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Journal Article 2013; 34(1): 14-17 PubMed PMID: 23524619 Citation  Keywords:  Adolescent, Adult, Aged, Aged, 80 and over, Blood-Brain Barrier:metabolism, Chemistry, Clinical:methods, Female, Ghrelin:blood, Humans, Male, Middle Aged, Multiple Sclerosis, Chronic Progressive:blood, Multiple Sclerosis, Relapsing-Remitting:blood, Reprod.   

: Ghrelin, an orexigenic peptide, exerts immunomodulatory and other effects in the CNS and has neuroprotective properties. Ghrelin is predominantly produced by X/A-like cells in the gastric mucosa. Hence, ghrelin's main source of production lies outside the CNS while important functions of ghrelin are operated by specific receptors in the CNS. We analyzed 82 samples of our repository (45 samples form patients with multiple sclerosis and 37 control samples) for cerebrospinal fluid (CSF) and corresponding serum concentrations of ghrelin. Desacyl ghrelin concentrations were measured with a commercially available enzyme immunometric assay. We validated the assay for CSF samples. The test-retest reproducibility for ghrelin in CSF samples was excellent. Ghrelin CSF concentrations were higher in patients with multiple sclerosis (p<0.02) compared with controls. CSF concentrations correlated with serum concentrations in patients with multiple sclerosis (p<0.01). No such correlation was found in controls. Our findings endorse existing hypotheses that ghrelin affects the central inflammatory process in MS. The correlation between serum and CSF concentrations in MS, but not in controls, suggests a differential regulation of blood-to-brain transport mechanisms for ghrelin in MS and indicates that central effects of ghrelin in MS might be amenable to pharmacological manipulation of the systemic ghrelin secretion....

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Comparative Study 2012; 33(Suppl 3): 179-182 PubMed PMID: 23353864 Citation  Keywords:  Abnormalities, Multiple:epidemiology, Abortion, Spontaneous:epidemiology, Appetite Depressants:adverse effects, Cyclobutanes:adverse effects, Czech Republic:epidemiology, Databases, Factual:statistics & numerical data, Drug Prescriptions:statistics & nume.   

OBJECTIVES: Both, obesity as well as anorexia may be associated with infertility and other complications of pregnancy. Weight loss during pregnancy is therefore considered a risk factor. Weight loss and appetite suppressant are contraindicated during pregnancy, but the unintended exposure is probably not associated with higher risk. Our work was focused on trends in the appetite suppressants use in the Czech Republic and their embryotoxicity.

METHODS: The pregnancies exposed to various appetite suppressants were followed prospectively in the years 1997-2012. The study group was compared to the comparison group which enrolled pregnant women exposed to non-teratogenic drugs. Drugs used as appetite suppressants were sibutramine and phentermine.

RESULTS: Number of calls for this type of exposure was rare till 2005. Their number started to increase until 2009. Later, number of calls decreased because both drugs were withdrawn from the market. This finding reflects increasing tendency for the weight control in the group of fertile women in the Czech Republic. In our study, we did not reveal differences in pregnancy outcomes between study and comparison groups.

CONCLUSIONS: However, we should be aware of the increasing food supplements exposure, that could be used as alternative to the appetite suppressants. Their potential risk results from the limited or completely absent control of their origin. Some of them have probably only placebo effect, but some of them could represent the risk....

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Comparative Study 2012; 33(Suppl 3): 60-65 PubMed PMID: 23353845 Citation  Keywords:  Abnormalities, Multiple:chemically induced, Acetone:toxicity, Animals, Dimethyl Sulfoxide:toxicity, Dose-Response Relationship, Drug, Edema:chemically induced, Embryo, Nonmammalian:drug effects, Ethanol:toxicity, Eye Abnormalities:chemically induced, Meth.   

OBJECTIVES: The aim of this study was to determine the effects of 96 hour exposure to selected solvents on the embryonic stages of zebrafish (Danio rerio). We investigated mortality and various types of changes which appeared (oedema, tail and eye defects, weak pigmentation, and deformation of the body). Based on the results, values of NOEC and LOEC for embryos of D. rerio were determined.

