The Relationship Between Carotid Intima-media Thickness and Homosystein in Ischemic Stroke

Objective: The vast majority of ischemic strokes occur due to atherosclerosis. Although the precise mechanism is unknown, high homocysteine (HM) levels are considered to play a role in the development of atherosclerosis. In this study, the relationship between high HM and carotid intima-media thickness (CIMT), as an early predictor of atherosclerosis, is evaluated in patients with ischemic stroke

Epileptic Seizure as First Presenting Symptom of Multiple Sclerosis: A Case Report

While epileptic seizures are seen in the course of multiple sclerosis, they are rarely the first symptom. The first epileptic seizure of a 26-yearold woman with multiple sclerosis is described in the present report. The patient presented to the emergency department with generalized tonic-clonic seizure. Neurologic examination was normal except for right-sided hemiparesis and hyperactive deep tendon reflexes. Cranial MRI revealed periventricular, multiple millimetric lesions and a 45x27-mm, semi-ring-enhanced, cortical, T2/FLAIR, hyperintense lesion in the centrum semiovale. IgG index was high, and oligoclonal band was positive in cerebrospinal fluid examination. Electroencephalography showed prominent fronto-temporal activity on the left side and sharp wave paroxysms. Multiple sclerosis was diagnosed, and pulse corticosteroid therapy was initiated. Due to recurrent seizures, antiepileptic drug was added to treatment; seizures were controlled with monotherapy. It is known that patients with multiple sclerosis experience seizures. Multiple sclerosis should be considered in the differential diagnosis of young patients presenting with seizures

Predictive value of early serum cytokine changes on long-term interferon beta-1a efficacy in multiple sclerosis

WOS: 000357245400005PubMed ID: 25026220Background: In a previous study, we had evaluated short-term effects of interferon beta-1a (IFNB-1a) 44 mu g s.c. three times per week treatment on serum levels of IFN-gamma (IFNG), IL-23, IL-17, IL-10, IL-9, IL-4 and TGF-beta (TGFB) and found a reduction only in IL-17 and IL-23 levels after 2 months of treatment. Methods: Using the same multiple sclerosis (MS) cohort, we assessed the predictive value of early cytokine level changes (difference between 2nd month and baseline levels as measured by ELISA) on the efficacy of long-term IFNB-1a treatment. Results: The alteration in IFNG levels of patients without any relapse was statistically lower than that of patients having one or more relapses (p = 0.019, Student's t-test). When patients with or without expanded disability severity scale (EDSS) progression were compared, none of the cytokine level changes showed a significant difference between groups. IL-17 and IL-23 level changes did not predict relapse and EDSS progression in IFNB-1a-treated MS patients. Conclusion: Our results show that the predictive power of early IFNG measurement on relapse occurrence may potentially extend a time span of several years

Effect of short-term interferon-beta treatment on cytokines in multiple sclerosis: Significant modulation of IL-17 and IL-23

WOS: 000306159200032PubMed ID: 22652415Therapeutic effect of interferon-beta (IFN-beta) treatment has been associated with modulation of the balance between Th1, Th17, Th2 and regulatory T (Treg) cells, whereas the impact of disease modifying drugs on Th9-immunity in multiple sclerosis (MS) has not been studied. To investigate the short-term effects of IFN-beta treatment on cytokines in MS, we determined serum levels of IL-17, IL-23, IL-10, IL-4, IFN-gamma, IL-9 and TGF-beta in relapsing remitting MS patients before and 2 months after IFN-beta treatment by ELISA. MS patients showed increased IL-17, IL-23 and IL-4 levels and decreased IL-9 levels as compared to healthy controls. IFN-beta treatment only reduced IL-17 and IL-23 levels, whereas the levels of other cytokines remained unchanged. IFN-beta treatment appears to exert its earliest therapeutic effect on Th17-immunity. The influence of IL-9 on MS pathogenesis needs to be further studied. (C) 2012 Elsevier Ltd. All rights reserved

Effect of short-term interferon-beta treatment on cytokines in multiple sclerosis: Significant modulation of IL-17 and IL-23

Therapeutic effect of interferon-beta (IFN-beta) treatment has been associated with modulation of the balance between Th1, Th17, Th2 and regulatory T (Treg) cells, whereas the impact of disease modifying drugs on Th9-immunity in multiple sclerosis (MS) has not been studied. To investigate the short-term effects of IFN-beta treatment on cytokines in MS, we determined serum levels of IL-17, IL-23, IL-10, IL-4, IFN-gamma, IL-9 and TGF-beta in relapsing remitting MS patients before and 2 months after IFN-beta treatment by ELISA. MS patients showed increased IL-17, IL-23 and IL-4 levels and decreased IL-9 levels as compared to healthy controls. IFN-beta treatment only reduced IL-17 and IL-23 levels, whereas the levels of other cytokines remained unchanged. IFN-beta treatment appears to exert its earliest therapeutic effect on Th17-immunity. The influence of IL-9 on MS pathogenesis needs to be further studied. (C) 2012 Elsevier Ltd. All rights reserved

