RESUMEN
A comparative morphological study of primary and relapsing desmoid tumors was carried out. Immunohistochemical analysis showed that the progress of desmoid tumors in the form of relapses was paralleled by an increase in the counts of immunopositive cells and intensity of ß-catenin and cycloxygenase-2 expression.
Asunto(s)
Ciclooxigenasa 2/genética , Fibromatosis Abdominal/patología , Fibromatosis Agresiva/patología , beta Catenina/genética , Adolescente , Adulto , Anciano , Progresión de la Enfermedad , Femenino , Fibromatosis Abdominal/diagnóstico , Fibromatosis Abdominal/genética , Fibromatosis Agresiva/diagnóstico , Fibromatosis Agresiva/genética , Expresión Génica , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Pronóstico , RecurrenciaRESUMEN
A complex study of 50 patients with active typical remitting multiple sclerosis (MS) was carried out. Neuropsychological testing using Wechsler and Stroop tests and MRI of the brain with the morphometric analysis of focal and diffusive changes were used in the study. Patients were stratified into two subgroups by the changes in the performance of neuropsychological tests. The disease course was assessed during five years. In all cases, the natural course of the disease, i.e. when patients did not receive disease modifying drugs, was analyzed. The transition to secondary progressive MS and the marked increase in MS severity on the EDSS were found in the subgroup of patients who demonstrated changes in the neuropsychological test performance. The strongest correlation was observed between EDSS scores and the diffusive atrophy of the brain white matter on MRI. The data of neuropsychological testing and some brain MRI parameters may be recommended as a predictive test in remitting MS.
Asunto(s)
Esclerosis Múltiple Recurrente-Remitente/patología , Esclerosis Múltiple Recurrente-Remitente/psicología , Adulto , Atrofia/patología , Progresión de la Enfermedad , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Pronóstico , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
Treatment of multiple sclerosis (MS) remains one of the most serious problems of modern medicine though a significant progress in understanding of disease pathogenesis has been achieved over the last years. Currently there are the ways of modifying the disease course that improve the remote prognosis. In this review, we present results of studies of drugs modifying the MS course which have been approved for MS treatment and those that are in the stage of clinical trials and expected to enlarge possibilities of MS treatment.
Asunto(s)
Factores Inmunológicos/uso terapéutico , Esclerosis Múltiple/tratamiento farmacológico , Esclerosis Múltiple/inmunología , Humanos , Resultado del TratamientoRESUMEN
Adherence to long-term therapy is a necessary condition of successful long-term treatment of the such chronic disabling disease as multiple sclerosis (MS). We studied factors associated with the rejection of treatment with disease modifying drugs (DMD) in 153 patients of the Moscow multiple sclerosis center who received or rejected the DMD treatment by their own choice. The groups were compared by neurological, socio-demographic and neuropsychological characteristics. The EDSS, HADS and the original socio-demographic questionnaire have been administered. Patients receiving glatimer acetate rejected the treatment less often compared to those receiving other DMD. The withdrawal of any DMD in the anamnesis predicted the future rejection of treatment. The first four months was the most risky period with respect to the rejection. Lack of family support, absence of work and age were independent factors associated with the rejection of DMD. Marked anxiety, lack of cooperation and lack of compliance were associated with the patient's rejection of treatment. No significant correlations of the treatment rejection, duration and type of MS course with depression were found.
Asunto(s)
Factores Inmunológicos/uso terapéutico , Esclerosis Múltiple/tratamiento farmacológico , Cooperación del Paciente , Adolescente , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
Because multiple sclerosis (MS) mostly affects young working-age adults, the search for new effective disease-modifying drugs is extremely important. All the first line MS therapies approved in Russia are injectable medications for continuous subcutaneous or intramuscular self-administration once weekly or once daily. This fact is often a reason for a patient to refuse the treatment. Also it can result in specific side-effects. Natalizumab (Tysabri) is the first of a new class of drugs, alpha4-integrin antagonists, approved in the USA and EU for the treatment of active RRMS. It has shown a significant influence on clinical and MRI-activity of the disease. Natalizumab monotherapy leads to significant decrease in annualized relapse rate, disability progression risk and lesion load. This article reviews recent publications on the mechanism of action, effectiveness and safety of natalizumab, a new promising drug for MS therapy.
Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Esclerosis Múltiple/tratamiento farmacológico , Anticuerpos Monoclonales/administración & dosificación , Anticuerpos Monoclonales Humanizados , Humanos , Inyecciones Intramusculares , Inyecciones Subcutáneas , Natalizumab , Prevención Secundaria , Resultado del TratamientoRESUMEN
The diagnosis of multiple sclerosis (MS) is a life-altering experience that has far-reaching and diverse implications for newly diagnosed patients and their families. Since the disease is complex and highly variable, it places physical, emotional and social challenges on everyone concerned. A number of responsible decisions must be made, the most difficult one being the consent to long-term therapy. Joint effort of both physicians and patients allow the latter to take up properly new life circumstances, get adequate motivation, right and regular implementation of the long-term treatment plan aiming to prevent the disease progression. The management of many chronic diseases involves medications that must be injected on the frequent basis. In MS, such injections can reduce the frequency of relapses and slow the disease progression. Pretreatment injection self-efficacy expectations, injection anxiety, therapeutic expectations and ability to self-inject are significantly related to adherence. Poor patient adherence to long-term therapy severely compromises the treatment effectiveness.
