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Lebrun C, Vukusic S, Abadie V, Achour C, Ader F, Alchaar H, Alkhedr A, Andreux F, Androdias G, Arjmand R, Audoin B, Audry D, Aufauvre D, Autreaux C, Ayrignac X, Bailbe M, Benazet M, Bensa C, Bensmail D, Berger E, Bernady P, Bertagna Y, Biotti D, Blanchard-Dauphin A, Bonenfant J, Bonnan M, Bonnemain B, Borgel F, Botelho-Nevers E, Boucly S, Bourre B, Boutière C, Branger P, Brassat D, Bresch S, Breuil V, Brochet B, Brugeilles H, Bugnon P, Cabre P, Camdessanché JP, Carra-Dalière C, Casez O, Chamouard JM, Chassande B, Chataignier P, Chbicheb M, Chenet A, Ciron J, Clavelou P, Cohen M, Colamarino R, Collongues N, Coman I, Corail PR, Courtois S, Coustans M, Creange A, Creisson E, Daluzeau N, Davenas C, De Seze J, Debouverie M, Depaz R, Derache N, Divio L, Douay X, Dulau C, Durand-Dubief F, Edan G, Elias Z, Fagniez O, Faucher M, Faucheux JM, Fournier M, Gagneux-Brunon A, Gaida P, Galli P, Gallien P, Gaudelus J, Gault D, Gayou A, Genevray M, Gentil A, Gere J, Gignoux L, Giroux M, Givron P, Gout O, Grimaud J, Guennoc AM, Hadhoum N, Hautecoeur P, Heinzlef O, Jaeger M, Jeannin S, Kremer L, Kwiatkowski A, Labauge P, Labeyrie C, Lachaud S, Laffont I, Lanctin-Garcia C, Lannoy J, Lanotte L, Laplaud D, Latombe D, Lauxerois M, Le Page E, Lebrun-Frenay C, Lejeune P, Lejoyeux P, Lemonnier B, Leray E, Loche CM, Louapre C, Lubetzki C, Maarouf A, Mada B, Magy L, Maillart E, Manchon E, Marignier R, Marque P, Mathey G, Maurousset A, Mekies C, Merienne M, Michel L, Milor AM, Moisset X, Montcuquet A, Moreau T, Morel N, Moussa M, Naudillon JP, Normand M, Olive P, Ouallet JC, Outteryck O, Pacault C, Papeix C, Patry I, Peaureaux D, Pelletier J, Pichon B, Pittion S, Planque E, Pouget MC, Pourcher V, Radot C, Robert I, Rocher F, Ruet A, Ruet A, Saint-Val C, Salle JY, Salmon A, Sartori E, Schaeffer S, Stankhof B, Taithe F, Thouvenot E, Tizon C, Tourbah A, Tourniaire P, Vaillant M, Vermersch P, Vidil S, Wahab A, Warter MH, Wiertlewski S, Wiplosz B, Wittwer B, Zaenker C, Zephir H. Immunization and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society. Rev Neurol (Paris) 2019; 175:341-357. [DOI: 10.1016/j.neurol.2019.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 03/31/2019] [Accepted: 04/11/2019] [Indexed: 10/26/2022]
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Laplaud DA, Barbin L, Casey R, Debouverie M, Vukusic S, Labauge P, Brassat D, Wiertlewski S, De Seze J, Edan G, Brochet B, Moreau T, Berger E, Clavelou P, Castelnovo G, Ciron J, Pelletier J, Bourre B, Lubetzki C, Al Khedr A, Vermersch P, Lebrun-Frenay C, Defer G, Tourbah A, Camdessanche JP, Stankoff B, Labeyrie C, Patry I, Creange A, Gout O, Heinzlef O, Casez O, Magy L, Guennoc AM, De Broucker T, Nifle C, Dupel-Pottier C, Leray E, Rollot F, Foucher Y. Efficacité comparée du Teriflunomide et du Dimethyl-Fumarate : une étude observationnelle française multicentrique. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.04.009] [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: 10/16/2022] Open
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Ciron J, Audoin B, Bourre B, Brassat D, Durand-Dubief F, Laplaud D, Maillart E, Papeix C, Vukusic S, Zephir H, Marignier R, Collongues N. Recommendations for the use of Rituximab in neuromyelitis optica spectrum disorders. Rev Neurol (Paris) 2018; 174:255-264. [DOI: 10.1016/j.neurol.2017.11.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 11/07/2017] [Indexed: 01/08/2023]
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Lavie C, Rollot F, Durand-Dubief F, Marignier R, Ionescu I, Casey R, Moreau T, Tourniaire P, Hutchinson M, D’Hooghe MB, Laplaud DA, Clavelou P, De Sèze J, Debouverie M, Brassat D, Pelletier J, Lebrun-Frenay C, Le Page E, Castelnovo G, Berger E, Hautecoeur P, Heinzlef O, Durelli L, Clerico M, Trojano M, Patti F, Vukusic S, Alpérovitch A, Carton H, d’Hooghe M, Hommes O, Hutchinson M, Adeleine P, Biron A, Cortinovis-Tourniaire P, Grimaud J, Hours M, Moreau T, Vukusic S, Confavreux C, Chauplannaz G, Confavreux C, Cortinovis-Tourniaire P, Grimaud J, Latombe D, Moreau T, Clanet M, Lau G, Rumbach L, Goas J, Rouhart F, Mazingue A, Roullet E, Madigand M, Hautecoeur P, Brunet P, Edan G, Allaire C, Riffault G, Leche J, Benoit T, Simonin C, Ziegler F, Baron J, Rivrain Y, Dumas R, Loche D, Bourrin J, Huttin B, Delisse B, Gibert I, Boulay C, Verceletto M, Durand G, Bonneviot G, Gil R, Hedreville M, Belair C, Poitevin R, Devoize J, Wyremblewski P, Delestre F, Setiey A, Comi G, Filippi M, Ghezzi A, Martinelli V, Rossi P, Zaffaroni M, Tola M, Amato M, Fioretti C, Meucci G, Inglese M, Mancardi G, Gambi D, Thomas A, Cavazzuti M, Citterio A, Heltberg A, Hansen H, Fernandez O, Romero F, Arbizu T, Hernandez J, De Andres de Frutos C, Geffner Sclarky D, Aladro Benito Y, Reyes Yanes P, Aguilar M, Burguera J, Yaya R, Bonakim Dib W, Arzua-Mouronte D, d’Hooghe M, Sindic C, Carton H, Medaer R, Roose H, Geens K, Guillaume D, Van Zandycke M, Janssens J, Cornette M, Mol L, Weilbach F, Flachenecker P, Hartung H, Haas J, Tendolkar I, Sindrn E, Kölmel H, Reichel D, Rauch M, Preuss S, Poser S, Mauch E, Strausser-Fuchs S, Kolleger H, Hawkins S, Howell S, Rees J, Thompson A, Johnson M, Boggild M, Gregory R, Bates D, Bone I, Hutchinson M, Polman C, Frequin S, Jongen P, Hommes O, Correia de Sa J, Rio M, Huber S, Lechner-Scott J, Kappos L, Ionescu I, Cornu C, Confavreux C, Vukusic S, El-Etr M, Baulieu E, El-Etr M, Schumacher M, Ionescu I, Confavreux C, Cornu C, Vukusic S, Hartung H, Miller D, Hutchinson M, Pugeat M, d’Archangues C, Conard J, Ménard J, Sitruk-Ware R, Pelissier C, Dat S, Belaïsch-Allard J, Athéa N, Büschsenschutz D, Lyon-Caen O, Gonsette R, Boissel J, Ffrench P, Durand-Dubief F, Cotton F, Pachai C, Bracoud L, Vukusic S, Ionescu I, Androdias G, Marignier R, Chauplannaz G, Laplaud D, Wiertlewski S, Lanctin-Garcia C, Moreau T, Couvreur G, Madinier G, Clavelou P, Taithe F, Aufauvre D, Guy N, Ferrier A, De Sèze J, Collongues N, Debouverie M, Viala F, Brassat D, Gerdelat-Mas A, Henry P, Pelletier J, Rico-Lamy A, Lebrun-Frenay C, Lepage E, Deburghraeve V, Edan G, Castelnovo G, Berger E, Hautecoeur P, Blondiau M, Heinzlef O, Coustans M, Clerc C, Rieu L, Lauxerois M, Hinzelin G, Ouallet J, Minier D, Vion P, Gromaire-Fayolle N, Derache N, Thouvenot E, Sallansonnet-Froment M, Tourniaire P, Toureille L, Borgel F, Stankoff B, Grimaud J, Moroianu C, Guennoc A, Tournier-Gervason C, Peysson S, Trojano M, Patti F, D’Amico E, Motti L, Zaffaroni M, Durelli L, Tavella A. Neuraxial analgesia is not associated with an increased risk of post-partum relapses in MS. Mult Scler 2018; 25:591-600. [DOI: 10.1177/1352458518763080] [Citation(s) in RCA: 8] [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
Background: Obstetrical analgesia remains a matter of controversy because of the fear of neurotoxicity of local anesthetics on demyelinated fibers or their potential relationship with subsequent relapses. Objective: To assess the impact of neuraxial analgesia on the risk of relapse during the first 3 months post-partum, with a focus on women who experienced relapses during pregnancy. Methods: We analyzed data of women followed-up prospectively during their pregnancies and at least 3 months post-partum, collected in the Pregnancy in Multiple Sclerosis (PRIMS) and Prevention of Post-Partum Relapses with Progestin and Estradiol in Multiple Sclerosis (POPARTMUS) studies between 1992–1995 and 2005–2012, respectively. The association of neuraxial analgesia with the occurrence of a post-partum relapse was estimated by logistic regression analysis. Results: A total of 389 women were included, 215 from PRIMS and 174 from POPARTMUS. In total, 156 women (40%) had neuraxial analgesia. Overall, 24% experienced a relapse during pregnancy and 25% in the 3 months post-partum. Women with a pregnancy relapse were more likely to have a post-partum relapse (odds ratio (OR) = 1.83, p = 0.02), independently of the use of neuraxial analgesia. There was no association between neuraxial analgesia and post-partum relapse (OR = 1.08, p = 0.78). Conclusion: Neuraxial analgesia was not associated with an increased risk of post-partum relapses, whatever multiple sclerosis (MS) activity during pregnancy.