Predictive value of early serum cytokine changes on long-term interferon beta-1a efficacy in multiple sclerosis

Background: In a previous study, we had evaluated short-term effects of interferon beta-1a (IFNB-1a) 44 mu g s.c. three times per week treatment on serum levels of IFN-gamma (IFNG), IL-23, IL-17, IL-10, IL-9, IL-4 and TGF-beta (TGFB) and found a reduction only in IL-17 and IL-23 levels after 2 months of treatment. Methods: Using the same multiple sclerosis (MS) cohort, we assessed the predictive value of early cytokine level changes (difference between 2nd month and baseline levels as measured by ELISA) on the efficacy of long-term IFNB-1a treatment. Results: The alteration in IFNG levels of patients without any relapse was statistically lower than that of patients having one or more relapses (p = 0.019, Student's t-test). When patients with or without expanded disability severity scale (EDSS) progression were compared, none of the cytokine level changes showed a significant difference between groups. IL-17 and IL-23 level changes did not predict relapse and EDSS progression in IFNB-1a-treated MS patients. Conclusion: Our results show that the predictive power of early IFNG measurement on relapse occurrence may potentially extend a time span of several years

Comparative analysis of fingolimod versus teriflunomide in relapsing-remitting multiple sclerosis

Background: Fingolimod and teriflunomide are commonly used in the treatment of relapsing-remitting multiple sclerosis (RRMS). These have not been compared in controlled trials, but only in observational studies, with inconclusive results. Comparison of their effect on relapse and disability in a real-world setting is therefore needed

Clinical and Demographic Characteristics and Two-Year Efficacy and Safety Data of 508 Multiple Sclerosis Patients with Fingolimod Treatment

Introduction: Fingolimod is the first oral immunomodulatory treatment used as secondary care therapy in the treatment of multiple sclerosis for the last 10 years. The objective of our study is to reveal the experiences of the first generic fingolimod active ingredient treatment in different centers across Turkey. Method: The first generic fingolimod efficacy and safety data of patients followed-up in 29 different clinical multiple sclerosis units in Turkey were analyzed retrospectively. Data regarding efficacy and safety of the patients were transferred to the data system both before the treatment and on the 6th, 12th and 24th month following the treatment. The data were analyzed using the IBM SPSS 20.00. P value of <0.05 was considered to be statistically significant. Results: A total of 508 multiple sclerosis patients, 331 of whom were women, were included in the study. Upon comparing the Expanded Disability Status values before and after the treatment, a significant decrease was observed, especially at month 6 and thereafter. Since bradycardia occurred in 11 of the patients (2.3%), the first dose had to be longer than 6 hours. During the observation of the first dose, no issues that could prevent the use of the drug occured. Side effects were seen in 49 (10.3%) patients during the course of fingolimod treatment. Respectively, the most frequent side effects were bradycardia, hypotension, headache, dizziness and tachycardia. Conclusion: The observed results regarding efficacy and safety were similar to clinical trial data in the literature and real life data in terms of the first equivalent with fingolimod active ingredient

The Turkish experience of COVID-19 infection in people with NMOSD and MOGAD: A milder course?

Background: COVID-19 is a multisystemic infection with variables consequences depending on individual and comorbid conditions. The course and outcomes of COVID-19 during neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disorders (MOGAD) are not clearly known

The Turkish experience of COVID-19 infection in people with NMOSD and MOGAD: A milder course?

Background: COVID-19 is a multisystemic infection with variables consequences depending on individual and comorbid conditions. The course and outcomes of COVID-19 during neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disorders (MOGAD) are not clearly known. Objective/methods: The aim of this study was to examine the features and outcomes of COVID-19 infection in NMOSD and MOGAD patients. The patients' demographic and clinical factors, disease modifying treatment (DMT) used and disease information of COVID-19 infection were recorded. Conditions leading to hospitalization and severe exposure to COVID-19 infection were also analyzed. Results: The study included 63 patients from 25 centers. Thirty-two patients (50.8%) belong to AQP-4 seropositive group, 13 (20.6%) and 18 (28.6%) were in MOG-positive and double-seronegative groups, respectively. Risk factors for severe COVID-19 infection and hospitalization were advanced age, high disability level and the presence of comorbid disease. Disease severity was found to be high in double-seronegative NMOSD and low in MOGAD patients. No statistically significant effect of DMTs on disease severity and hospitalization was found. Conclusion: In NMOSD and MOGAD patients, advanced age, high disability and presence of comorbid disease pose risks for severe COVID-19 infection. There was no direct significant effect of DMTs for COVID-19 infection. © 2021 Elsevier B.V