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Biomedical subjects

L Kappos

Publications and source records attributed to L Kappos.

At least 127 records · Page 7Linked to original sources
PubMed1990

Occurrence of MRI abnormalities in patients with isolated optic neuritis.

24 patients with clinically isolated optic neuritis (ON) were examined with MRI. Only 5 patients (22.9%) had a normal MRI scan. The number of detected clinically silent lesions ranged from 0 to 38. They were mainly located in the frontal and parietal white matter. All patients with more than 3 lesions on MRI had pathological findings in CSF. There was no correlation between the number and location of lesions and age at onset of ON.

Adult↗
PubMed1990

Myelin basic protein-specific T lymphocyte lines from MS patients and healthy individuals.

We derived a total of 146 T lymphocyte lines specific for human myelin basic protein (MBP) from the peripheral blood of 20 MS patients and from a control group of 12 healthy donors, and determined the reactivities of T cell lines by [3H]thymidine incorporation on exposure to MBP and MBP peptides 1-44, 45-89, and 90-170. We defined HLA restriction of the T lines by using monoclonal antibodies against monomorphic determinants on human HLA-DR, HLA-DQ, and HLA-DP molecules. MBP-specific T cell lines could be isolated with a comparable efficiency from MS patients and healthy individuals. In both groups, MBP-specific T lymphocytes recognized at least 4 different epitopes in the MBP molecule, and specificities showed comparable patterns for different MBP peptides. MBP-specific T cell lines derived from MS patients and controls were restricted by DR products of the human major histocompatibility class II locus. Notable phenotypic differences of T cell lines existed between the 2 groups. Lines isolated from MS patients expressed predominantly the CD3+ CD4+ CD8- phenotype, while some control lines were composed of up to 87% CD3+CD4+CD8+ T lymphocytes. These findings illustrate the presence of MBP-specific T cells in MS patients and controls that are similarly sensitized to MBP and restricted by HLA-DR products.

Adult↗
PubMed1989

MRI study of Baló's concentric sclerosis before and after immunosuppressive therapy.

An intra vitam diagnosis of Baló's concentric sclerosis in a 39-year-old male is described. To our knowledge this is the first reported case of ante-mortem diagnosis based solely on magnetic resonance imaging (MRI) findings. MRI showed features unique to this process. After high-dose intravenous therapy with prednisone, the clinical symptoms improved, and MRI showed marked changes of the concentric lesions.

Adult↗
PubMed1988

Cyclosporine versus azathioprine in the long-term treatment of multiple sclerosis--results of the German multicenter study.

In a double-blind controlled trial of 194 patients with clinically definite active multiple sclerosis, 98 were randomized to treatment with cyclosporine (CyA, 5 mg/kg/day), and 96 to treatment with azathioprine (Aza, 2.5 mg/kg/day). Eighty-five patients in the CyA group and 82 in the Aza group completed a treatment period of 24 to 32 months in accordance with the study protocol. No significant differences could be detected between the two treatment groups at the end of the trial. Assessment was done by serial quantitative neurological examinations and Kurtzke's Expanded Disability Status Scale. Frequency of relapse and patient self-evaluation also failed to show significant differences. Overall deterioration observed in both groups during the trial was only minor. The incidence of side effects in the CyA group was more than two times that in the Aza group. We conclude that CyA as a single agent cannot be the drug of final choice in long-term immunosuppressive treatment of relapsing-remitting and relapsing-progressive multiple sclerosis.

Adolescent↗
PubMed1988

Magnetic resonance imaging in the evaluation of treatment in multiple sclerosis.

Magnetic resonance scans of 74 patients with multiple sclerosis participating in a controlled trial were compared 6 months before and at the end of a 24-32 months-treatment period with either Cyclosporin A (n = 31) or Azathioprine (n = 43). Both qualitative rating and computation of lesion volume showed deterioration in more than 40% of the patients, while by clinical criteria only 10-30% were worse. No significant difference was noted when the two treatment groups were compared. If careful repositioning and standardized image parameters are used, MRI is an indispensable tool for the objective determination of disease progression in MS although it cannot replace clinical examination.

Azathioprine↗
PubMed1988

Clinical trials of immunosuppression and immunomodulation in multiple sclerosis.

Although clinical trials in multiple sclerosis are extremely difficult to conduct because of the unpredictable course of the disease and the problem of defining and monitoring disease activity, some controlled and several uncontrolled studies suggest that global immunosuppression may result in a small but beneficial effect. After some methodological considerations the results of recent trials are reviewed especially those concerned with the use of cyclophosphamide, azathioprine and cyclosporine. Major improvements in our ability to slow-down disease progression may develop through the administration of more sophisticated, phase-adapted therapies using combinations of different immunosuppressive and modulating agents which should be applied in earlier phases of the disease. Improved monitoring of disease evolution by the addition of magnetic resonance imaging to current clinical scales and by ameliorated immunological techniques is an indispensable prerequisite of any further therapeutic progress.

Adjuvants, Immunologic↗
PubMed1987

Multiple sclerosis and human T-cell lymphotropic retroviruses: negative serological results in 135 German patients.

A total of 135 sera and 18 cerebrospinal fluid (CSF) samples from patients with multiple sclerosis (MS) were screened for antibodies to human T-cell lymphotropic virus type I (HTLV-I) and human immunodeficiency virus (HIV) by ELISA tests. None of the sera or CSF reacted with HIV antigens. Only 3 out of 135 MS sera but no MS CSF showed increased reactions in the ELISA test for HTLV-I. However, these positive reactions were classified as non-specific by immunoprecipitation. Thus no serological evidence for infection with HIV, HTLV-I, or a related retrovirus was found in the MS patients.

Antibodies, Viral↗
PubMed1987

An attempt to quantify magnetic resonance imaging in multiple sclerosis--correlation with clinical parameters.

The diagnostic value of magnetic resonance imaging (MRI) in multiple sclerosis (MS) is uncontested. But only little information exists on its usefullness in monitoring disease activity. We describe a method of quantification that can be performed in longitudinal MRI-investigations. We used a standardized method of scanning and determined the area of demyelinating lesions with an interactive planimetric computer system. In order to determine the approximate lesion volumes, the computed area was multiplied by the slice thickness. In 89 patients with clinically definite MS we found an average lesion volume of 11900 mm3. The mean score in Kurtzke's expanded disability scale was 3.0. The correlation between computed lesion volume and neurological deficit was significant, but only weak (rho = 0.3). We conclude, that planimetric evaluation of MRI can be a valuable supplement to clinical rating scales in MS patients. The method described here, used in combination with high spacial resolution and better tissue specificity of latest generation MRI scanners, could be helpful in the evaluation of treatment in many other CNS diseases.

Brain↗