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Affiliation(s)
- Caroline Lavie
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France
| | - Fabien Rollot
- Observatoire Français de la Sclérose en Plaques (OFSEP),
Lyon, France
| | | | - Romain Marignier
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France/Centre de Recherche en Neurosciences de Lyon,
INSERM U1028, CNRS UMR5292, Equipe Neuro-Oncologie et Neuro-Inflammation, Lyon, France;
Université de Lyon 1, Lyon, France
| | - Iuliana Ionescu
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France
| | - Romain Casey
- Observatoire Français de la Sclérose en Plaques (OFSEP),
Lyon, France
| | - Thibault Moreau
- Department of Neurology, EA4184, University Hospital of
Dijon, Dijon, France
| | | | - Michael Hutchinson
- School of Medicine and Medical Science, University College
Dublin, Dublin, Ireland/Department of Neurology, St Vincent’s University Hospital,
Dublin, Ireland
| | - Marie Béatrice D’Hooghe
- National MS Center Melsbroek, Melsbroek, Belgium; Center
for Neurosciences, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - David-Axel Laplaud
- Service de Neurologie, CHU de Nantes, CIC015 INSERM,
Nantes, France/INSERM UMR1064, Nantes, France
| | - Pierre Clavelou
- Service de Neurologie, CHU de Clermont-Ferrand,
Clermont-Ferrand, France/INSERM UMR1107, Clermont Université, Université d’Auvergne,
Neuro-Dol, Clermont-Ferrand, France
| | - Jérôme De Sèze
- Department of Neurology, Clinical Investigation Center
INSERM 1434, Hôpitaux Universitaires de Strasbourg, FMTS INSERM 1119, Strasbourg,
France
| | - Marc Debouverie
- EA 4360 APEMAC, University of Lorraine, Nancy,
France/Department of Neurology, Nancy University Hospital, Nancy, France
| | - David Brassat
- Pôle Neurosciences, CHU Toulouse Purpan, Toulouse,
France/INSERM U1043, CNRS UMR 5282, Université Toulouse III, Toulouse, France
| | - Jean Pelletier
- Service de Neurologie, Hôpital de la Timone, Pôle de
Neurosciences Cliniques, AP-HM, Aix-Marseille Université, Marseille, France/CNRS,
Aix-Marseille Université, CRMBM UMR7339, Marseille, France
| | | | - Emmanuelle Le Page
- Clinical Neuroscience Centre, CIC-P 1414 INSERM, Rennes
University Hospital, Rennes, France
| | | | - Eric Berger
- Department of Neurology, CHU Besançon, Besançon,
France
| | - Patrick Hautecoeur
- Service de Neurologie, Groupement des Hôpitaux de
l’Institut Catholique de Lille, Lille, France
| | - Olivier Heinzlef
- Department of Neurology, Hôpital CHI de
Poissy/Saint-Germain-en-Laye, Paris, France
| | - Luca Durelli
- Division of Neurology, Department of Clinical and
Biological Sciences, University of Torino, San Luigi Gonzaga University Hospital,
Orbassano, Italy
| | - Marinella Clerico
- Division of Neurology, Department of Clinical and
Biological Sciences, University of Torino, San Luigi Gonzaga University Hospital,
Orbassano, Italy
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and
Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Patti
- Department of Medical and Surgical Sciences, and Advanced
Technologies, G.F. Ingrassia, Multiple Sclerosis Center, University of Catania, Catania,
Italy
| | - Sandra Vukusic
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France/Observatoire Français de la Sclérose en Plaques
(OFSEP), Lyon, France/Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS
UMR5292, Equipe Neuro-Oncologie et Neuro-Inflammation, Lyon, France/Université de Lyon
1, Lyon, France
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Denève M, Biotti D, Dumas H, Patsoura S, Ferrier M, Meluchova Z, Mahieu L, Heran F, Vignal C, Deschamps R, Gout O, Menjot de Champfleur N, Ayrignac X, Dallière C, Labauge P, Cognard C, Brassat D, Bonneville F. Caractéristiques IRM des neuromyélites optiques associées aux anticorps anti-MOG. J Neuroradiol 2018. [DOI: 10.1016/j.neurad.2018.01.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Le Berre L, Rousse J, Gourraud PA, Imbert-Marcille BM, Salama A, Evanno G, Semana G, Nicot A, Dugast E, Guérif P, Adjaoud C, Freour T, Brouard S, Agbalika F, Marignier R, Brassat D, Laplaud DA, Drouet E, Van Pesch V, Soulillou JP. Decrease of blood anti-α1,3 Galactose Abs levels in multiple sclerosis (MS) and clinically isolated syndrome (CIS) patients. Clin Immunol 2017; 180:128-135. [PMID: 28506921 DOI: 10.1016/j.clim.2017.05.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/17/2017] [Accepted: 05/05/2017] [Indexed: 02/07/2023]
Abstract
The etiology of multiple sclerosis (MS) remains elusive. Among the possible causes, the increase of anti-Neu5Gc antibodies during EBV primo-infection of Infectious mononucleosis (IMN) may damage the integrity of the blood-brain barrier facilitating the transfer of EBV-infected B cells and anti-EBV T cell clones in the brain. We investigated the change in titers of anti-Neu5Gc and anti-α1,3 Galactose antibodies in 49 IMN, in 76 MS, and 73 clinically isolated syndrome (CIS) patients, as well as age/gender-matched healthy individuals. Anti-Gal and anti-Neu5Gc are significantly increased during IMN (p=0.02 and p<1.10-4 respectively), but not in acute CMV primo-infection. We show that, whereas there was no change in anti-Neu5Gc in MS/CIS, the two populations exhibit a significant decrease in anti-Gal (combined p=2.7.10-3), in contrast with patients with non-MS/CIS central nervous system pathologies. Since anti-Gal result from an immunization against α1,3 Gal, lacking in humans but produced in the gut, our data suggest that CIS and MS patients have an altered microbiota or an altered response to this microbiotic epitope.
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Affiliation(s)
- L Le Berre
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.
| | - J Rousse
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France; Xenothera, Nantes, F44000 France
| | - P-A Gourraud
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - B-M Imbert-Marcille
- EA 4271 - Immunovirologie et Polymorphisme Génétique, Centre Hospitalo-Universitaire de Nantes, Nantes, F44093, France
| | - A Salama
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France; Xenothera, Nantes, F44000 France
| | - G Evanno
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France; Xenothera, Nantes, F44000 France
| | - G Semana
- INSERM, UMR 917 - University of Rennes, Rennes, F35016 France; EFS Bretagne Rennes, F35016 France
| | - A Nicot
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - E Dugast
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - P Guérif
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - C Adjaoud
- Centre Hospitalo-Universitaire de Nantes - Ecole Sages Femmes - Hopital Mere Enfant, Nantes, F44000 France
| | - T Freour
- Laboratoire de Biologie du Développement et de la Reproduction, CHU de Nantes, Nantes, F44093 France
| | - S Brouard
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - F Agbalika
- Unit of Virology, Saint-Louis Hospital AP-HP, Université Paris-Diderot, Paris VII F75010, France
| | - R Marignier
- INSERM UMR 1028 - Centre de Recherche en Neurosciences de Lyon, Faculté de médecine - RTH Laënnec, Lyon, F69372 France
| | - D Brassat
- Department of Neurology - CHU Toulouse, Toulouse, F31300 France
| | - D-A Laplaud
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - E Drouet
- Institute of Structural Biology, University Grenoble Alpes, UMR CNRS CEA UGA 5545 CEA, CNRS 38044 Grenoble, F38042 France
| | - V Van Pesch
- Unité de Neurochimie, Institute of Neuroscience, Université catholique de Louvain, Belgium
| | - J-P Soulillou
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
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Kuhle J, Hardmeier M, Disanto G, Gugleta K, Ecsedi M, Lienert C, Amato MP, Baum K, Buttmann M, Bayas A, Brassat D, Brochet B, Confavreux C, Edan G, Färkkilä M, Fredrikson S, Frontoni M, D'Hooghe M, Hutchinson M, De Keyser J, Kieseier BC, Kümpfel T, Rio J, Polman C, Roullet E, Stolz C, Vass K, Wandinger KP, Kappos L. A 10-year follow-up of the European multicenter trial of interferon β-1b in secondary-progressive multiple sclerosis. Mult Scler 2015; 22:533-43. [PMID: 26362898 DOI: 10.1177/1352458515594440] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 05/20/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To explore long-term effects of treatment and prognostic relevance of variables assessed at baseline and during the European secondary progressive multiple sclerosis (SPMS) trial of interferon beta 1b (IFNB-1b). METHODS We assessed 362 patients (60% female; median age 41 years; Expanded Disability Status Scale (EDSS): 5.5; 51% randomized to IFNB-1b) for their EDSS and treatment history after 10 years. Non-parametric analysis of covariance (ANCOVA) and multivariate linear regression models were applied. RESULTS Median EDSS was 6.0 at the end of the randomized controlled trial (RCT), in the IFNB-1b and placebo groups, and 7.0 in long-term follow-up patients (those receiving IFNB-1b in the RCT were 6.5 and those receiving placebo in the RCT were 7.0; p = 0.086). 24 patients (6.6%) were deceased. The EDSS at baseline and the EDSS change during the RCT were the most important predictors of the EDSS 10 years later (partial R(2): 0.47). The ability to predict changes in EDSS 10 years after the RCT was limited (R(2): 0.12). Magnetic resonance imaging (MRI) measures remained in the predictive models, but explained < 5% of the variability. CONCLUSIONS The results from this analysis did not provide convincing evidence to support a favorable long-term outcome in those patients allocated IFNB-1b during the RCT, in our SPMS cohort. The progressive stage of the disease remains largely unpredictable by clinical and conventional MRI measures, so better prognostic markers are needed.
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Affiliation(s)
- J Kuhle
- Neurology, Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel/Blizard Institute, Queen Mary University of London, Barts, UK/London School of Medicine and Dentistry, UK University Hospital Basel, Switzerland
| | - M Hardmeier
- Neurology, Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel
| | - G Disanto
- Blizard Institute, Queen Mary University of London, Barts, UK/London School of Medicine and Dentistry, UK. Neurocentre of Southern Switzerland, Ospedale Civico, Lugano, Switzerland
| | - K Gugleta
- Neurology, Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel
| | - M Ecsedi
- Neurology, Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel
| | - C Lienert
- Department of Medicine, Neurology, Kantonsspital Baselland Bruderholz, Switzerland
| | - M P Amato
- Department NEUROFARBA, Section Neurosciences, University of Florence, Italy
| | - K Baum
- Department of Neurology, Klinik Hennigsdorf, Germany
| | - M Buttmann
- Department of Neurology, University of Würzburg, Germany
| | - A Bayas
- Department of Neurology, Klinikum Augsburg, Germany
| | - D Brassat
- Unité Institut national de la santé et de la recherche médicale (INSERM) 563, Centre hospitalier universitaire Purpan, Toulouse, France
| | - B Brochet
- Department of Neurology, and INSERM-CHU CIC-P 0005, Centre hospitalier universitaire de Bordeaux, France
| | - C Confavreux
- Centre de coordination EDMUS pour la sclérose en plaques, Hôpital Neurologique Pierre-Wertheimer, Lyon, France
| | - G Edan
- Department of Neurology, Centre hospitalier universitaire Pontchaillou, Rennes, France
| | - M Färkkilä
- Department of Neurology, Central Hospital, Helsinki University, Finland
| | - S Fredrikson
- Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - M Frontoni
- Department of Neurological Sciences, University of Rome La Sapienza, Italy
| | - M D'Hooghe
- Department of Neurology, National MS Center, Melsbroek, Belgium/Vrije Universiteit Brussel, Belgium
| | - M Hutchinson
- Saint Vincent's University Hospital, University College Dublin, Ireland
| | - J De Keyser
- Departments of Neurology, University Medical Center Groningen, Netherlands
| | - B C Kieseier
- Department of Neurology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - T Kümpfel
- Institute of Clinical Neuroimmunology, Ludwig Maximilians University, Munich, Germany
| | - J Rio
- MS Center of Catalonia (Cemcat), Vall d'Hebron University Hospital, Barcelona, Spain
| | - C Polman
- MS Center Amsterdam, Vrije University Medical Center, Netherlands
| | - E Roullet
- Department of Neurology, Hôpital Tenon, Paris, France
| | - C Stolz
- PAREXEL International GmbH, Berlin, Germany
| | - K Vass
- University Clinic of Neurology, Medical University of Vienna, Austria
| | - K P Wandinger
- University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - L Kappos
- Neurology, Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel
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8
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Collongues N, Brassat D, Maillart E, Labauge P, Ouallet JC, Carra-Dalliere C, Moreau T, Bourre B, Papeix C, Brochet B, Audoin B, Vukusic S, de Seze J, Marignier R. Efficacy of rituximab in refractory neuromyelitis optica. Mult Scler 2015; 22:955-9. [DOI: 10.1177/1352458515602337] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 08/02/2015] [Indexed: 11/17/2022]
Abstract
Background: Despite a growing use of rituximab (RTX) in neuromyelitis optica (NMO), data are lacking in patients with refractory NMO (RNMO), defined as cases with at least one relapse during immunosuppressive therapy. Objective: The purpose of this study was to assess RTX as a maintenance therapy in RNMO. Methods: Out of a total of 305 NMO cases from a population-based cohort, 21 RNMO patients received RTX during a mean follow-up period of 31 months. Results: After RTX, 11 patients (52.3%) were relapse free, meaning that 47.7% were refractory to RTX. The mean annualized relapse rate decreased from 1.3 to 0.4 ( p<0.001) and median EDSS from 5 to 3 ( p=0.02). Body mass index (BMI) was predictive of EDSS worsening. Conclusions: RTX is an effective and well-tolerated treatment in RNMO. BMI could be a predictive factor for efficacy.
