibitors exhibit more sequence variations. In the IKBL gene a predisposing allele was identified (13.1% vs 7.5% in the control group, P < 0.001). This difference in the allelic distribution was even increased in the group of MS patients with a relapsing remitting course of the disease (14.9%, P < 0.0001). A protecting allele was found in the NFKBIA promotor for the patients with primary progressive MS (15.4% vs 28.4% in the control group, P < 0.01). Given predisposing alleles increase MS risk dramatically in certain combinations.
Collapse
Affiliation(s)
- B Miterski
- Department of Molecular Human Genetics, Ruhr-University, 44780 Bochum, Germany
| | | | | | | | | | | | | |
Collapse
|
26
|
Aktas O, Ari N, Rieks M, Hoffmann V, Schimrigk S, Przuntek H, Pöhlau D. Multiple sclerosis: modulation of apoptosis susceptibility by glatiramer acetate. Acta Neurol Scand 2001; 104:266-70. [PMID: 11696019 DOI: 10.1034/j.1600-0404.2001.00125.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 11/23/2022]
Abstract
OBJECTIVES We investigated whether therapy of multiple sclerosis (MS) with glatiramer acetate (GA) involves the modulation of programmed cell death (apoptosis) in disease-relevant T-helper lymphocytes. MATERIAL AND METHODS Blood was drawn from 15 relapsing-remitting MS patients both before (baseline) as well as 6, 12, and 18 weeks after GA therapy and from 15 healthy controls. Detection of apoptosis was performed in response to in vitro stimulation with GA, myelin basic protein or medium alone. RESULTS T-helper lymphocytes from untreated MS patients displayed an overall increased apoptosis susceptibility in vitro, compared to controls. During subsequent GA therapy, apoptosis vulnerability of these T cells in MS patients significantly declined under the initial baseline before treatment, and was finally equal in treated patients and controls. GA itself had no direct apoptosis-modulatory properties in vitro. CONCLUSION Our findings indicate that therapy of multiple sclerosis with glatiramer acetate presumably involves the compensation of altered apoptosis in T-helper lymphocytes.
Collapse
Affiliation(s)
- O Aktas
- Division of Neuroimmunology, Department of Neurology, Charité, Berlin, Germany.
| | | | | | | | | | | | | |
Collapse
|
27
|
Poehlau D, Kiltz U, Rieks M, Hoffmann V, Rebmann V, Schimrigk S, Grosse-Wilde H, Przuntek H. Therapeutic immunoadsorption increases the level of circulating soluble HLA molecules. Vox Sang 2000; 78:119-21. [PMID: 10765148 DOI: 10.1159/000031161] [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: 02/16/2023]
Abstract
BACKGROUND AND OBJECTIVES Immunoadsorption (IA) is an established procedure to remove Igs and immune complexes from peripheral blood. Since Igs reportedly bind to human leucocyte antigen (HLA) molecules, we were interested to know whether removal of Ig will also influence the plasma concentration of soluble HLA (sHLA). PATIENTS AND METHODS Nine patients suffering from severe autoimmune disease and undergoing 17 single courses of IA treatment were monitored for their sHLA class I (sHLA-I) and sHLA-DR plasma levels. Plasma was separated by a hollow-fiber-type separator. Plasma samples were taken before therapy, after 15 min of recirculation (without operating the adsorber), after 1 and 2 liters of plasma adsorption, and 24 and 48 h after the end of IA. RESULTS Before treatment the mean levels of sHLA-I and sHLA-DR were 0.37 (+/-0.06 SEM) and 0. 32+/-0.05 microg/ml, respectively. After 2 liters of plasma filtration, an increase in sHLA-DR (0.80+/-0.10 microg/ml) was observed (p<0.001), whereas sHLA-I was only slightly affected (mean: 0.45+/-0.06 microg/ml). sHLA concentrations returned to initial levels after 24 h. CONCLUSION The significant increase in sHLA-DR may contribute to the immunomodulatory effect of IA.
Collapse
Affiliation(s)
- D Poehlau
- Sauerlandklinik Hachen, Neurologische Spezialklinik, Sundern-Hachen, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Poehlau D, Kiltz U, Rieks M, Hoffmann V, Rebmann V, Schimrigk S, Grosse-Wilde H, Przuntek H. Therapeutic Immunoadsorption Increases the Level of Circulating Soluble HLA Molecules. Vox Sang 2000. [DOI: 10.1046/j.1423-0410.2000.7820119.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
29
|
Poehlau D, Postert T, Rieks M, Baier J, Nastos I, Amoiridis G, Schimrigk S, Hoffmann V, Przuntek H. [Mechanisms of action of intravenous immunoglobulins]. Fortschr Med 1996; 114:420-4. [PMID: 9036095] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Intravenous immunoglobulins (IVIG) are now used to treat various diseases, including autoimmune diseases, systemic inflammatory diseases, allografts and for replacement therapy in the case of IgG deficiency. Only in some of the indications has the efficacy of this treatment been confirmed in large-scale studies. Also, in many cases the modes of action remain unclear. Principally, the following therapeutic strategies can be differentiated: Replacement treatment, blocking of the effector molecules, influencing of the cellular and humoral limbs of the immune defence system and interaction with cytokines. In certain CNS diseases, displacement of pathological immunoglobulins may be involved. It would be desirable to acquire more detailed knowledge about modes of action with the aim of using IVIG with greater specificity in the future.
Collapse
Affiliation(s)
- D Poehlau
- Neurologische Klinik, St.-Josef-Hospital, Ruhr-Universität Bochum
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Affiliation(s)
- S Schimrigk
- Neurologische Abteilung, St. Joseph Hospital, Bochum, Deutschland
| | | |
Collapse
|
31
|
Schimrigk S, Rieks M, Bode A, Schilling P, Alberti T, Hörstgen H, Pöhlau D, Przuntek H. Quantitative analysis of intracellular TH1- AND TH2 cytokines and surface markers in patients with multiple sclerosis (MS) and control groups. J Neuroimmunol 1995. [DOI: 10.1016/0165-5728(95)99024-d] [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: 11/25/2022]
|