Treatment of depression in people who have multiple sclerosis
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Depression is common among people with multiple sclerosis (MS). Research suggests that treatments for depression are effective in this population, though few patients appear to access these treatments. Our objectives were to consider whether persons with MS and significant depressive symptoms, prompted to seek treatment by letter, did so, what professionals they consulted, and the benefits of any treatment obtained. A total of 495 individuals with MS (401 female; 94 male), aged 22-65 years (mean: 45.8 years), were surveyed in three phases at yearly intervals. Significant depressive symptoms were found over the three phases (50-60.2%). Despite a high prevalence of depressive symptoms, few participants sought treatment, even though prompted to do so. Where treatment was sought, general practitioners remained the principal group consulted. Contrary to previous reports of the efficacy of treatment in clinical trials, no strong support for this was found. Future research needs to consider why the majority of people with MS do not seek treatment for depression, and why interventions, which are not clinical trials, seem to lack effectiveness. Multiple Sclerosis 2007; 13: 632-635. http://msj.sagepub.comKeywords:
Depression
Clinical neurology
Multiple sclerosis is a multifactorial and heterogeneous neurological disease; hence, several experimental animal models had to be developed to mimic the different features of human pathology. Three main classes of animal models have been developed: experimental autoimmune encephalomyelitis (EAE), cuprizone intoxication, and Theiler's murine encephalomyelitis virus (TMEV) infection. The EAE model is the most versatile as it allows the reproduction of different patterns of multiple sclerosis; it is mostly relevant for relapsing-remitting multiple sclerosis and has allowed the development of several first-line, disease-modifying drugs for the treatment of multiple sclerosis. The other two models are less flexible than the EAE model and, to date, have not led to the discovery of any clinically relevant therapies. The cuprizone model mostly mimics the acute and chronic courses of multiple sclerosis, and it may represent a useful tool to develop novel therapies to protect oligodendrocytes and stimulate remyelination. Finally, the TMEV infection is the reference model to specifically study viral-mediated mechanisms of acute and primary progressive multiple sclerosis.
Remyelination
Encephalomyelitis
Demyelinating disease
Animal model
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Background: There is a growing need for biomarkers that can help in early diagnosis of multiple sclerosis (MS) and in recognizing patients with MS activity.Moreover, many studies are recently focusing on biomarkers that may help in diagnosis of the transition from relapsing remitting multiple sclerosis (RRMS) to secondary progressive multiple sclerosis (SPMS).Circulating microRNAs (miRNAs) are now considered promising biomarkers.Objectives: Studying the role of plasma miRNA-145 and miRNA-484 in the diagnosis of MS, disease activity and in diagnosing the transition from RRMS to SPMS.Patients and Methods: Forty-six subjects of both sexes were included, 31 patients with MS )21 with RRMS, 8 with SPMS and Two patients with primary progressive multiple sclerosis (PPMS)) and 15 healthy controls.Expression analysis of plasma miRNAs; miR-145 and miR-484 were assessed by real-time quantitative polymerase chain reaction (PCR) after miRNA extraction.Results: MicroRNAs 145 and 484 could significantly discriminate between MS cases and controls, with best cut-off values > 0.6 and > 1.7 respectively.They could also significantly discriminate between active and inactive MS cases, with best cut-off values > 0.8 and > 2 respectively.Plasma miRNA-145 could discriminate between RRMS and SPMS cases, with best cut-off value ≤1.4.Conclusion: Plasma miRNAs 145 and 484 might be used as promising biomarkers for early diagnosis of MS and in diagnosis of disease activity.Plasma miRNA-145 could be also helpful in diagnosis of the transition from RRMS to SPMS.
Relapsing remitting
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This article is the first in a series on multiple sclerosis. It describes how this neurological disease affects a person's level of abilities. Multiple sclerosis (MS) is a progressive neurological disease. MS is generally diagnosed between the ages of 20 and 50years but can appear later and, in rare cases, children can be affected. The Multiple Sclerosis Society (2007) states ‘MS is the most common disabling neurological condition affecting young adults’. Around 85000 people in the UK have MS.