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Affiliation(s)
- N Collongues
- Department of Neurology, Hopital de Hautepierre, France
| | - D Brassat
- Department of Neurology, Hopital Purpan, France
| | - E Maillart
- Department of Neurology, Hopital Pitie-Salpetriere, France
| | - P Labauge
- Department of Neurology, Hopital Universitaire de Montpellier, France
| | - JC Ouallet
- Department of Neurology, Centre Hospitalier Universitaire de Bordeaux, France
| | - C Carra-Dalliere
- Department of Neurology, Hopital Universitaire de Montpellier, France
| | - T Moreau
- Department of Neurology, Hopital Universitaire de Dijon, France
| | - B Bourre
- Department of Neurology, Hopital Charles Nicolle, France
| | - C Papeix
- Department of Neurology, Hopital Pitie-Salpetriere, France
| | - B Brochet
- Department of Neurology, Centre Hospitalier Universitaire de Bordeaux, France
| | - B Audoin
- Department of Neurology, Hopital Universitaire de Marseille, France
| | - S Vukusic
- Department of neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France
| | - J de Seze
- Department of Neurology, Hopital de Hautepierre, France
| | - R Marignier
- Department of neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France
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9
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Pique J, Bonneville F, Brassat D, Peaureaux D, Benaiteau M, Dumas H, Fabre N, Clanet M, Biotti D. Peripheral late reactivation of a previously typical monofocal Baló’s concentric sclerosis lesion. Mult Scler 2015; 21:1080-3. [DOI: 10.1177/1352458515586087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 04/09/2015] [Indexed: 11/17/2022]
Abstract
We report a 41-year-old woman with rapidly progressive left hemiparesis, revealing an inflammatory reactivation of a previously known parietal Baló’s concentric sclerosis lesion. The first attack occurred five years before. After a slow recovery following high-dose steroid infusions the patient stabilized. Because of recurrent ataxia and left hemiparesis a new magnetic resonance imaging was performed showing an extension of the initial lesion with a peripheral gadolinium enhancement on T1-weighted images. Such a reactivation pattern of an isolated Baló’s concentric sclerosis lesion, occurring some years later, is described for the first time.
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Affiliation(s)
- J Pique
- Pole des Neurosciences, B4 Neurology Unit, CHU Purpan, Toulouse, France
| | - F Bonneville
- Department of Neuroradiology, Hôpital Pierre-Paul-Riquet, CHU Purpan, Toulouse, France
| | - D Brassat
- Pole des Neurosciences, B4 Neurology Unit, CHU Purpan, Toulouse, France/INSERM UMR 1043 et Université Toulouse III, France
| | - D Peaureaux
- Pole des Neurosciences, B4 Neurology Unit, CHU Purpan, Toulouse, France
| | - M Benaiteau
- Pole des Neurosciences, B4 Neurology Unit, CHU Purpan, Toulouse, France
| | - H Dumas
- Department of Neuroradiology, Hôpital Pierre-Paul-Riquet, CHU Purpan, Toulouse, France
| | - N Fabre
- Pole des Neurosciences, B4 Neurology Unit, CHU Purpan, Toulouse, France
| | - M Clanet
- Pole des Neurosciences, B4 Neurology Unit, CHU Purpan, Toulouse, France/INSERM UMR 1043 et Université Toulouse III, France
| | - D Biotti
- Pole des Neurosciences, B4 Neurology Unit, CHU Purpan, Toulouse, France
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10
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Siri A, Carra-Dalliere C, Ayrignac X, Pelletier J, Audoin B, Pittion-Vouyovitch S, Debouverie M, Lionnet C, Viala F, Sablot D, Brassat D, Ouallet JC, Ruet A, Brochet B, Taillandier L, Bauchet L, Derache N, Defer G, Cabre P, de Seze J, Lebrun Frenay C, Cohen M, Labauge P. Isolated tumefactive demyelinating lesions: diagnosis and long-term evolution of 16 patients in a multicentric study. J Neurol 2015; 262:1637-45. [DOI: 10.1007/s00415-015-7758-8] [Citation(s) in RCA: 16] [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] [Received: 03/19/2015] [Revised: 04/17/2015] [Accepted: 04/20/2015] [Indexed: 12/31/2022]
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11
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Hinsinger G, Galéotti N, Nabholz N, Urbach S, Rigau V, Demattei C, Lehmann S, Camu W, Labauge P, Castelnovo G, Brassat D, Loussouarn D, Salou M, Laplaud D, Casez O, Bockaert J, Marin P, Thouvenot E. Chitinase 3-like proteins as diagnostic and prognostic biomarkers of multiple sclerosis. Mult Scler 2015; 21:1251-61. [DOI: 10.1177/1352458514561906] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 11/05/2014] [Indexed: 01/15/2023]
Abstract
Background: Despite sensitivity of MRI to diagnose multiple sclerosis (MS), prognostic biomarkers are still needed for optimized treatment. Objective: The objective of this paper is to identify cerebrospinal fluid (CSF) diagnostic biomarkers of MS using quantitative proteomics and to analyze their expression at different disease stages. Methods: We conducted differential analysis of the CSF proteome from control and relapsing–remitting MS (RRMS) patients followed by verification by ELISA of candidate biomarkers in CSF and serum in control, clinically isolated syndrome (CIS), RRMS and progressive MS (PMS) patients. Results: Twenty-two of the 527 quantified proteins exhibited different abundances in control and RRMS CSF. These include chitinase 3-like protein 1 (CHI3L1) and 2 (CHI3L2), which showed a strong expression in brain of MS patients, especially in astrocytes and microglial cells from white matter plaques. CSF and serum CHI3L1 levels increased with the disease stage and CIS patients with high CSF (>189 ng/ml) and serum (>33 ng/ml) CHI3L1 converted more rapidly to RRMS (log rank test, p < 0.05 and p < 0.001, respectively). In contrast, CSF CHI3L2 levels were lower in PMS than in RRMS patients. Accordingly, CSF CHI3L1/CHI3L2 ratio accurately discriminated PMS from RRMS. Conclusions: CSF CHI3L1 and CHI3L2 and serum CHI3L1 might help to define MS disease stage and have a prognostic value in CIS.
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Affiliation(s)
- G Hinsinger
- Institut de Génomique Fonctionnelle, CNRS UMR 5203, INSERM U661, Université Montpellier 1, Université Montpellier 2, France
| | - N Galéotti
- Institut de Génomique Fonctionnelle, CNRS UMR 5203, INSERM U661, Université Montpellier 1, Université Montpellier 2, France
| | - N Nabholz
- Service d’Ophtalmologie, Hôpital Gui de Chauliac, CHU de Montpellier, France
| | - S Urbach
- Institut de Génomique Fonctionnelle, CNRS UMR 5203, INSERM U661, Université Montpellier 1, Université Montpellier 2, France
| | - V Rigau
- Service d’Anatomopathologie, Hôpital Gui de Chauliac, CHU de Montpellier, France
| | - C Demattei
- Département d’Information Médicale, CHU de Nîmes, France
| | - S Lehmann
- Service de Biochimie, Hôpital Gui de Chauliac, CHU de Montpellier, France
| | - W Camu
- Service de Neurologie, Hôpital Gui de Chauliac, CHU de Montpellier, France
| | - P Labauge
- Service de Neurologie, Hôpital Gui de Chauliac, CHU de Montpellier, France
| | - G Castelnovo
- Service de Neurologie, Hôpital Carémeau, CHU de Nîmes, France
| | - D Brassat
- Service de Neurologie, Hôpital Purpan, CHU de Toulouse, France
| | - D Loussouarn
- Service d’Anatomopathologie, CHU de Nantes, France
| | | | - D Laplaud
- INSERM 1064, France/Service de Neurologie, CHU de Nantes, France
| | - O Casez
- Service de Neurologie, CHU de Grenoble, France
| | - J Bockaert
- Institut de Génomique Fonctionnelle, CNRS UMR 5203, INSERM U661, Université Montpellier 1, Université Montpellier 2, France
| | - P Marin
- Institut de Génomique Fonctionnelle, CNRS UMR 5203, INSERM U661, Université Montpellier 1, Université Montpellier 2, France
| | - E Thouvenot
- Institut de Génomique Fonctionnelle, CNRS UMR 5203, INSERM U661, Université Montpellier 1, Université Montpellier 2, France/Service de Neurologie, Hôpital Carémeau, CHU de Nîmes, France
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12
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Kuhle J, Disanto G, Dobson R, Adiutori R, Bianchi L, Topping J, Bestwick JP, Meier UC, Marta M, Costa GD, Runia T, Evdoshenko E, Lazareva N, Thouvenot E, Iaffaldano P, Direnzo V, Khademi M, Piehl F, Comabella M, Sombekke M, Killestein J, Hegen H, Rauch S, D’Alfonso S, Alvarez-Cermeño JC, Kleinová P, Horáková D, Roesler R, Lauda F, Llufriu S, Avsar T, Uygunoglu U, Altintas A, Saip S, Menge T, Rajda C, Bergamaschi R, Moll N, Khalil M, Marignier R, Dujmovic I, Larsson H, Malmestrom C, Scarpini E, Fenoglio C, Wergeland S, Laroni A, Annibali V, Romano S, Martínez AD, Carra A, Salvetti M, Uccelli A, Torkildsen Ø, Myhr KM, Galimberti D, Rejdak K, Lycke J, Frederiksen JL, Drulovic J, Confavreux C, Brassat D, Enzinger C, Fuchs S, Bosca I, Pelletier J, Picard C, Colombo E, Franciotta D, Derfuss T, Lindberg RLP, Yaldizli Ö, Vécsei L, Kieseier BC, Hartung HP, Villoslada P, Siva A, Saiz A, Tumani H, Havrdová E, Villar LM, Leone M, Barizzone N, Deisenhammer F, Teunissen C, Montalban X, Tintoré M, Olsson T, Trojano M, Lehmann S, Castelnovo G, Lapin S, Hintzen R, Kappos L, Furlan R, Martinelli V, Comi G, Ramagopalan SV, Giovannoni G. Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study. Mult Scler 2015; 21:1013-24. [DOI: 10.1177/1352458514568827] [Citation(s) in RCA: 196] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 11/19/2014] [Indexed: 11/15/2022]
Abstract
Background and objective: We explored which clinical and biochemical variables predict conversion from clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS) in a large international cohort. Methods: Thirty-three centres provided serum samples from 1047 CIS cases with at least two years’ follow-up. Age, sex, clinical presentation, T2-hyperintense lesions, cerebrospinal fluid (CSF) oligoclonal bands (OCBs), CSF IgG index, CSF cell count, serum 25-hydroxyvitamin D3 (25-OH-D), cotinine and IgG titres against Epstein-Barr nuclear antigen 1 (EBNA-1) and cytomegalovirus were tested for association with risk of CDMS. Results: At median follow-up of 4.31 years, 623 CIS cases converted to CDMS. Predictors of conversion in multivariable analyses were OCB (HR = 2.18, 95% CI = 1.71–2.77, p < 0.001), number of T2 lesions (two to nine lesions vs 0/1 lesions: HR = 1.97, 95% CI = 1.52–2.55, p < 0.001; >9 lesions vs 0/1 lesions: HR = 2.74, 95% CI = 2.04–3.68, p < 0.001) and age at CIS (HR per year inversely increase = 0.98, 95% CI = 0.98–0.99, p < 0.001). Lower 25-OH-D levels were associated with CDMS in univariable analysis, but this was attenuated in the multivariable model. OCB positivity was associated with higher EBNA-1 IgG titres. Conclusions: We validated MRI lesion load, OCB and age at CIS as the strongest independent predictors of conversion to CDMS in this multicentre setting. A role for vitamin D is suggested but requires further investigation.