METHODS: Embryonal toxicity tests were conducted according to OECD guideline 212. Ethanol and methanol were tested at concentrations of 0.1, 0.5, 1, 1.5, 2%; acetone at concentrations of 0.1, 0.5, 1, 1.25, 1.5%; and dimethylsulfoxide at concentrations of 1, 1.5, 2, 2.5, 3%.

RESULTS: The LOEC values of ethanol and methanol were detected in the 1% concentration. Statistically significant changes (oedema) were reported in 1% ethanol, and oedema, weak pigmentation and deformation of the body were observed in 1% methanol. After exposure to acetone, the most common occurrence of oedema was in the 0.5% concentration (LOEC = 0.5%). The solvent dimethylsulfoxide caused oedema and body deformation at the 2% concentration (LOEC = 2%).

CONCLUSIONS: The NOEC concentrations of the individual solvents were as follows: ethanol and methanol, 0.5%; acetone, 0.1%; and dimethylsulfoxide, 1.5%. These concentrations of individual solvents were higher than the maximum recommended concentration for toxicity tests on fish. For this reason, it can be assumed that the concentration of solvent allowed by the norm does not affect the procedure or results of such tests....

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Case Reports 2012; 33(6): 579-589 PubMed PMID: 23160229 Citation  Keywords:  Adult, Antibodies, Monoclonal, Humanized:therapeutic use, Brain:pathology, Drug Resistance, Female, Humans, Magnetic Resonance Imaging, Male, Multiple Sclerosis:drug therapy, Natalizumab, Secondary Prevention, Treatment Outcome, Young Adult,.   

: Pediatric cerebrospinal multiple sclerosis (MS) constitutes about 2-5% of all MS cases. The International Pediatric MS Study Group (IPMSSG) applies diagnostic criteria for adults to MS in childhood and adolescence. Recent publications highlight an increasing number of MS in children resistant to the first-line treatment, i.e. disease modifying therapy (DMT). Furthermore, the number of published case studies on children with highly active MS treated with natalizumab also rises, whereas long-term risks as well as therapeutic potential of this therapy in pediatric population have been at the centre of attention. This paper presents a group of 5 children in whom natalizumab was selected to manage highly active disease or resistance to conventional MS treatment and provided very good clinical as well as MRI results....

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Journal Article 2012; 33(1): 67-75 PubMed PMID: 22467115 Citation  Keywords:  Anisotropy, Diffusion Tensor Imaging, Humans, Multiple Sclerosis, Physical Therapy Modalities, Pilot Projects,.   

OBJECTIVES: The aim of this study was to confirm the immunoregulatory and anti-inflammatory changes in the immunologic profile after two months of the facilitation physiotherapy in patients with multiple sclerosis; and to determine whether the changes in the immunologic profile correlate with the changes in dehydroepiandrosterone, the brain microstructure and clinical functions.

DESIGN & SETTING: A group of 12 patients with multiple sclerosis was examined twice: at the beginning and 2 months later after the patients had undergone the facilitation therapy. Standardized tests evaluating chosen clinical functions (balance, righting, equilibrium and protective reactions, tremor, dysdiadochokinesis, dysmetry, fine hand function and walking), immune parameters (parameters of the humoral and cellular immunity), dehydroepiandrosterone and diffusion tensor imaging (the fractional anisotropy, mean diffusivity) were measured. The patients underwent the facilitation physiotherapy in two sessions lasting two hours each week for two months.

RESULTS: All clinical and diffusion tensor imaging parameters significantly improved following the therapy. Without the correction for multiple comparisons, there were significant changes in the IgG, IgG1 subclasses, in the numbers of Neutrophils and Lymphocytes, the T cells (CD3+) absolute number, the T cytotoxic subpopulation (CD3+CD8+) absolute number, B cells (CD19+) and the Natural killer cells. In addition, there was a significant correlation between the changes in the clinical functions and the changes in IgG1 (r=0.67), and between the changes in the mean diffusivity and the changes in CD3+CD8+ absolute (r=-0.61). The changes in the immune parameters and the mentioned correlations were not significant in view of the number of comparisons and thus necessitate further validation. No changes in the dehydroepiandrosterone concentration after the therapy were confirmed.

CONCLUSION: The study suggests new possibilities of physiotherapy to influence the psycho-neuro-endocrine-immune response in patients with multiple sclerosis....

