Headache after lumbar puncture: failure of different preventive measures.
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Adult↗
Biomedical subjects
D Caputo
Publications and source records attributed to D Caputo.
HTLVI antibodies in multiple sclerosis and other neurological diseases.
The sera and the CSFs from 157 Multiple Sclerosis (MS) patients and 43 other neurological diseases (OND) cases have been evaluated for the presence of HTLVI antibodies. A commercial passive agglutination assay (PPA), an indirect fluorescence assay (IFA), and a Western Immunoblotting (WIB) performed in our laboratories have been employed. No OND samples showed HTLVI antibodies, while 14 sera and 1 CSF from MS patients resulted positive by PPA and 4 sera were positive with the IFA. When tested with WIB 6 MS sera showed a reactivity against one or more HTLVI proteins. Our results lead us to affirm that in a small number of MS patients, when sensitive tests are employed, it is possible to observe an antibody response toward proteins that share one or more epitope with HTLVI antigens.
HTLV-I Antibodies↗
Circulating immune complexes in serum and in cerebrospinal fluid of patients with multiple sclerosis. Characterization and correlation with the clinical course.
We studied circulating immune complexes (IC) in the serum and cerebrospinal fluid (CSF) of patients with clinically defined multiple sclerosis (MS), in order to establish a correlation with the clinical course of the disease and to investigate the molecular composition of the IC isolated from patients in active phase of the disease. Serum IC levels were found to be significantly increased in patients from the progressive and active relapsing-remittent subgroups with both the CIC-conglutinin and C1q-binding methods. High levels of IC in CSF were detected only in the subgroup consisting of the relapsing-remittent patients in disease exacerbation when IC were determined by the C1q-binding test. No significant increase in serum or in CSF were found using the mRF-I test. The preliminary results of a qualitative investigation on serum IC in MS indicated that they are heterogeneous in nature, their size is mainly of the intermediate type, and they contain IgG, IgM, complement components and beta 2-microglobulins, the latter presenting an observation both new and interesting for studies on serum IC in MS patients.
Adolescent↗
Azathioprine reduces intrathecal IgG synthesis in multiple sclerosis.
Intrathecal IgG synthesis and CSF oligoclonal bands were reexamined after 18-24 months in 66 patients with multiple sclerosis; 40 of them received azathioprine (AZA) 2.5 mg/Kg/die; all received a course of dexamethasone (DEXA) during clinical relapses. The IgG Index was significantly reduced in the group treated with AZA, especially in patients with short disease duration, low disability and high IgG index. Changes observed in CSF banding pattern were not significant. These results suggest an effect of AZA on IgG synthesis, as reported by in vitro studies.
Adult↗
The role of lymphocyte subset analysis in defining the clinical evolution of multiple sclerosis.
Thirty patients with definite multiple sclerosis (MS) were examined monthly for one year. Each time, neurological examination, clinical history and monoclonal-antibody-defined T cell subsets were evaluated. Particularly, the helper/suppressor ratio (T4/T8) and the T4/T8 test-to-test variability (delta T4/T8) were considered in relation to the occurrence of clinical exacerbations. Statistically significant correlations were found between clinical course and laboratory parameters, suggesting a possible role of T cell subset analysis in defining the clinical evolution of MS.
Adult↗
Longitudinal survey of T-lymphocytes and viral antibodies in MS patients.
Our study focused on the relationship between lymphocyte H/S ratios and antiviral antibodies. We have concluded a longitudinal survey of 29 clinically definite MS patients for 8 months seeking a possible correlation among clinical modifications, fluctuations of T-cell subsets and antiviral antibody titers. For this purpose in each patient the following parameters were recorded monthly:--clinical history and neurological examination;--blood T-cell subpopulation as defined by monoclonal antibodies of the OKT series;--serum antibody titers against measles, herpes simplex type 1 and 2, HTLV-1 viruses. All these data were compared with the different MS subgroups as defined by clinical course: stable, relapsing, progressive. We found that constantly normal OKT4+/OKT8+ ratios correlate with a stable clinical course; that highly fluctuating ratios parallel clinical exacerbation; that constantly high ratios are associated with a chronic-progressive course. These results are discussed with special reference to the correlation between OKT8+ lymphocyte percentages and anti-HTLV-1 antibodies, since this last virus has recently been claimed to be of pathogenetic importance in MS.