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Affiliation(s)
- J Kuhle
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK/ Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - G Disanto
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - R Dobson
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - R Adiutori
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - L Bianchi
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - J Topping
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - JP Bestwick
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, Barts and the London School for Medicine and Dentistry, UK
| | - U-C Meier
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - M Marta
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - G Dalla Costa
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - T Runia
- Department of Neurology, Erasmus MC University Medical Center, The Netherlands
| | - E Evdoshenko
- Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia
| | - N Lazareva
- Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia
| | - E Thouvenot
- Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France
| | - P Iaffaldano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - V Direnzo
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - M Khademi
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - F Piehl
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - M Comabella
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d’Hebron (VHIR), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - M Sombekke
- Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network
| | - J Killestein
- Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network
| | - H Hegen
- Department of Neurology, Innsbruck Medical University, Austria
| | - S Rauch
- Department of Radiology, Innsbruck Medical University, Austria
| | - S D’Alfonso
- Department of Health Sciences and IRCAD, Eastern Piedmont University, Italy
| | | | - P Kleinová
- Department of Neurology, Charles University in Prague, Czech Republic
| | - D Horáková
- Department of Neurology, Charles University in Prague, Czech Republic
| | - R Roesler
- Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany
| | - F Lauda
- Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany
| | - S Llufriu
- Center for Neuroimmunology and Department of Neurology. Institut d’investigacions Biomèdiques August Pi Sunyer (IDIBAPS) – Hospital Clinic of Barcelona, Spain
| | - T Avsar
- Dr Orhan Öcalgiray Molecular Biology-Biotechnology and Genetics Research Centre, Istanbul Technical University, Turkey
| | - U Uygunoglu
- Department of Neurology, Istanbul University, Turkey
| | - A Altintas
- Department of Neurology, Istanbul University, Turkey
| | - S Saip
- Department of Neurology, Istanbul University, Turkey
| | - T Menge
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany
| | - C Rajda
- Department of Neurology, University of Szeged, Hungary
| | | | - N Moll
- Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d’histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France
| | - M Khalil
- Department of Neurology, Medical University of Graz, Austria
| | - R Marignier
- Department of Neurology, Université de Lyon, Université Claude Bernard-Lyon 1, France
| | - I Dujmovic
- Clinic of Neurology, Belgrade University School of Medicine, Serbia
| | - H Larsson
- Unit of Functional Imaging, Glostrup Hospital, University of Copenhagen, Denmark
| | - C Malmestrom
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - E Scarpini
- Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico
| | - C Fenoglio
- Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico
| | - S Wergeland
- KG Jebsen Centre for MS-Research, Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Norway
| | - A Laroni
- Department of Neurology, University of Genoa, Italy
| | - V Annibali
- Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy
| | - S Romano
- Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy
| | - AD Martínez
- Department of Neurology of Hospital Británico of Buenos Aires, Argentina
| | - A Carra
- Department of Neurology of Hospital Británico of Buenos Aires, Argentina
| | - M Salvetti
- Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy
| | - A Uccelli
- Department of Neurology, University of Genoa, Italy
| | - Ø Torkildsen
- KG Jebsen Centre for MS-Research, Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Norway
| | - KM Myhr
- Department of Neurology, University of Genoa, Italy
| | - D Galimberti
- Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico
| | - K Rejdak
- Department of Neurology, Medical University of Lublin, Poland
| | - J Lycke
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - JL Frederiksen
- Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark
| | - J Drulovic
- Clinic of Neurology, Belgrade University School of Medicine, Serbia
| | - C Confavreux
- Department of Neurology, Université de Lyon, Université Claude Bernard-Lyon 1, France
| | - D Brassat
- Department of Neurology, University of Toulouse, France
| | - C Enzinger
- Department of Neurology, Medical University of Graz, Austria
| | - S Fuchs
- Department of Neurology, Medical University of Graz, Austria
| | - I Bosca
- MS Unit, Neurology Department, La Fe University and Polytechnic Hospital, Instituto de investigación Sanitaria La Fe, Spain
| | - J Pelletier
- Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d’histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France
| | - C Picard
- Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d’histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France
| | - E Colombo
- C. Mondino National Neurological Institute, Italy
| | - D Franciotta
- C. Mondino National Neurological Institute, Italy
| | - T Derfuss
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - RLP Lindberg
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - Ö Yaldizli
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - L Vécsei
- Department of Neurology, University of Szeged, Hungary
| | - BC Kieseier
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany
| | - HP Hartung
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany
| | - P Villoslada
- Center for Neuroimmunology and Department of Neurology. Institut d’investigacions Biomèdiques August Pi Sunyer (IDIBAPS) – Hospital Clinic of Barcelona, Spain
| | - A Siva
- Department of Neurology, Istanbul University, Turkey
| | - A Saiz
- Center for Neuroimmunology and Department of Neurology. Institut d’investigacions Biomèdiques August Pi Sunyer (IDIBAPS) – Hospital Clinic of Barcelona, Spain
| | - H Tumani
- Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany
| | - E Havrdová
- Department of Neurology, Charles University in Prague, Czech Republic
| | - LM Villar
- Department of Neurology and Immunology, Hospital Ramón y Cajal, Spain
| | - M Leone
- MS Centre, SCDU Neurology, Head and Neck Department, AOU Maggiore della Carità, Italy
| | - N Barizzone
- Department of Health Sciences and IRCAD, Eastern Piedmont University, Italy
| | - F Deisenhammer
- Department of Neurology, Innsbruck Medical University, Austria
| | - C Teunissen
- Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network
| | - X Montalban
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d’Hebron (VHIR), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - M Tintoré
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d’Hebron (VHIR), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - T Olsson
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - M Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - S Lehmann
- Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France
| | - G Castelnovo
- Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France
| | - S Lapin
- Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia
| | - R Hintzen
- Department of Neurology, Erasmus MC University Medical Center, The Netherlands
| | - L Kappos
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - R Furlan
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - V Martinelli
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - G Comi
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - SV Ramagopalan
- Department of Physiology, Anatomy and Genetics and Medical Research Council Functional Genomics Unit, University of Oxford, UK
| | - G Giovannoni
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
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Lionnet C, Carra C, Ayrignac X, Levade T, Gayraud D, Castelnovo G, Besson G, Androdias G, Vukusic S, Confavreux C, Zaenker C, De Seze J, Collongues N, Blanc F, Tranchant C, Wallon D, Hannequin D, Gerdelat-Mas A, Brassat D, Clanet M, Zephir H, Outteryck O, Vermersch P, Labauge P. [Cerebrotendinous xanthomatosis: a multicentric retrospective study of 15 adults, clinical and paraclinical typical and atypical aspects]. Rev Neurol (Paris) 2014; 170:445-53. [PMID: 24746394 DOI: 10.1016/j.neurol.2014.01.675] [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: 08/25/2013] [Revised: 01/13/2014] [Accepted: 01/16/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Cerebrotendinous xanthomatosis, a metabolic leukodystrophy with an autosomal recessive inheritance, is secondary to deficiency of sterol 27-hydroxylase, an enzyme involved in cholesterol catabolism. Classical symptoms include clinical or infraclinical xanthomas affecting the skin and tendons, early cataracts, neurological signs and diarrhea. Brain imaging reveals involvement of the dentate nuclei and periventricular white matter hyperintensities. The diagnosis is based on an increased cholestanol level in serum, confirmed by the presence of a mutation in the CYP27A1 gene. Treatment is based on chenodeoxycholic acid. METHOD We report a retrospective multicentric study of 15 cases of cerebrotendinous xanthomatosis diagnosed in French adults. Clinical, molecular and MRI findings were recorded in all patients. RESULTS The average age at diagnosis was 39years (range 27-65). Disease onset occurred in childhood in 73% of patients and in adulthood in 27%. All patients with a pediatric onset were diagnosed during adulthood (age range 28-65years). Clinical symptoms variably associated cerebellar syndrome, pyramidal syndrome, cognitive decline, epilepsy, neuropathy (sought in 10 of our patients, present in forms in 8), psychiatric disorders, cataract and xanthomas. One patient had an atypical presentation: monoparesis associated with xanthomas. Brain MRI was abnormal in all: findings consisted in T2-weighted hyperintensity of the dentate nuclei (47%), periventricular leuoencephalopathy (73%) which preferentially involved the posterior cerebral part (60%), leucoencephalopathy with a vascular pattern (7%), hyperintensity of the cortico-spinal tracts (53%), globi pallidi, corpus callosum and cerebral atrophy (33%). Serum cholestanol was elevated in 93% of patients. The most frequent mutation was 1183C>T (n=5/15). Under treatment with chenodeoxycholic acid, eight patients improved initially, followed by stabilization in five of them, and worsening in the others. Four patients died. CONCLUSION Patients with the xanthoma-neurological disorder association should be tested for cerebrotendinous xanthomatosis. The disease often begins in childhood with a diagnostic delay but also in adulthood. Involvement of the dentate nuclei is specific but not sensitive and the supratentorial leucoencephalopathy is not specific but with an antero-posterior gradient. A vascular distribution and involvement of the corpus callosum are possible. Serum cholestanol assay is very reliable: an elevated level provides the diagnosis, which must nevertheless be confirmed by molecular biology.
