Objective:To investigate pregnancy-related disease activity in a contemporary multiple sclerosis (MS) cohort.Methods:Using data from the MSBase Registry, we included pregnancies conceived after 31 Dec 2010 from women with relapsing-remitting MS or clinically isolated syndrome. Predictors of intrapartum relapse, and postpartum relapse and disability progression were determined by clustered logistic regression or Cox regression analyses.Results:We included 1998 pregnancies from 1619 women with MS. Preconception annualized relapse rate (ARR) was 0.29 (95% CI 0.27-0.32), fell to 0.19 (0.14-0.24) in third trimester, and increased to 0.59 (0.51-0.67) in early postpartum. Among women who used fingolimod or natalizumab, ARR before pregnancy was 0.37 (0.28-0.49) and 0.29 (0.22-0.37), respectively, and increased during pregnancy. Intrapartum ARR decreased with preconception dimethyl fumarate use. ARR spiked after delivery across all DMT groups. Natalizumab continuation into pregnancy reduced the odds of relapse during pregnancy (OR 0.76 per month [0.60-0.95], p=0.017). DMT re-initiation with natalizumab protected against postpartum relapse (HR 0.11 [0.04-0.32], p<0.0001). Breastfeeding women were less likely to relapse (HR 0.61 [0.41-0.91], p=0.016). 5.6% of pregnancies were followed by confirmed disability progression, predicted by higher relapse activity in pregnancy and postpartum.Conclusion:Intrapartum and postpartum relapse probabilities increased among women with MS after natalizumab or fingolimod cessation. In women considered to be at high relapse risk, use of natalizumab before pregnancy and continued up to 34 weeks gestation, with early re-initiation after delivery is an effective option to minimize relapse risks. Strategies of DMT use have to be balanced against potential fetal/neonatal complications.
The present study aimed to evaluate phytochemical and antioxidant activity (in vitro and in vivo) of Origanum vulgare (L.) ethanolic extract. The phytochemical test was assessed using the Clule method in ethanol, ethyl acetate, and hexane. In vitro evaluation of antioxidant activity was determined by radical scavenging assay using DPPH (2,2-diphenyl-1-picrylhydrazyl) as an artificial free radical activity. In vivo test was conducted to evaluate the effect of malondialdehyde (MDA) level in blood plasma during maximum physical activity treatment. In vivo test was done using 25 male Sprague Dawley rats in pre and post-test control group design. The phytochemical test of O. vulgare ethanol extract was showed some compounds, such as a flavonoid, alkaloid, triterpenoid/steroid, essential oil, and tannin, then in ethyl acetate and hexane. In vitro assay showed that O. vulgare extract has strong antioxidant activity with an IC 50 value of 133.47 µg/mL. While in the in vivo test, the most effective dosage is 20 mg/200 gr B.W., represented by a significant decrease of MDA level (0.509 nmol/mL) before and after treatment. So, the ethanolic extract of clove has potency as an herbal antioxidant because of the low level of IC 50 and can decrease the MDA level.
IgG (CSF) and 78% of GAD65-IgG (CSF/serum) cohorts (OR=1.32, p=0.002, OR=2.78, p<0.001, respectively). Men accounted for 62% of the LGI1-IgG cohort (OR=1.87, p <0.001). Age and sex interacted for NMDA-R-IgG, particularly in females <20 years (OR=7.72, p <0.001). Conclusion The most frequently detected were NMDA-R-IgG, LGI1-IgG, GAD65-IgG and MOG-IgG1. Age and sex associations may suggest paraneoplastic, endocrinological or aging influences on neurological autoimmunity.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.