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Adyuvantes Inmunológicos/uso terapéutico , Interferón beta/uso terapéutico , Esclerosis Múltiple/terapia , Apoyo Social , Humanos , Interferon beta-1b , Motivación , Esclerosis Múltiple/tratamiento farmacológico , Cooperación del Paciente , Ajuste SocialRESUMEN
In experiments with normal and thymectomized rats it has been revealed that exposure of normal animals to 0.35 Gy of gamma-radiation induces changes in blood cells subsets, depression of NK functional activity, decrease in polymorphonuclear leukocyte basal chemiluminescence level, suppression of the delayed type of hypersensitivity reaction and stimulation of local IgE-synthesis in respiratory organs. At the same time irradiation of adult thymectomized animals did not resulted in significant fluctuations in cellular and humoral immunity indices as well as blood cells functional activity level. Some mechanisms of radiation-induced immune system disturbances mediated via thymus are discussed.
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Sistema Inmunológico/efectos de la radiación , Traumatismos Experimentales por Radiación/inmunología , Timo/inmunología , Animales , Formación de Anticuerpos/efectos de la radiación , Hipersensibilidad Tardía/inmunología , Hipersensibilidad Inmediata/inmunología , Inmunidad Celular/efectos de la radiación , Inmunoglobulina E/biosíntesis , Células Asesinas Naturales/inmunología , Células Asesinas Naturales/efectos de la radiación , Pulmón/inmunología , Masculino , Dosis de Radiación , Ratas , Timo/efectos de la radiación , Tráquea/inmunologíaRESUMEN
A study was made of total and local immunity of two groups of Papio hamadryads subjected to single and ten-fold external gamma-irradiation at a cumulative dose of 5 cGy. It has been shown that with equal dosages changes in the relative and absolute number of lymphocytes in the peripheral blood, the number of circulating T-cells and their functional activity are more pronounced in animals subjected to fractionated irradiation. Both groups exhibited similar disturbances in the functional activity of antibody-dependent killers and in local immunity of stomatopharynx. Analysis of the immunological data and the results of hydrocortisone content determinations in blood serum of exposed animals has demonstrated the presence of both direct effect of low-level radiation on the immune system and indirect effect that is particularly pronounced in case of multifraction long-term irradiation.
Asunto(s)
Citotoxicidad Celular Dependiente de Anticuerpos/efectos de la radiación , Hidrocortisona/efectos de la radiación , Células Asesinas Naturales/efectos de la radiación , Orofaringe/efectos de la radiación , Dosis de Radiación , Linfocitos T/efectos de la radiación , Animales , Citotoxicidad Celular Dependiente de Anticuerpos/inmunología , Rayos gamma , Hidrocortisona/sangre , Células Asesinas Naturales/inmunología , Orofaringe/inmunología , Papio , Linfocitos T/inmunología , Factores de TiempoRESUMEN
Mast cells and macrophages isolated from sensitized rats are unequivalent producer of enzymes in systems in vitro. Allergen intensifies exocytosis of acid phosphatase in them but the activity of allergen-induced enzyme secretion by macrophages ++ in immunized rats is lower than the activity of spontaneous secretion of acid phosphatase in suspensions of macrophages + in nonimmunized rats. Macrophages rather than mast cells show the ability for exocytosis of C4-gamma-glutamyltranspeptidase, leukotriene++ catabolism enzyme. Cocultivation of immune macrophages with syngeneic mast cells in the presence of allergen is followed with sharp depression of the activity of this enzyme secretion, that can create conditions for prolongation of eicosanoid effects in allergy.
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Fosfatasa Ácida/metabolismo , Macrófagos/enzimología , Mastocitos/fisiología , Cavidad Peritoneal/citología , gamma-Glutamiltransferasa/metabolismo , Animales , Células Cultivadas , Técnicas In Vitro , Ratas , Ratas EndogámicasRESUMEN
In a test of adoptive cutaneous anaphylaxis, the influence of the phospholipase A2 inhibitor mepacrine, on the intensity of the local anaphylactic reaction was investigated in the skin of recipients following intracutaneous injection of syngenic immune splenocytes. Injection of the mepacrine solution with preincubated sensibilized splenocytes inhibits the cutaneous anaphylactic reaction after a single intravenous administration of allergen to recipients. The inoculation of immune splenocytes, preincubated in mepacrine but without the phospholipase A2 inhibitor, to the skin of syngeneic recipients is accompanied by less suppression of the local skin anaphylactic reaction than with a common injection of mepacrine with immune splenocytes.