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Affiliation(s)
- C Lionnet
- Service de neurologie, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France
| | - C Carra
- Service de neurologie, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France
| | - X Ayrignac
- Service de neurologie, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France
| | - T Levade
- Laboratoire de biochimie, hôpital Rangueil, CHU de Toulouse, 1, avenue J.-Poulhès, 31403 Toulouse, France
| | - D Gayraud
- Service de neurologie, centre hospitalier du pays d'Aix, avenue des Tamaris, 13616 Aix-en-Provence cedex 1, France
| | - G Castelnovo
- Service de neurologie, hôpital Caremeau, CHU de Nîmes, place du Professeur-Debré, 30029 Nîmes cedex 4, France
| | - G Besson
- Service de neurologie, CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France
| | - G Androdias
- Service de neurologie, hôpital Pierre-Wertheimer, CHU de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - S Vukusic
- Service de neurologie, hôpital Pierre-Wertheimer, CHU de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - C Confavreux
- Service de neurologie, hôpital Pierre-Wertheimer, CHU de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - C Zaenker
- Cabinet privé, 64, rue Robert-Schuman, 68000 Colmar, France
| | - J De Seze
- Service de neurologie, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France
| | - N Collongues
- Service de neurologie, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France
| | - F Blanc
- Service de neurologie, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France
| | - C Tranchant
- Service de neurologie, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France
| | - D Wallon
- Service de neurologie, CHU de Rouen, 1, rue Germont, 70031 Rouen, France
| | - D Hannequin
- Service de neurologie, CHU de Rouen, 1, rue Germont, 70031 Rouen, France
| | - A Gerdelat-Mas
- Service de neurologie, hôpital Purpan, CHU de Toulouse, place du Docteur-Baylac, 31059 Toulouse cedex 9, France
| | - D Brassat
- Service de neurologie, hôpital Purpan, CHU de Toulouse, place du Docteur-Baylac, 31059 Toulouse cedex 9, France
| | - M Clanet
- Service de neurologie, hôpital Purpan, CHU de Toulouse, place du Docteur-Baylac, 31059 Toulouse cedex 9, France
| | - H Zephir
- Service de neurologie D, hôpital Roger-Salengro, CHU de Lille, avenue du Pr-Émile-Laine, 59037 Lille cedex, France
| | - O Outteryck
- Service de neurologie D, hôpital Roger-Salengro, CHU de Lille, avenue du Pr-Émile-Laine, 59037 Lille cedex, France
| | - P Vermersch
- Service de neurologie D, hôpital Roger-Salengro, CHU de Lille, avenue du Pr-Émile-Laine, 59037 Lille cedex, France
| | - P Labauge
- Service de neurologie, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France.
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Bodiguel E, Bensa C, Brassat D, Laplaud D, Le Page E, Ouallet JC, Zephir H, De Seze J. Multiple sclerosis and pregnancy. Rev Neurol (Paris) 2014; 170:247-65. [PMID: 24684929 DOI: 10.1016/j.neurol.2013.09.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 09/26/2013] [Indexed: 10/25/2022]
Abstract
The question of pregnancy in patients with multiple sclerosis is regularly raised due to the prevalence of the disease in middle age women. The multiple sclerosis think tank (Groupe de Réflexion sur la Sclérose en Plaques [GRESEP]) decided to develop recommendations on this issue, with consideration to both the impact of multiple sclerosis on pregnancy, and that of pregnancy on the disease. As with topics of previous works, the formal expert consensus method was used. The working group was composed of hospital-based and private practice neurologists. The reading group was composed of neurologists, anaesthetists and obstetricians. Each recommendation is presented with the relevant level of consensus.
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Affiliation(s)
- E Bodiguel
- Hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France; Service de neurologie, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Faculté de médecine, université Paris Descartes, Sorbonne Paris Cité, 12, rue de l'École de Médecine, 75270 Paris cedex 06, France.
| | - C Bensa
- Service de neurologie, fondation Rothschild, 25, rue Manin, 75019 Paris, France
| | - D Brassat
- Inserm U1043, pôle des neurosciences, hôpital Purpan, université Toulouse-3, place du Dr-Baylac, BP 3028, 31024 Toulouse cedex 3, France
| | - D Laplaud
- Inserm UMR643, service de neurologie, pavillon Jean-Monnet, hôtel-Dieu, CHU de Nantes, 30, boulevard Jean-Monnet, 44093 Nantes 01, France; Faculté de médecine de Nantes, 1, rue Gaston-Veïl, 44000 Nantes, France
| | - E Le Page
- CIC-P 0203 Inserm, pôle des neurosciences cliniques, CHU Pontchaillou, pavillon Clemenceau, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France
| | - J-C Ouallet
- Pôle des neurosciences cliniques, université de Bordeaux Segalen, CHU de Bordeaux Pellegrin Tripode, 1, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - H Zephir
- Pôle de neurologie, hôpital Roger-Salengro, CHRU de Lille, avenue du Pr-Émile-Laine, 59037 Lille, France
| | - J De Seze
- Service de neurologie, laboratoire d'imagerie et de neurosciences cognitives (LINC), CNRS, centre d'investigation clinique (CIC) de Strasbourg, université de Strasbourg, CHU de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
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15
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Brassat D. Marqueurs d’inflammation dans la sclérose en plaques. Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.459] [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: 10/25/2022]
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16
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Collongues N, Papeix C, Zéphir H, Audoin B, Cotton F, Durand-dubief F, Vukusic S, Brassat D, Laplaud D, Marignier R. Cadre nosologique et stratégie diagnostique de la myélite aiguë transverse longitudinalement étendue. Rev Neurol (Paris) 2014; 170:6-12. [DOI: 10.1016/j.neurol.2013.04.008] [Citation(s) in RCA: 9] [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] [Received: 03/08/2013] [Accepted: 04/05/2013] [Indexed: 12/14/2022]
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Outteryck O, Ongagna J, Brochet B, Rumbach L, Lebrun-Frenay C, Debouverie M, Zéphir H, Ouallet J, Berger E, Cohen M, Pittion S, Laplaud D, Wiertlewski S, Cabre P, Pelletier J, Rico A, Defer G, Derache N, Camu W, Thouvenot E, Moreau T, Fromont A, Tourbah A, Labauge P, Castelnovo G, Clavelou P, Casez O, Hautecoeur P, Papeix C, Lubetzki C, Fontaine B, Couturier N, Bohossian N, Clanet M, Vermersch P, de Sèze J, Brassat D. A prospective observational post-marketing study of natalizumab-treated multiple sclerosis patients: clinical, radiological and biological features and adverse events. The BIONAT cohort. Eur J Neurol 2013; 21:40-8. [DOI: 10.1111/ene.12204] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 04/30/2013] [Indexed: 11/29/2022]
Affiliation(s)
- O. Outteryck
- Neurologie; Université de Lille Nord de France (EA2686); Hôpital Roger Salengro CHRU Lille; Lille France
| | | | - B. Brochet
- Neurologie; CHU Pellegrin; Bordeaux France
| | - L. Rumbach
- Neurologie; CHU Besançon; Besançon France
| | | | | | - H. Zéphir
- Neurologie; Université de Lille Nord de France (EA2686); Hôpital Roger Salengro CHRU Lille; Lille France
| | | | - E. Berger
- Neurologie; CHU Besançon; Besançon France
| | - M. Cohen
- Neurologie; Hôpital Pasteur; Nice France
| | | | | | | | - P. Cabre
- Neurologie; CHU Fort de France; Fort de France France
| | - J. Pelletier
- Neurologie; Hôpital de la Timone; Marseille France
| | - A. Rico
- Neurologie; Hôpital de la Timone; Marseille France
| | - G. Defer
- Neurologie; CHU Caen; Caen France
| | | | - W. Camu
- Neurologie; CHU Montpellier; Montpellier France
| | | | | | | | | | - P. Labauge
- Neurologie; CHU Montpellier; Montpellier France
| | | | - P. Clavelou
- Neurologie; CHRU Clermont Ferrand; Clermont Ferrand France
| | - O. Casez
- Neurologie; CHU Grenoble; Grenoble France
| | | | - C. Papeix
- Neurologie; Hôpital de la Salpêtrière; Paris France
| | - C. Lubetzki
- Neurologie; Hôpital de la Salpêtrière; Paris France
| | - B. Fontaine
- Neurologie; Hôpital de la Salpêtrière; Paris France
| | - N. Couturier
- Pole des neurosciences CHU Purpan; INSERM U1043; Toulouse France
| | - N. Bohossian
- Pole des neurosciences CHU Purpan; INSERM U1043; Toulouse France
| | - M. Clanet
- Pole des neurosciences CHU Purpan; INSERM U1043; Toulouse France
| | - P. Vermersch
- Neurologie; Université de Lille Nord de France (EA2686); Hôpital Roger Salengro CHRU Lille; Lille France
| | - J. de Sèze
- Neurologie; Hôpital Civil; Strasbourg France
| | - D. Brassat
- Pole des neurosciences CHU Purpan; INSERM U1043; Toulouse France
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Cohen M, Maillart E, Vukusic S, Brassat D, De Seze J, Tourbah A, Lebrun C. ENIGM : enquête nationale à propos de l’introduction du fingolimod en relais au natalizumab chez les patients atteints de sclérose en plaques rémittente. Rev Neurol (Paris) 2013. [DOI: 10.1016/j.neurol.2013.01.238] [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]
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19
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Ouallet JC, Bodiguel E, Bensa C, Blanc F, Brassat D, Laplaud D, Zephir H, de Seze J, Magy L. Recommendations for useful serum testing with suspected multiple sclerosis. Rev Neurol (Paris) 2013; 169:37-46. [DOI: 10.1016/j.neurol.2011.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 09/20/2011] [Indexed: 10/14/2022]
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20
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Bensa C, Bodiguel E, Brassat D, Laplaud D, Magy L, Ouallet JC, Zephir H, De Seze J, Blanc F. Recommendations for the detection and therapeutic management of cognitive impairment in multiple sclerosis. Rev Neurol (Paris) 2012; 168:785-94. [DOI: 10.1016/j.neurol.2012.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 02/07/2012] [Accepted: 02/13/2012] [Indexed: 10/28/2022]
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Abstract
The term "spasticity" describes the velocity-dependent increase in tonic stretch reflexes. The symptom is commonly seen in patients with injury to the central nervous system. It is rarely isolated but, instead, part of a set of symptoms that is sometimes confusing. However, the pathophysiology of the symptom has evolved over the past three decades, and it is now considered part of a global process that includes not only spinal reflex loop modifications, but also changes in the biomechanical properties of muscle fibers. Finally, recent studies of changes in the membrane properties of motor neurons and the occurrence of plateau potential have opened new perspectives. This review aims to describe these new pathophysiological models.
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Affiliation(s)
- P Marque
- Unité 825 Inserm, Pavillon Baudot, CHU Purpan, 1 Place Baylac, 31059 Toulouse cedex 9, France.
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22
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Zéphir H, Bodiguel E, Bensa C, Blanc F, Laplaud D, Magy L, Ouallet JC, De Seze J, Brassat D. Recommendations for a definition of multiple sclerosis in support of early treatment. Rev Neurol (Paris) 2012; 168:328-37. [DOI: 10.1016/j.neurol.2011.12.008] [Citation(s) in RCA: 2] [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] [Received: 12/12/2011] [Accepted: 12/20/2011] [Indexed: 10/28/2022]
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Bourre B, Marignier R, Zéphir H, Papeix C, Brassat D, Castelnovo G, Collongues N, Vukusic S, Labauge P, Outteryck O, Fontaine B, Vermersch P, Confavreux C, de Seze J. Neuromyelitis optica and pregnancy. Neurology 2012; 78:875-9. [PMID: 22402855 DOI: 10.1212/wnl.0b013e31824c466f] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [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] Open
Abstract
OBJECTIVE The purpose of our study was to assess the influence of pregnancy on the course of neuromyelitis optica (NMO) and the impact of epidural analgesia and breastfeeding on its activity in the postpartum period. METHODS We performed a retrospective study of patients with NMO diagnosed according to Wingerchuk criteria. We noted the number of relapses during the year before pregnancy (BP), during pregnancy (first trimester, second trimester, third trimester), and the year after (Y + 1: first trimester, second trimester [PP2], and third and fourth trimesters postpartum). Epidural analgesia and breastfeeding were recorded. Disability was evaluated with the Kurtzke Expanded Disability Status Scale (EDSS). The annualized relapse rate (ARR) was calculated. RESULTS We identified 124 patients (85 female) in the French NOMADMUS cohort on November 1, 2010. A total of 20 women (including 25 pregnancies) were informative with complete files. Comparisons between the ARR of each period and BP (1.0 ± 0.09) only showed an increased tendency for PP2 (0.8 ± 0.06, p = 0.07). Epidural analgesia and breastfeeding had no influence on the course of NMO. The EDSS score increased from 1.5 ± 1.7 BP to 2.6 ± 1.9 Y + 1 (p = 0.027). CONCLUSION This study shows that pregnancy influences the activity of NMO, a finding that justifies close medical monitoring. We found no evidence to suggest that either epidural analgesia or breastfeeding has an aggravating effect on NMO.
