Abstract Background and Aims This study aimed to identify the clinical characteristics and electrodiagnostic subtypes of Guillain‐Barré syndrome (GBS) in Istanbul. Methods Patients with GBS were prospectively recruited between April 2019 and March 2022 and two electrodiagnostic examinations were performed on each patient. The criteria of Ho et al., Hadden et al., Rajabally et al., and Uncini et al. were compared for the differentiation of demyelinating and axonal subtypes, and their relations with anti‐ganglioside antibodies were analyzed. Results One hundred seventy‐seven patients were included, 69 before the coronavirus disease 2019 pandemic (April 2019–February 2020) and 108 during the pandemic (March 2020–March 2022), without substantial changes in monthly frequencies. As compared with the criteria of Uncini et al., demyelinating GBS subtype diagnosis was more frequent according to the Ho et al. and Hadden et al. criteria (95/162, 58.6% vs. 110/174, 63.2% and 121/174, 69.5%, respectively), and less frequent according to Rajabally et al.'s criteria (76/174, 43.7%). Fourteen patients' diagnoses made using Rajabally et al.'s criteria were shifted to the other subtype with the second electrodiagnostic examination. Of the 106 analyzed patients, 22 had immunoglobulin G anti‐ganglioside antibodies (14 with the axonal subtype). They had less frequent sensory symptoms (54.5% vs. 83.1%, p = 0.009), a more frequent history of previous gastroenteritis (54.5% vs. 22.9%, p = 0.007), and a more severe disease as compared with those without antibodies. Interpretation Serial electrodiagnostic examinations are more helpful for accurate subtype diagnosis of GBS because of the dynamic pathophysiology of the disease. We observed no significant increase in GBS frequency during the pandemic in this metropolis.
ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Tamam Y, Yüceer H, Düzel B, Şen M, Ulusoy C, Tuzun E. Serum levels of inflammasome pathway factors in clinically isolated syndrome and multiple sclerosis patients: a pilot study. Central European Journal of Immunology. 2020;45(2):237-240. doi:10.5114/ceji.2020.96877. APA Tamam, Y., Yüceer, H., Düzel, B., Şen, M., Ulusoy, C., & Tuzun, E. (2020). Serum levels of inflammasome pathway factors in clinically isolated syndrome and multiple sclerosis patients: a pilot study. Central European Journal of Immunology, 45(2), 237-240. https://doi.org/10.5114/ceji.2020.96877 Chicago Tamam, Yusuf, Hande Yüceer, Berna Düzel, Melis Şen, Canan Ulusoy, and Erdem Tuzun. 2020. "Serum levels of inflammasome pathway factors in clinically isolated syndrome and multiple sclerosis patients: a pilot study". Central European Journal of Immunology 45 (2): 237-240. doi:10.5114/ceji.2020.96877. Harvard Tamam, Y., Yüceer, H., Düzel, B., Şen, M., Ulusoy, C., and Tuzun, E. (2020). Serum levels of inflammasome pathway factors in clinically isolated syndrome and multiple sclerosis patients: a pilot study. Central European Journal of Immunology, 45(2), pp.237-240. https://doi.org/10.5114/ceji.2020.96877 MLA Tamam, Yusuf et al. "Serum levels of inflammasome pathway factors in clinically isolated syndrome and multiple sclerosis patients: a pilot study." Central European Journal of Immunology, vol. 45, no. 2, 2020, pp. 237-240. doi:10.5114/ceji.2020.96877. Vancouver Tamam Y, Yüceer H, Düzel B, Şen M, Ulusoy C, Tuzun E. Serum levels of inflammasome pathway factors in clinically isolated syndrome and multiple sclerosis patients: a pilot study. Central European Journal of Immunology. 2020;45(2):237-240. doi:10.5114/ceji.2020.96877.
Introduction: Prevision of conversion from clinically isolated syndrome (CIS) to multiple sclerosis (MS) is required to avoid unnecessary use of immunomodulating agents and to recognize patients with high disease activity. Our aim was to evaluate the value of phosphorylated neurofilament heavy chain (pNFH, a marker for neuroaxonal degeneration) and Cyclic adenosine monophosphate response element-binding protein (cAMP response element-binding protein [CREB], a marker for neuroregeneration) levels in the prediction of conversion from CIS to MS. Methods: Twenty-three consecutively recruited treatment-naïve CIS patients were followed for 36 months. pNFH and CREB levels were measured in the first episode cerebrospinal fluid (CSF) and the serum of 12 converting (CIS-MS) and 11 nonconverting CIS patients (CIS-CIS) by enzyme-linked immunosorbent assay. Results: Baseline CSF but not serum samples of CIS-CIS patients displayed significantly lower pNFH levels compared to patients with CIS-MS. The analysis of receiver operating characteristic curve presented a high specificity for the prediction of MS conversion for the CSF pNFH cut-off level of 730.9 pg/ml. CSF pNFH levels significantly correlated with serum and CSF CREB levels. Higher baseline CSF pNFH and CREB levels were associated with more rapid progression to MS or increased disability scores. Conclusion: CSF pNFH measurement may potentially determine MS patients with unfavorable clinical progression after the first attack. pNFH and CREB appear to be increased in parallel in CSF of CIS patients with higher disease activity. These results suggest that neurofilaments are not only indicators of axonal degeneration but also partly a marker of neuronal differentiation and new axon regeneration mediated by CREB signaling pathway.
Background/Aim: Obstructive sleep apnea syndrome (OSAS) is associated with intermittent episodes of hypoxia, endothelial dysfunction and associated cardiovascular problems. Our aim was to investigate whether OSAS-related hypoxia alters the expression of rho-associated protein kinase (ROCK), a marker of chronic hypoxia and endothelial dysfunction. Materials and Methods: ROCK1 and ROCK2 levels were measured by immunoblotting in peripheral blood mononuclear cells (PBMC) of 47 OSAS patients and 17 healthy controls. Results: OSAS patients showed significantly lower PBMC ROCK1 and ROCK2 levels than healthy controls in the morning, but not in the evening. ROCK1/2 levels were correlated with blood triglyceride, visceral adiposity index, minimum oxygen saturation, C-reactive protein concentration, lymphocyte levels and sleep efficiency. Conclusion: Intermittent hypoxia induced by OSAS does not permanently alter ROCK protein expression levels. OSAS appears to be associated with endothelial dysfunction through inflammation and lipid metabolism pathways.
