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Biomedical subjects

M Eoli

Publications and source records attributed to M Eoli.

51 records · Page 3Linked to original sources

A double blind study on azathioprine efficacy in multiple sclerosis: final report.

Forty patients, affected by multiple sclerosis with remitting-relapsing or progressive course, were included in a double blind study of treatment with azathioprine (2 mg/kg/day) lasting 3 years. The mean changes on the Expanded Disability Status Scale and in the survival analysis show a trend in favour of azathioprine both in slowing disease progression and reducing relapse frequency. These findings, repeatedly observed in similar trials, indicate that azathioprine should be used in the treatment of multiple sclerosis.

Actuarial Analysis↗

Presence of T-cell subset abnormalities in newly diagnosed cases of multiple sclerosis and relationship with short-term clinical activity.

Abnormalities of T-cell subsets in patients with multiple sclerosis are well known; in order to assess whether immunological abnormalities are relevant in the pathogenesis of the disease after its clinical onset, peripheral blood lymphocyte subsets (CD3+, CD4+, CD4(+)-CD45RA+, CD4+CD45RA-, CD8+, CD8+CD57+, CD57+, CD25+) were analysed serially in 25 patients at the first clinical episode suggestive of inflammatory demyelinating disease and in an equal number of age- and sex-matched controls. During the follow-up period (12-18 months, mean 14) 6 of 25 patients presented new relapses: in this subgroup of patients, significant changes in CD4+ ratio (% CD4+CD45RA-/%CD4+CD45RA+) were detected in comparison both with healthy controls and with clinically stable patients. Patients clinically stable at follow-up did not display immunological abnormalities, regardless of the presence or absence of cerebrospinal fluid and/or magnetic resonance imaging alterations consistent with multiple sclerosis. These findings suggest a possible prognostic role of early T-cell subset imbalance in multiple sclerosis.

Adolescent↗

Phenotype analysis of unstimulated lymphocytes and anti-CD3-stimulated proliferating T-cells from cerebrospinal fluid and peripheral blood in patients with multiple sclerosis and other neurological diseases.

In 15 patients with multiple sclerosis (MS) and in 11 patients with other neurological diseases (OND), the phenotype of fresh unstimulated CSF and PB mononuclear cells and of "in vitro" expanded T-cells was studied by monoclonal antibody stain and cytofluorimeter analysis. A compartment-specific decrease of CD8+Leu8+ and CD8+Leu8- cells in CSF was detected; moreover, lower levels of CD8+Leu8- cells were seen in MS than in OND patients, both in CSF and in PB. Although the percentages of unstimulated CSF CD4+ cells did not differ between MS and OND, a higher proportion of "in vitro" expanded CD4+ T-cells was obtained from MS patients than from OND. Among MS patients, T-cell growth was very scarce or absent in those sampled during relapses. The results suggest alterations both within the CD4+ "helper" and the CD8+ "suppressor-cytotoxic" populations in the CSF of MS patients, and stress the relevance of functional analysis in conjunction with phenotype studies.

Adult↗

Short-term neurophysiological monitoring in multiple sclerosis bouts. Evaluation of steroid treatment.

Visual (VEP) and brainstem auditory (BAEP) evoked potentials (EP) were recorded in 21 multiple sclerosis (MS) patients in acute relapse before and after steroid treatment. VEPs were abnormal in 14/21 patients and BAEPs in 10/21 patients before treatment. In 4 patients with acute optic neuritis (ON), an improvement of VEPs paralleled clinical evolution in 3 cases. Substantial and contrasting changes in VEPs or BAEPs, with no clinical counterpart, were related to a spontaneous fluctuation of EPs in acute relapses of MS. These changes suggest frequent subclinical (multifocal and, possibly, sequential) central nervous system involvement in MS bouts. Group analysis showed nonsignificant changes in EP parameters before and after treatment. Our results indicate that evoked potentials (EPs) are of limited value for monitoring the short-term effect of steroid treatment in MS in bouts.

Adult↗

HLA antigens in Italian multiple sclerosis patients.