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Affiliation(s)
- B Bourre
- Department of Neurology, Hôpital Charles Nicolle, Rouen, France.
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Malhotra S, Morcillo-Suárez C, Brassat D, Goertsches R, Lechner-Scott J, Urcelay E, Fernández O, Drulovic J, García-Merino A, Martinelli Boneschi F, Chan A, Vandenbroeck K, Navarro A, Bustamante MF, Río J, Akkad DA, Giacalone G, Sánchez AJ, Leyva L, Alvarez-Lafuente R, Zettl UK, Oksenberg J, Montalban X, Comabella M. IL28B polymorphisms are not associated with the response to interferon-β in multiple sclerosis. J Neuroimmunol 2011; 239:101-4. [PMID: 21889215 DOI: 10.1016/j.jneuroim.2011.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2011] [Revised: 08/04/2011] [Accepted: 08/05/2011] [Indexed: 01/09/2023]
Abstract
Recent studies have revealed an association between interleukin 28B (IL28B) and response to IFN-alpha treatment in hepatitis C patients. Here we investigated the influence of IL28B polymorphisms in the response to interferon-beta (IFNβ) in multiple sclerosis (MS) patients. We genotyped two SNPs of the IL28B gene (rs8099917 and rs12979860) in 588 MS patients classified into responders (n=281) and non-responders (n=307) to IFNβ. Combined analysis of the study cohorts showed no significant associations between SNPs rs8099917 and rs12979860 and the response to treatment. These findings do not support a role of IL28B polymorphisms in the response to IFNβ in MS patients.
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Affiliation(s)
- S Malhotra
- Centre d'Esclerosi Múltiple de Catalunya, CEM-Cat, Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain
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Collongues N, Marignier R, Zéphir H, Blanc F, Vukusic S, Outteryck O, Fleury M, Ruet A, Borgel F, Thouvenot E, Moreau T, Defer G, Derache N, Pelletier J, Audoin B, Debouverie M, Labauge P, Gout O, Camu W, Brassat D, Brochet B, Vermersch P, Confavreux C, Seze JD. High-risk syndrome for neuromyelitis optica: a descriptive and comparative study. Mult Scler 2011; 17:720-4. [DOI: 10.1177/1352458510396923] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Neuromyelitis optica (NMO) frequently begins with a monofocal episode of optic neuritis or myelitis. A concept named high-risk syndrome (HRS) for NMO has been proposed for patients with monofocal episodes and NMO-IgG antibodies. Objective: To describe HRS patients and compare them with NMO patients. Methods: We identified 30 patients with HRS: 18 with extensive myelitis (HRM) and 12 with optic neuritis (HRON), in a database pooling patients from 25 centres in France. Clinical, laboratory/magnetic resonance imaging (MRI) data and outcome were analysed and compared with a national cohort of 125 NMO patients extracted from the same database. Results: Mean follow-up was 4.8 years. Mean age at onset was 42.8 years (range: 12.4–70) with a female:male ratio of 0.9. Asymptomatic lesions were report on visual evoked potentials in 4/8 tested HRM patients and on spinal cord MRI in 2/7 HRON patients. Three patients died, two owing to a cervical lesion. HRS and NMO patients had similar clinical/paraclinical data, except for a predominance of men in the HRS group and a later mean age at onset in the HRM subgroup. Conclusion: The description of HRS patients is compatible with a monofocal form of NMO. Asymptomatic lesions could be included in a new set of NMO diagnostic criteria.
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Affiliation(s)
- N Collongues
- Strasbourg University Hospital, Strasbourg, France
| | | | - H Zéphir
- Lille University Hospital, Lille, France
| | - F Blanc
- Strasbourg University Hospital, Strasbourg, France
| | - S Vukusic
- Lyon University Hospital, Lyon, France
| | | | - M Fleury
- Strasbourg University Hospital, Strasbourg, France
| | - A Ruet
- Bordeaux University Hospital, Bordeaux, France
| | - F Borgel
- Grenoble University Hospital, Grenoble, France
| | - E Thouvenot
- Montpellier University Hospital, Montpellier, France
| | - T Moreau
- Dijon University Hospital, Dijon, France
| | - G Defer
- Caen University Hospital, Caen, France
| | - N Derache
- Caen University Hospital, Caen, France
| | - J Pelletier
- Marseille University Hospital, Marseille, France
| | - B Audoin
- Marseille University Hospital, Marseille, France
| | | | - P Labauge
- Nîmes University Hospital, Nîmes, France
| | - O Gout
- Rothschild Foundation Hospital, Paris, France
| | - W Camu
- Montpellier University Hospital, Montpellier, France
| | - D Brassat
- Toulouse University Hospital, Toulouse, France
| | - B Brochet
- Bordeaux University Hospital, Bordeaux, France
| | | | | | - J de Seze
- Strasbourg University Hospital, Strasbourg, France
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Moulis G, Delavigne K, Alvarez M, Brassat D, Bonneville F, Massip P, Adoue D. [Chronic headaches]. Rev Med Interne 2010; 32:46-7. [PMID: 21145627 DOI: 10.1016/j.revmed.2010.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Accepted: 04/10/2010] [Indexed: 11/18/2022]
Affiliation(s)
- G Moulis
- Service de médecine interne, CHU de Toulouse-Purpan, université de Toulouse, université Paul-Sabatier, place du Docteur-Baylac, Toulouse cedex, France
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Collongues N, Marignier R, Zéphir H, Papeix C, Blanc F, Ritleng C, Tchikviladzé M, Outteryck O, Vukusic S, Fleury M, Fontaine B, Brassat D, Clanet M, Milh M, Pelletier J, Audoin B, Ruet A, Lebrun-Frenay C, Thouvenot E, Camu W, Debouverie M, Créange A, Moreau T, Labauge P, Castelnovo G, Edan G, Le Page E, Defer G, Barroso B, Heinzlef O, Gout O, Rodriguez D, Wiertlewski S, Laplaud D, Borgel F, Tourniaire P, Grimaud J, Brochet B, Vermersch P, Confavreux C, de Seze J. Neuromyelitis optica in France: a multicenter study of 125 patients. Neurology 2010; 74:736-42. [PMID: 20194912 DOI: 10.1212/wnl.0b013e3181d31e35] [Citation(s) in RCA: 158] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There have been few epidemiologic studies on neuromyelitis optica (NMO) and none used the recent 2006 diagnostic criteria. Here we describe the clinical, laboratory, MRI, and disability course of NMO in a French cohort of 125 patients. METHODS We performed an observational, retrospective, multicenter study. Data were collected from September 2007 through August 2008, corresponding to the endpoint of the study. We identified 125 patients fulfilling the 2006 NMO criteria. Selection was made using hospital files and a specific clinical questionnaire for NMO. RESULTS Mean age at onset was 34.5 years (range 4-66) with a mean disease duration of 10 +/- 7.8 years at the endpoint. The patients were mainly (87%) Caucasian, with a female:male ratio of 3:1. In 90% of cases, the association of optic neuritis, longitudinal extensive myelitis, and a Paty-negative initial brain MRI was sufficient to fulfill the supportive criteria. Eighty-eight percent of patients were treated with immunosuppressive therapies. Median delay from onset to Expanded Disability Status Scale (EDSS) score 4 was 7 years; score 6, 10 years; and score 7, 21 years. The first episode of myelitis was immediately followed by an EDSS score > or = 4 in 37.3% of cases, and a severe residual visual loss was observed in 22% of patients after the first episode of optic neuritis. Multivariate analysis did not reveal any predictors of a poor evolution other than a high number of MRI brain lesions at diagnosis, which were predictive of a residual visual acuity < or = 1/10. CONCLUSIONS Our demographic data provide new data on disability in patients with neuromyelitis optica, most of whom were receiving treatment.
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Affiliation(s)
- N Collongues
- Department of Neurology, University Hospital of Strasbourg, 67091 Strasbourg, France.
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Michel L, Foucher Y, De Sèze J, Vukusic S, Confavreux C, Brassat D, Clavelou P, Ouallet JC, Brochet B, Pelletier J, Labauge P, Lebrun C, Lefrere F, Jacq-Foucher M, Wiertlewski S, Laplaud DA. Étude rétrospective multicentrique évaluant le retentissement des traitements utilisés pour la fécondation in vitro sur le risque de poussées de Sclérose en plaques. Rev Neurol (Paris) 2010. [DOI: 10.1016/s0035-3787(10)70004-7] [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: 11/16/2022]
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Fernandes de Abreu DA, Babron MC, Babron MCI, Rebeix I, Rebeix C, Fontenille C, Fontenille J, Yaouanq J, Yaouanq D, Brassat D, Brassat B, Fontaine B, Fontaine F, Clerget-Darpoux F, Jehan F, Feron F. Season of birth and not vitamin D receptor promoter polymorphisms is a risk factor for multiple sclerosis. Mult Scler 2009; 15:1146-52. [PMID: 19965563 DOI: 10.1177/1352458509106780] [Citation(s) in RCA: 39] [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] [Indexed: 11/16/2022]
Abstract
Both genetic and environmental factors contribute to multiple sclerosis, the most common neurodegenerative disorder with onset in young adults. The objective of the current study is, based on the hypothesis that environmentally predisposed individuals are at risk for multiple sclerosis, to investigate whether they also carry genetic variants within the vitamin D machinery. Using medical files and DNA samples from 583 trios (a patient and both parents) of the French Multiple Sclerosis Genetics Group as well as data from the French Statistics Bureau, we aimed to assess whether: (1) a seasonality of birth was observed in French multiple sclerosis patients; (2) three single nucleotide polymorphisms within the promoter region of the vitamin D receptor were associated with multiple sclerosis susceptibility; and (3) the combination of a high risk month of birth and vitamin D receptor polymorphisms were correlated to multiple sclerosis incidence. We observed a significantly reduced number of individuals born in November who were later diagnosed as multiple sclerosis patients. However, we found no association between the three studied vitamin D receptor polymorphisms and multiple sclerosis. In conclusion, our data suggest that high levels of vitamin D during the third trimester of pregnancy could be a protective factor for multiple sclerosis.