Adolescent↗
Magnetic resonance in multiple sclerosis.
Magnetic Resonance Imaging was performed in more than 200 patients with clinical suspicion or knowledge of Multiple Sclerosis. One hundred and forty-seven (60 males and 87 females) had MR evidence of multiple sclerosis lesions. The MR signal of demyelinating plaques characteristically has prolonged T1 and T2 relaxation times and the T2-weighted spin-echo sequences are generally superior to the T1-weighted images because the lesions are better visualized as areas of increased signal intensity. MR is also able to detect plaques in the brainstem, cerebellum and within the cervical spinal cord. MR appears to be an important, non-invasive method for the diagnosis of Multiple Sclerosis and has proven to be diagnostically superior to CT, evoked potentials (EP) and CSF examination. In a selected group of 30 patients, with the whole battery of the relevant MS studies, MR was positive in 100%, CT in 33.3%, EP in 56% and CSF examination in 60%. In patients clinically presenting only with signs of spinal cord involvement or optic neuritis or when the clinical presentation is uncertain MR has proven to be a very useful diagnostic tool for diagnosis of MS by demonstrating unsuspected lesions in the cerebral hemispheres.
Female↗
Lymphocytoplasmapheresis in multiple sclerosis: one-year results in 6 patients.
6 patients with definite MS underwent lymphocytoplasmapheresis for one year. Clinical data, evoked potential recordings and peripheral blood lymphocyte helper/suppressor ratio were assessed before and after the treatment and were compared with those of a control group of 10 multiple sclerosis patients. Lymphocytoplasmapheresis did not significantly modify clinical and laboratory findings compared with the control group.
Adult↗
Evaluation of evoked potentials and lymphocyte subsets as possible markers of multiple sclerosis: one year follow up of 30 patients.
Evoked potentials and T-lymphocyte helper/suppressor ratio (H/S) were evaluated serially together with neurological status in 30 definite multiple sclerosis patients to evaluate their possible role in monitoring disease progression. Evoked potentials in many cases reflected the clinical status of the pathways tested, but some exceptions were observed, probably due to subclinical relapses or physical factors. In some instances the occurrence of subclinical relapses was suggested by increased H/S ratios. Serial H/S values increased in parallel with clinical and subclinical relapses, and seemed to show specific patterns in relation to the type of clinical course (relapsing, stable, chronic progressive). Our results suggest that evoked potentials and H/S ratio serial analysis can contribute to a better assessment of the progress of multiple sclerosis.
Adolescent↗
Lymphocytoplasmapheresis in multiple sclerosis: preliminary laboratory findings.
Short-term treatment with lymphocytoplasmapheresis was evaluated in 6 multiple sclerosis patients with special reference to the electrophysiological and immunological findings. Visual, somatosensory, brainstem auditory evoked potentials, flicker fusion test, helper/suppressor blood lymphocyte ratio, serum immunocomplexes and immunoglobulins and Kurtzke scores were evaluated in each patient before and after treatment. No statistically significant results were obtained.
Adult↗
T-cell subsets in multiple sclerosis: relationships between peripheral blood and cerebrospinal fluid.
We contemporarily studied cerebrospinal fluid (CSF) and peripheral blood (PB) T-cell subsets, defined by monoclonal antibodies, in 29 patients with multiple sclerosis (MS) and 10 patients with other neurological diseases (OND). All subjects showed a clear-cut prevalence of CSF T-cells. Similarly, T-helper and T-suppressor subsets tended to show higher percentages in CSF in almost all subjects except relapsing MS, who were characterized by low percentages of T-suppressors in PB and even much lower percentages in CSF. Helper/suppressor ratios were found to be almost similar in the two body compartments of OND patients, lower in CSF than in PB of chronic progressive MS, always higher in CSF than in PB of relapsing MS. MS patients in remission showed both patterns of progressive MS and OND patients. Our results demonstrate that the loss of PB T-suppressor in relapsing MS is not due to a migration of such cells into CSF. Furthermore, regarding T-lymphocyte subsets, a typical CSF/PB pattern characterizes relapsing MS from other patients.