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Multiple sclerosis is a disorder of the immune system that is caused by a malfunction of our body defenses. In multiple sclerosis, healthy cells of the nervous system are destroyed, and this leads to many health problems, like paralysis. Multiple sclerosis affects a lot of people worldwide. Treatments exist but are still not entirely efficient and do not work for all patients. Many researchers are studying this disease and our group is focusing on specific cells of the immune system that might be playing a role in multiple sclerosis.
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Multiple sclerosis-associated genetic variants indicate that the adaptive immune system plays an important role in the risk of developing multiple sclerosis. It is currently not well understood how these multiple sclerosis-associated genetic variants contribute to multiple sclerosis risk. CD4+ T cells are suggested to be involved in multiple sclerosis disease processes.We aim to identify CD4+ T cell differential gene expression between multiple sclerosis patients and healthy controls in order to understand better the role of these cells in multiple sclerosis.We applied RNA sequencing on CD4+ T cells from multiple sclerosis patients and healthy controls.We did not identify significantly differentially expressed genes in CD4+ T cells from multiple sclerosis patients. Furthermore, pathway analyses did not identify enrichment for specific pathways in multiple sclerosis. When we investigated genes near multiple sclerosis-associated genetic variants, we did not observe significant enrichment of differentially expressed genes.We conclude that CD4+ T cells from multiple sclerosis patients do not show significant differential gene expression. Therefore, gene expression studies of all circulating CD4+ T cells may not result in viable biomarkers. Gene expression studies of more specific subsets of CD4+ T cells remain justified to understand better which CD4+ T cell subsets contribute to multiple sclerosis pathology.
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多発性硬化症（multiple sclerosis：MS）は，本邦の指定難病の一つに定められる中枢神経系の炎症性脱髄疾患である．時間的および空間的に多発する組織硬化を特徴とし，病変部に応じた症状を示す．典型的には再発と寛解を繰り返しながら神経症状が進行し，根治療法は未だ存在しない．MS患者検体やMS動物モデルである実験的自己免疫性脳脊髄炎（experimental autoimmune encephalomyelitis：EAE）を用いた多くの研究により，その本態は中枢神経系の髄鞘タンパク質を標的とした自己免疫疾患であることが明らかとなっている．病態形成には獲得免疫である自己反応性T細胞が中心的な役割を果たしており，近年の研究成果によりB細胞の役割も注目を集めている．MSは再発寛解型MSと進行型MSに分類され，再発寛解型MSに対してはこれらの獲得免疫を標的とする多くの疾患修飾薬が開発されている．進行型MSに対する治療薬はここ数年で承認が始まったばかりであり，神経障害が蓄積する進行期に有効な治療法の確立が待ち望まれている．進行型MSの病態では，獲得免疫だけでなく自然免疫やグリア細胞が免疫病態の重要な構成要素として認知されつつあるが，免疫細胞と神経細胞，グリア細胞間のクロストークの分子機序には未だ不明な点を多く残している．本稿では，MSの病態，および免疫細胞を標的する疾患修飾薬について概説するとともに，EAEを用いた我々の研究成果を交えてアストロサイトによるMS病態の制御機構について紹介する．
Pathogenesis
Encephalomyelitis
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Natalizumab
Clinical neurology
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Neuroradiology
Clinical neurology
Optic neuritis
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Reports on fatty acids levels in multiple sclerosis remain inconclusive.To determine the erythrocyte membrane fatty acid levels in multiple sclerosis patients and correlate with Kurtzke Expanded Disability Status Scale.Fatty acid composition of 31 multiple sclerosis and 30 control individuals were measured by gas chromatography.The membrane phosphatidylcholine C20:4n - 6 concentration was lower in the multiple sclerosis patients when compared to that of the control group, P = 0.04 and it correlated inversely with the EDSS and FSS.Decrease in C20:4n - 6 in the erythrocyte membrane could be an indication of depleted plasma stores, and a reflection of disease severity.
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