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Affiliation(s)
- D A Fernandes de Abreu
- Neurobiologie des Interactions Cellulaires et Neurophysiopathologie (NICN), CNRS UMR 6184, IFR Jean Roche, Faculté de Médecine Nord, Marseille, France
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Moulis G, Martin-Blondel G, Forgues M, Brassat D, Adoue D. Atteinte du système nerveux central au cours de la sclérodermie systémique. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.03.154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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31
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Collongues N, Marignier R, Zéphir H, Papeix C, Blanc F, Tchikviladzé M, Ritleng C, Outteryck O, Vukusic S, Fleury M, Mignot C, Brassat D, Clanet M, Milh M, Ruet A, Lebrun-Frenay C, Camu W, Debouverie M, Créange A, Moreau T, Labauge P, Castelnovo G, Edan G, Lepage E, Defer G, Barroso B, Thouvenot E, Heinzlef O, Gout O, Rodriguez D, Augustin J, Wiertlewski S, Laplaud D, Borgel F, Slassi I, Berroir S, Tourniaire P, Grimaud J, Brochet B, Vermersch P, Confavreux C, de Sèze J. Neuromyélite optique de Devic et patients à haut risqué : enquête rétrospective nationale. Rev Neurol (Paris) 2009. [DOI: 10.1016/s0035-3787(09)70025-6] [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: 11/15/2022]
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32
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Schmit E, Gouraud PA, Debouverie M, Lebrun-Frenay C, Lepage E, Defer G, Moreau T, Vukusic S, Mrejem S, Fontaine B, Edan G, Couturier N, Parmentier L, Merle H, Clanet M, Brassat D. Critères clinico-radiologiques d’introduction d’un traitement de seconde ligne dans la sclérose en plaques : l’expérience de 294 patients traités par interféron suivis pendant 5 ans. Rev Neurol (Paris) 2009. [DOI: 10.1016/s0035-3787(09)70013-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lebrun C, Bensa C, Debouverie M, De Seze J, Wiertlievski S, Brochet B, Clavelou P, Brassat D, Labauge P, Roullet E. Unexpected multiple sclerosis: follow-up of 30 patients with magnetic resonance imaging and clinical conversion profile. J Neurol Neurosurg Psychiatry 2008; 79:195-8. [PMID: 18202208 DOI: 10.1136/jnnp.2006.108274] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [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] [Indexed: 11/04/2022]
Abstract
The concept of preclinical multiple sclerosis is now well recognised, and a diagnosis of silent brain T2 lesions is frequent because of the ease of performing MRI. Nevertheless, patients with incidental brain MRI fulfilling Barkhof- Tintoré criteria are more rare. We report a descriptive retrospective study of clinical and 5 year MRI follow-up in patients with subclinical demyelinating lesions fulfilling MRI Barkhof-Tintoré criteria with a normal neurological examination. 30 patients were identified and the first brain MRI was performed for various medical events: headaches (n = 14), migraine with (n = 2) or without (n = 4) aura, craniocerebral trauma (n = 3), depression (n = 3), dysmenorrhoea (n = 2), epilepsy (n = 1) and cognitive changes (n = 1). Mean time for the second brain MRI was 6 months (range 3-30). 23 patients had temporospatial dissemination (eight with gadolinium enhancement). 11 patients had clinical conversion: optic neuritis (n = 5), brainstem (n = 3), sensitive symptoms (n = 2) and cognitive deterioration (n = 1). Eight (72%) already had criteria of dissemination to space and time before the clinical event. Mean time between the first brain MRI and clinically isolated syndrome (CIS) was 2.3 years. To our knowledge, this is the first cohort of CIS with preclinical follow-up. Early treatment should be discussed in view of the predictive value on conversion of the MRI burden of the disease.
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Couturier N, Bucciarelli F, Dagrassa L, Fontaine B, Clanet M, Brassat D. Facteurs epigénéiques et Sclerose en plaques. Rev Neurol (Paris) 2008. [DOI: 10.1016/s0035-3787(08)70051-1] [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]
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35
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Cournu-Rebeix I, Cohen J, Semana G, Brassat D, Rosenheim M, Fontaine au nom de REFGENSEP B. F - 8 Caractérisation de la cohorte constituée par le réseau français d’étude génétique de la sclérose en plaques (REFGENSEP). Rev Neurol (Paris) 2007. [DOI: 10.1016/s0035-3787(07)90840-1] [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: 11/26/2022]
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36
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Schmit E, Couturier N, Merle H, Gourraud P, Clanet M, Brassat D. F - 31 Définition précoce de la réponse à long terme à l’interféron bêta dans la sclérose en plaques. Rev Neurol (Paris) 2007. [DOI: 10.1016/s0035-3787(07)90863-2] [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: 11/17/2022]
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37
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Brassat D, Motsinger AA, Caillier SJ, Erlich HA, Walker K, Steiner LL, Cree BAC, Barcellos LF, Pericak-Vance MA, Schmidt S, Gregory S, Hauser SL, Haines JL, Oksenberg JR, Ritchie MD. Multifactor dimensionality reduction reveals gene-gene interactions associated with multiple sclerosis susceptibility in African Americans. Genes Immun 2006; 7:310-5. [PMID: 16625214 PMCID: PMC4339061 DOI: 10.1038/sj.gene.6364299] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Multiple sclerosis (MS) is a common disease of the central nervous system characterized by inflammation, myelin loss, gliosis, varying degrees of axonal pathology, and progressive neurological dysfunction. Multiple sclerosis exhibits many of the characteristics that distinguish complex genetic disorders including polygenic inheritance and environmental exposure risks. Here, we used a highly efficient multilocus genotyping assay representing variation in 34 genes associated with inflammatory pathways to explore gene-gene interactions and disease susceptibility in a well-characterized African-American case-control MS data set. We applied the multifactor dimensionality reduction (MDR) test to detect epistasis, and identified single-IL4R(Q576R)- and three-IL4R(Q576R), IL5RA(-80), CD14(-260)- locus association models that predict MS risk with 75-76% accuracy (P<0.01). These results demonstrate the importance of exploring both main effects and gene-gene interactions in the study of complex diseases.
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Affiliation(s)
- D Brassat
- Department of Neurology and Center for Human Genetics, School of Medicine, University of California at San Francisco, USA
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Abstract
The authors report the analysis of HLA-class II allelic heterogeneity in a well characterized multiple sclerosis (MS) Sicilian dataset. Family-based association analysis revealed evidence for excess transmission to affected individuals for alleles HLA-DRB1*1501, DRB1*04, and DQB1*0302. When analyzed as haplotypes, the authors observed excess transmission for the DRB1*0400-DQB1*0302 haplotype. Sicilian patients share the HLA-DRB1*1501 susceptibility allele with affected living in continental Italy, but also display the allelic heterogeneity that characterizes Mediterranean populations.
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Affiliation(s)
- D Brassat
- Department of Neurology, School of Medicine, University of California at San Francisco, CA 94143-0435, USA
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39
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Petzold A, Brassat D, Mas P, Rejdak K, Keir G, Giovannoni G, Thompson EJ, Clanet M. Treatment response in relation to inflammatory and axonal surrogate marker in multiple sclerosis. Mult Scler 2004; 10:281-3. [PMID: 15222692 DOI: 10.1191/1352458504ms1021sr] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [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: 11/05/2022]
Abstract
BACKGROUND This study aimed to investigate if treatment response could retrospectively be related to inflammatory or axonal pathology as measured by plasma surrogate markers. METHODS In this 1-year observational study 30 multiple sclerosis (MS) patients with relapsing-remitting disease were treated with intramuscular IFNbeta-1a or subcutaneous IFNbeta-1b. Responders and nonresponders were defined according to clinical and magnetic resonance imaging criteria. The control group consisted of 14 healthy subjects. Plasma levels of surrogate markers for inflammation (nitric oxide metabolites (NOx)), astrocytic activation (S100B) and axonal damage (NfH(SM135)) were measured using standard assays. RESULTS There were 11 nonresponders and 19 responders to IFNbeta treatment. Median S100B levels were elevated in a higher proportion of treatment responders (63%, 42.9 pg/mL) compared to nonresponders (18%, 11.7 pg/mL, P < 0.05, Fisher's exact test) and controls (0%, 2 pg/mL, P < 0.001). Levels of NOx were found to be more frequently elevated in nonresponders (72%, 39 microM) compared to healthy controls (0%, 37 microM, P < 0.05). Levels of NfH(SM135) were more frequently elevated in responders (58%, 300 pg/mL, P < 0.001) and nonresponders (72%, 500 pg/mL, P < 0.001) compared to controls (0%, 4.5 pg/mL). CONCLUSION Patients with relapsing-remitting MS who had surrogate marker supported evidence for astrocytic activation responded more frequently to treatment with IFNbeta.
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Affiliation(s)
- A Petzold
- Institute of Neurology, Department of Neuroimmunology, Queen Square, London WC1N 3BG, UK.
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40
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Kenealy SJ, Babron MC, Bradford Y, Schnetz-Boutaud N, Haines JL, Rimmler JB, Schmidt S, Pericak-Vance MA, Barcellos LF, Lincoln RR, Oksenberg JR, Hauser SL, Clanet M, Brassat D, Edan G, Yaouanq J, Semana G, Cournu-Rebeix I, Lyon-Caen O, Fontaine B. A second-generation genomic screen for multiple sclerosis. Am J Hum Genet 2004; 75:1070-8. [PMID: 15494893 PMCID: PMC1182142 DOI: 10.1086/426459] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2004] [Accepted: 10/01/2004] [Indexed: 11/03/2022] Open
Abstract
Multiple sclerosis (MS) is a debilitating neuroimmunological and neurodegenerative disorder. Despite substantial evidence for polygenic inheritance of the disease, the major histocompatibility complex is the only region that clearly and consistently demonstrates linkage and association in MS studies. The goal of this study was to identify additional chromosomal regions that harbor susceptibility genes for MS. With a panel of 390 microsatellite markers genotyped in 245 U.S. and French multiplex families (456 affected relative pairs), this is the largest genomic screen for MS conducted to date. Four regions met both of our primary criteria for further interest (heterogeneity LOD [HLOD] and Z scores >2.0): 1q (HLOD=2.17; Z=3.38), 6p (HLOD=4.21; Z=2.26), 9q (HLOD; Z=2.71), and 16p (HLOD=2.64; Z=2.05). Two additional regions met only the Z score criterion: 3q (Z=2.39) and 5q (Z=2.17). Further examination of the data by country (United States vs. France) identified one additional region demonstrating suggestive linkage in the U.S. subset (18p [HLOD=2.39]) and two additional regions generating suggestive linkage in the French subset (1p [HLOD=2.08] and 22q [HLOD=2.06]). Examination of the data by human leukocyte antigen (HLA)-DR2 stratification identified four additional regions demonstrating suggestive linkage: 2q (HLOD=3.09 in the U.S. DR2- families), 6q (HLOD=3.10 in the French DR2- families), 13q (HLOD=2.32 in all DR2+ families and HLOD=2.17 in the U.S. DR2+ families), and 16q (HLOD=2.32 in all DR2+ families and HLOD=2.13 in the U.S. DR2+ families). These data suggest several regions that warrant further investigation in the search for MS susceptibility genes.
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MESH Headings
- Chromosome Mapping
- Chromosomes, Human, Pair 13/genetics
- Chromosomes, Human, Pair 16/genetics
- Chromosomes, Human, Pair 2/genetics
- Chromosomes, Human, Pair 6/genetics
- France
- Gene Frequency
- Genetic Testing/methods
- Genome, Human
- HLA-DR2 Antigen/genetics
- Humans
- Lod Score
- Microsatellite Repeats/genetics
- Models, Genetic
- Multiple Sclerosis/genetics
- United States
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Affiliation(s)
- S J Kenealy
- Center for Human Genetics Research, Vanderbilt University Medical Center, Nashville, TN 37232-0700, USA
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41
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Delobel P, Brassat D, Danjoux M, Lotterie J, Clanet M, Laurent G. Angéite granulomateuse cérébrale révélatrice d'une maladie de Hodgkin. Rev Med Interne 2002. [DOI: 10.1016/s0248-8663(02)80518-5] [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: 10/25/2022]
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Brassat D, Recher C, Waubant E, Le Page E, Rigal-Huguet F, Laurent G, Edan G, Clanet M. Therapy-related acute myeloblastic leukemia after mitoxantrone treatment in a patient with MS. Neurology 2002; 59:954-5. [PMID: 12297591 DOI: 10.1212/wnl.59.6.954] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.7] [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
The authors report a patient with severe secondary progressive MS who responded to mitoxantrone but developed a fatal acute myeloblastic leukemia 15 months after completion of mitoxantrone therapy. Therapy-related acute leukemia (TRAL) in relation with mitoxantrone is rare; this patient was the first case among a cohort of 802 French MS patients treated with mitoxantrone. Nevertheless, this case stresses the need to further evaluate the long-term risk of TRAL in patients with MS who receive mitoxantrone.