Adult↗
[Clinical, immunologic and electrophysiologic correlations in evaluating multiple sclerosis in relation to its development].
49 patients with multiple sclerosis (MS) were evaluated on several lines of investigation: clinical examination with disability rating scale, disease activity staging, multimodal evoked potentials and cerebrospinal fluid analysis. 24 patients were monthly re-examined and T-cell subsets were analysed in the peripheral blood. Evoked potentials were re-evaluated every 3 months in 24 patients. All paramethers were correlated in transversally and longitudinally during a 3 to 18 months follow-up. The results are discussed in the view of a methodological approach to a laboratory evaluation of disease evolution in its natural course and during therapeutic trials.
Adolescent↗
Monoclonal antibody analysis of blood T-cell subsets in multiple sclerosis.
The present study deals with the characterization of peripheral blood T-cell subpopulations in multiple sclerosis (MS) patients during different stages of the disease. An indirect immunofluorescence assay was performed using monoclonal antibodies directed at lymphocyte surface antigens. Patients in exacerbation were found to have significantly (p less than 0.001) reduced OKT8+ (T-suppressor) cells and a high helper/suppressor ratio (p less than 0.001). Patients in remission showed a significant increase of suppressor T-cells compared to controls (p less than 0.02) and patients during relapse (p less than 0.001); H/S ratio was consequently low compared to acute MS (p less than 0.001) and controls (p less than 0.1). Patients with a progressive course showed an intermediate T-subset pattern. The results are discussed in the light of the most recent neuroimmunological approaches to MS.
Acute Disease↗
Silver staining of cerebrospinal fluid proteins after isoelectric focusing. An ultrasensitive method.
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Cerebrospinal Fluid Proteins↗
Isotachophoresis evaluation of synthesis of intrathecal IgG subfractions in multiple sclerosis.
Cerebrospinal fluid (CSF) and serum samples from patients with multiple sclerosis and other neurological diseases were examined by capillary isotachophoresis (ITP). The percentage and the rate of synthesis of CSF IgG which migrated slowly with ITP were calculated. CSF specimens of most patients with multiple sclerosis contained increased percentages of slowly migrating IgG (slow IgG), corresponding to IgG oligoclonal bands in the "high-alkaline" region on isoelectric focusing. The patients with multiple sclerosis were found to have increased intrathecal synthesis of slow IgG, which correlated closely with the rate of intrathecal CNS IgG synthesis calculated by Tourtellotte's formula.
Cerebrospinal Fluid Proteins↗
Neuroimmunology in multiple sclerosis.
A review of latest immunological interpretations regarding the pathogenesis of Multiple the Sclerosis. Data on a new immunoenzymatic method for the identification of blood lymphocyte populations are presented together with preliminary results relating to an immunogenetic correlation between primary affective disorders and Multiple Sclerosis.
Antibody Formation↗
Viral antibodies in multiple sclerosis.
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Antibodies, Viral↗
[Evolution and prognosis of retrobulbar optic neuritis as the initial symptom of multiple sclerosis].
In 61 of 300 patients suffering from multiple sclerosis, disease onset was retrobulbar optical neuritis. Comparing the clinical data of these patients with those of the remaining 239 cases, the following typical features were observed: in patients with optical neuropathy, disease onset is more frequently acute and course, in the early years of the disease, is in fits and starts. Recurrence frequency is higher in these patients but not significantly so. Prognosis, deduced from the analysis of degrees of invalidity, does not differ substantially between the two groups. Current techniques of diagnosing multiple sclerosis in patients with retrobulbar optical neuritis are also discussed.
Adolescent↗