We analyzed HLA-A, -C, -B, -DR and -DQ specificities in 104 Italian multiple sclerosis patients and in 905 healthy controls. The frequencies of HLA-A23, A26, Cw4, DR3 and, especially DR5 antigens were significantly higher in multiple sclerosis patients than in controls. Patients with progressive course were characterized by high frequencies of B7, B8 and DR3 antigens: Cw1 and DRw11 shows a negative correlation with the extent of intrathecal IgG production. These data confirm that the HLA system may influence the clinical expression and the immune responses to the disease.

HLA Antigens↗

HLA and multiple sclerosis in Italy: a review of the literature.

HLA antigens of locus A, C, B, DR and DQ were typed in 104 Italian multiple sclerosis patients and in 905 healthy controls; the results have been compared with those published in the Italian literature. The Italian studies have been reviewed regarding the ethnic origin of the typed population and the corresponding prevalence of the disease. The data suggest a lack of association between A3 and B7 antigens and Italian multiple sclerosis and a relevance of other DR locus antigens (mainly DR4 and DR5), in addition to DR2, in the susceptibility to the disease.

HLA Antigens↗

Double blind study of intrathecal beta-interferon in multiple sclerosis: clinical and laboratory results.

Sixteen patients with clinically definite MS admitted to a double blind randomised controlled trial of intrathecal natural beta-IFN were followed for a mean of 22 months including the six month treatment period. Clinical response, evaluated in terms of relapse frequency and of progression rate, showed an increase in relapse rate in treated patients during the six month treatment period and, overall, no benefit in treated versus placebo patients. Serial evaluations were made of cerebrospinal fluid (CSF) cells, IgG, myelin basic protein and CSF and blood T-cell subsets. A rise in CSF IgG Index, MBP and DR+ cells in IFN-treated patients suggested an activation of intrathecal immune response in treated patients.

Adolescent↗

CSF T-cell subsets in multiple sclerosis: relationship to cerebrospinal fluid myelin basic protein and clinical activity.

Cerebrospinal fluid myelin basic protein and cerebrospinal fluid and peripheral blood T-cell subsets have been studied in patients with multiple sclerosis and other inflammatory and non-inflammatory nervous system diseases. These biological parameters have been correlated with clinical disease activity. No changes in peripheral blood T-cell subsets were seen in multiple sclerosis patients. Low cerebrospinal fluid T8+ cells occurred only in multiple sclerosis, while high cerebrospinal fluid T4+ cells were detected both in clinically active multiple sclerosis and in inflammatory nervous system diseases. A close relationship was found between cerebrospinal fluid T4/T8 ratio and myelin basic protein in relapsing multiple sclerosis patients.

Adolescent↗

Double-blind randomized trial of ACTH versus dexamethasone versus methylprednisolone in multiple sclerosis bouts. Clinical, cerebrospinal fluid and neurophysiological results.

30 patients with acute exacerbations of multiple sclerosis were treated by ACTH, dexamethasone or methylprednisolone in a double-blind randomized study. Clinical parameters were assessed; cerebrospinal fluid and neurophysiological parameters (visual- and brainstem-evoked potentials) were evaluated at the beginning and at the end of treatment. Dexamethasone was more effective than ACTH and 6-methylprednisolone in shortening bout duration. Neither CSF nor neurophysiological parameters were significantly affected by therapy.

Adolescent↗

Cryoglobulinemic neuropathy: case report.

We report the case of a 51-year-old man affected by mainly motor polyneuropathy with subacute onset and tendency to chronicization. Several possible etiological factors were present, but nerve biopsy, showing ischemic and inflammatory neuropathy, led us to consider cryoglobulinemia as the most important.

Biopsy↗

Spinal cord involvement and systemic lupus erythematosus: clinical and magnetic resonance findings in 5 patients.

We report the clinical, magnetic resonance imaging (MRI) and laboratory findings in 5 patients with clinical spinal cord involvement with an acute or subacute course; in two of the patients the myelitic episode preceded, in one it was concomitant to, and in two it followed the diagnosis of systemic lupus erythematosus (SLE). The marked clinical and MRI heterogeneity detected in our patients suggests that various factors may be implied in the pathogenesis of spinal cord involvement in SLE. The possibility of a future evolution to SLE should be kept in mind in women presenting spinal cord involvement with no other explanation, and should be assessed by means of extensive and repeated clinical and laboratory evaluations.

Adolescent↗