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Affiliation(s)
- D Brassat
- Department of Neurology, Hôpital Purpan, Toulouse University Medical Center, Toulouse, France.
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43
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Brassat D. [Therapeutic indications targeting etiology. (With the exception of primary progressive forms)]. Rev Neurol (Paris) 2001; 157:1014-28. [PMID: 11787332] [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: 02/23/2023]
Abstract
On the subject of the treatment of Multiple Sclerosis, JM Charcot stated in 1877 that "the time has not yet come when such a subject can be seriously considered". Fortunately such point of view is no more up to date. This chapter will review the available treatment for relapsing-remitting and secondary progressive Multiple Sclerosis. The immunosuppressive drugs and steroids have been used for many years. Immunomodulation appeared more recently. A review of the evidence on the use of those drugs will be performed.
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Affiliation(s)
- D Brassat
- Fédération de Neurologie, Hopital Purpan, place du Dr Baylac, 31059 Toulouse
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Werring DJ, Brassat D, Droogan AG, Clark CA, Symms MR, Barker GJ, MacManus DG, Thompson AJ, Miller DH. The pathogenesis of lesions and normal-appearing white matter changes in multiple sclerosis: a serial diffusion MRI study. Brain 2000; 123 ( Pt 8):1667-76. [PMID: 10908196 DOI: 10.1093/brain/123.8.1667] [Citation(s) in RCA: 237] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The idea that the initiating event in the formation of all new multiple sclerosis lesions is a focal blood-brain barrier (BBB) leakage associated with perivascular inflammation has been challenged recently by the observation of subtle abnormalities in some quantitative magnetic resonance (MR) parameters (including the magnetization transfer ratio) prior to lesion enhancement. MR diffusion imaging can non-invasively quantify the average apparent diffusion coefficient (ADC(av)), a measure of water molecule random motion that is sensitive to pathological change in multiple sclerosis lesions and to abnormalities in the normal-appearing white matter (NAWM). We therefore used MR diffusion imaging to investigate the dynamic evolution of water diffusion measurements in new enhancing multiple sclerosis lesions, in the NAWM from which they arise, and in anatomically matched contralateral NAWM regions from which no visible lesions develop. Gadolinium diethylenetriaminepentaacetic acid (Gd)-enhanced MRI and MR diffusion studies were performed monthly for 1 year in five multiple sclerosis patients with clinically and radiologically active disease. The ADC(av) was calculated at each time point of the study (before, during and after lesion appearance on Gd-enhanced scans) for each new enhancing lesion, and for regions matched for size and position in the contralateral NAWM. A steady and moderate increase in ADC(av) in prelesion NAWM was observed, which was followed by a rapid and marked increase at the time of Gd enhancement and a slower decay after the cessation of enhancement. In matched contralateral NAWM regions there was a significant but milder increase in ADC(av) at the time of the first noted lesion enhancement. These findings indicate that new focal lesions associated with frank BBB leakage are preceded by subtle, progressive alterations in tissue integrity beyond the resolution of conventional MRI. The increases in ADC(av) in anatomically matched contralateral regions after lesions have appeared supports the concept that structural damage in lesions causes damage or dysfunction in connected areas of NAWM.
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Abstract
The management of individuals with multiple sclerosis must be considered under the following headings: administration and follow-up of adequate disease-modifying treatment, symptomatic relief and neurorehabilitation. Neurorehabilitation deserves a four-step strategy: multidisciplinary assessment, identification of areas of potential functional improvement, setting of goals of short/long-term duration, and measurement of outcomes. The patient's perspective is important to evaluate through questionnaires about quality of life. Well organized disability services with multidisciplinary specialists are probably cost effective and efficient. Determining the actual economic impact of multiple sclerosis and defining the most cost-effective type of care for persons with multiple sclerosis is a need in all countries faced with the limitation of healthcare resources. In persons with multiple sclerosis the range of main symptoms includes the loss of mobility and spasticity, pain, tremor, abnormal eye movements, paroxysmal symptoms, bladder and bowel dysfunction, sexual disturbances, fatigue and depression. Current palliative treatments, which are reviewed, are partly successful depending on the type of symptoms under consideration.
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Affiliation(s)
- M G Clanet
- Fédération de Neurologie, CHU Toulouse Purpan, France.
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Brassat D, Camuzat A, Vidailhet M, Feki I, Jedynak P, Klap P, Agid Y, Dürr A, Brice A. Frequency of the DYT1 mutation in primary torsion dystonia without family history. Arch Neurol 2000; 57:333-5. [PMID: 10714658 DOI: 10.1001/archneur.57.3.333] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Idiopathic torsion dystonia is a clinically and genetically heterogeneous movement disorder. A GAG deletion at position 946 of the DYT1 gene was the first mutation found, in early-onset dystonia, with an autosomal dominant transmission and reduced penetrance. OBJECTIVE To evaluate the frequency of the DYT1 mutation in patients with idiopathic torsion dystonia but without a family history. DESIGN Prospective cohort study. SETTING Four botulinum toxin clinics in the Paris, France, area. PATIENTS A French population of 100 patients with dystonia. MAIN OUTCOME Frequency of the DYT1 mutation tested by polymerase chain reaction and enzyme restriction analysis for the 946 GAG deletion, and genotype-to-phenotype correlation. RESULTS Only 5 mutation carriers were identified, 4 of whom were part of a group of 10 patients with generalized dystonia. Onset was between ages 5 and 12 years as in typical early-onset dystonia. All 4 patients had cranial muscle involvement, which is atypical for DYT1 mutation carriers. One had segmental dystonia. Molecular analysis of relatives in 2 families demonstrated that the lack of family history was due to reduced penetrance. CONCLUSIONS For accurate diagnosis and genetic counseling, screening for the DYT1 deletion is of great interest in cases with generalized dystonia without a family history. In other cases, positive results are rare.
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Affiliation(s)
- D Brassat
- Fédération de Neurologie, INSERM U289, Hôpital de la Salpétrière, Paris, France
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Brassat D, Clanet M. [Treatment of symptoms and relapses of multiple sclerosis]. Rev Prat 1999; 49:1877-81. [PMID: 10598504] [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: 02/14/2023]
Abstract
Multiple sclerosis is a demyelinating disease of the central nervous system, with relapses. For more than 30 years steroids have been used in order to treat relapses. Available trials performed to determine which posology or administration route, and their efficacy, provided poor certitudes. Multiple sclerosis leads to symptoms that alter the quality of life. For fatigue, pain, spasticity and micturition disorder a treatment will be proposed.
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48
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Abstract
INTRODUCTION What is the role of genetic factors in the pathophysiology of idiopathic Parkinson's disease, one of the most frequent neurodegenerative disorders? In the past two years, identification of two genes and localization of a third one have supported the hypothesis that genetics factors are involved in idiopathic Parkinson's disease. We present arguments that support such hypothesis, and describe recent advances in genetic studies of idiopathic Parkinson's disease. CURRENT KNOWLEDGE AND KEY POINTS The first gene identified on chromosome 4 encodes alpha-synuclein. It causes a rare form of autosomal dominant Parkinson's disease. A locus on the short arm of chromosome 2 was recently identified in families with autosomal dominant Parkinson's disease. More recently, the gene encoding Parkin (located on chromosome 6) has been described. It already appears to be an important locus for juvenile parkinsonism with autosomal recessive transmission. CONCLUSION We now have to understand how mutations in these genes lead to selective degeneration of dopaminergic neurons, and to determine whether or not they participate in the genetic susceptibility of idiopathic Parkinson's disease.
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Affiliation(s)
- D Brassat
- Fédération de neurologie, hôpital de la Pitié-Salpêtrière, Paris, France
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Brassat D, Azais-Vuillemin C, Yaouanq J, Semana G, Reboul J, Cournu I, Mertens C, Edan G, Lyon-Caen O, Clanet M, Fontaine B. Familial factors influence disability in MS multiplex families. French Multiple Sclerosis Genetics Group. Neurology 1999; 52:1632-6. [PMID: 10331690 DOI: 10.1212/wnl.52.8.1632] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.6] [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: 11/15/2022] Open
Abstract
BACKGROUND Both genetic and environmental factors play a role in the pathophysiology of MS and may influence the clinical expression of the disease. OBJECTIVE To determine the contribution of familial factors to the clinical expression of MS. METHODS The French Multiple Sclerosis Genetics Group identified 87 sibling pairs. For each patient, sex, age at onset, duration of the disease, and disease course from onset were recorded. Disability was determined by the progression index (PI), defined as the ratio of the Expanded Disability Status Scale (EDSS) score disease duration when the latter exceeded 5 years. Statistical analyses were performed either with a group of patients (clinical features, relation between human leukocyte antigen and clinical features) or with a group of sibpairs (concordance for clinical features). RESULTS The mean age at onset was 29.6 years, the ratio of women to men was 59:28, and the mean PI was 0.27. There was no correlation for disease course and age at onset between sibs with MS. In contrast, we observed a weak but significant correlation of the PI in MS sibpairs (r = 0.234, p = 0.03). CONCLUSION This study revealed a concordance in MS sibling pairs for the disease severity, supporting the hypothesis that the degree of disability might be partly influenced by familial factors (environmental or genetic).
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Affiliation(s)
- D Brassat
- Fédération de Neurologie and INSERM, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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Mertens C, Brassat D, Reboul J, Eichenbaum-Voline S, Vuillemin-Azais C, Cournu I, Babron MC, Semana G, Edan G, Clanet M, Clerget-Darpoux F, Baron-Van Evercooren A, Lyon-Caen O, Liblau R, Fontaine B. A systematic study of oligodendrocyte growth factors as candidates for genetic susceptibility to MS. French Multiple Sclerosis Genetics Group. Neurology 1998; 51:748-53. [PMID: 9748021 DOI: 10.1212/wnl.51.3.748] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [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
OBJECTIVE To test 23 genes coding for growth factors and their receptors as candidates for MS genetic susceptibility in 84 multiplex families of French origin by linkage analysis. BACKGROUND Epidemiologic studies have indicated that genetic susceptibility in MS exists. To identify MS susceptibility genes, association and linkage studies were performed with candidate genes suggested by the pathology of MS. The most consistent result was genetic association and linkage of MS to human leukocyte antigen (HLA) DR15. Recent advances in the knowledge of MS pathology have suggested that the oligodendrocyte, the myelin-forming cell in the CNS, and its growth factors might play a crucial role in MS. METHODS Fifty-two polymorphic markers within or flanking 23 candidate genes were used. Data were analyzed with the maximum likelihood score (MLS) approach. We also searched for a genetic interaction with HLA. RESULTS Negative results were obtained for all candidate genes. The lower limits of the relative risk (Xs) possibly excluded for any candidate gene ranged from 1.3 to 2.8. Positive MLS values (up to 0.93) were observed for transforming growth factor beta 3 (TGFbeta3) in HLA DR15-associated families, suggesting a possible role for this growth factor in interaction with HLA. CONCLUSIONS Oligodendrocyte growth factors do not play a significant role in MS genetic susceptibility, at least in the tested sample. TGFbeta3, the only gene highlighted by this study, deserves further analysis.
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Affiliation(s)
- C Mertens
- INSERM CJF9608, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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