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Clinical Trial 2011; 32(4): 557-562 PubMed PMID: 21876515 Citation  Keywords:  Adult, Aged, Angioplasty:methods, Cerebrovascular Disorders:complications, Chronic Disease, Disability Evaluation, Female, Follow-Up Studies, Humans, Jugular Veins, Male, Middle Aged, Multiple Sclerosis, Chronic Progressive:complications, Multiple Scleros.   

OBJECTIVE: In this study, the mid-term results (6 month follow-up) of the endovascular treatment in patients with Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) and multiple sclerosis (MS) were prospectively evaluated.

METHODS: Thirty-six patients with confirmed MS and CCSVI underwent endovascular treatment by the means of the uni- or bilateral jugular vein angioplasty with optional stent placement. All the patients completed 6 month follow-up. Their MS-related disability status and quality of life were evaluated 1, 3 and 6 months postoperatively by means of the following scales: Expanded Disability Status Scale (EDSS), Multiple Sclerosis Impact Scale (MSIS-29), Epworth Sleepiness Scale (ESS), Heat Intolerance scale (HIS) and Fatigue Severity Scale (FSS). For patency and restenosis rate assessment, the control US duplex Doppler examination was used.

RESULTS: Six months after the procedure, restenosis in post-PTA jugular veins was found in 33% of cases. Among 17 patients who underwent stent implantation into the jugular vein, restenosis or partial in-stent thrombosis was identified in 55% of the cases. At the 6 month follow-up appointment, there was no significant improvement in the EDSS or the ESS. The endovascular treatment of the CCSVI improved the quality of life according to the MSIS-29 scale but only up to 3 months after the procedure (with no differences in the 6 month follow-up assessment). Six months after the jugular vein angioplasty (with or without stent placement), a statistically significant improvement was observed only in the FSS and the HIS.

CONCLUSIONS: The endovascular treatment in patients with MS and concomitant CCSVI did not have an influence on the patient's neurological condition; however, in the mid-term follow-up, an improvement in some quality-of-life parameters was observed....

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Case Reports 2011; 32(4): 415-420 PubMed PMID: 21876497 Citation  Keywords:  Acute Disease, Demyelinating Diseases:pathology, Female, Humans, Magnetic Resonance Imaging, Multiple Sclerosis:pathology, Severity of Illness Index, Treatment Failure, Young Adult,.   

: In this case report we describe the case of a 24 year-old female with a fulminant demyelinating disease of white matter. Disease progression was most probably consistent with the Marburg variant (malignant form) of multiple sclerosis with rapid deterioration of the patient's clinical condition, including bulbar symptoms and epileptic paroxysms and ending with persistent coma and tetraparesis, over the course of 6 months from first symptoms. Repeated Magnetic Resonance Imaging (MRI) examination showed progression of multiple demyelinating lesions culminating in a contiguous focal disorder of the white matter extending both supratentorially and infratentorially. The serial MRI changes closely mapped the deterioration in the patients clinical status. Our patient showed no response to repeated pulse corticotherapy, administration of intravenous immunoglobulins, serial plasmapheresis, and combined high-dose pulse immunosuppression (specify what was used here) and mitoxantrone....

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Case Reports 2011; 32(1): 4-6 PubMed PMID: 21407162 Citation  Keywords:  Adjuvants, Immunologic:administration & dosage, Adult, Female, Humans, Interferon beta-1b, Interferon-beta:administration & dosage, Lupus Erythematosus, Systemic:chemically induced, Multiple Sclerosis, Relapsing-Remitting:drug therapy, Time Factors,.   

: Drug-induced systemic lupus erythematosus (SLE) is a rare complication of therapies with some drugs. Breaking out after months or years of therapy with a certain drug, its occurrence is likely to increase with the duration of the medication and the cumulative quantity of the drug. The symptoms of this syndrome include, in particular, arthralgia, myalgia, fever, serositis, skin exanthema and production of antinuclear (ANA) antibodies. In contrast to SLE, its symptoms gradually abate after discontinuation of the inducing agent. The authors describe the case of a 43-year-old patient suffering from multiple sclerosis who experienced drug-induced SLE after 8-year application of interferon (IFN) beta-1b....

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