Esclerosis múltiple

Margarit, B. Povedano; Monteiro, G. Carvalho; Herán, I. Sánchez; Delgado, Francisco; Izquierdo, A. Yusta

doi:10.1016/j.med.2019.05.010

Cited by 5 publications

(6 citation statements)

References 21 publications

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“…Aproximadamente, el 15% de los pacientes con un solo evento desmielinizante nunca presentarán una segunda recaída, aunque se desconoce la frecuencia exacta de esta forma benigna de la enfermedad, ya que muchas de estas personas nunca solicitan atención médica o abandonan el seguimiento. La mayoría de los autores coinciden en que los pacientes que han tenido un curso benigno durante 15 años, rara vez desarrollarán un curso más grave (Margarit et al, 2019).…”

Section: Complicaciones Y Pronósticounclassified

“…El fallecimiento ocurre por afectación de las estructuras del tronco del encéfalo. Otra forma de EM "maligna", a veces llamada EM agresiva, se refiere a la enfermedad de curso rápidamente progresiva, que conduce a una discapacidad significativa en múltiples sistemas neurológicos en un tiempo relativamente corto después del inicio de la enfermedad (Margarit et al, 2019).…”

Section: Complicaciones Y Pronósticounclassified

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Esclerosis múltiples

Morales Coloma,

Prieto Ulloa,

Naranjo Guerrero

et al. 2023

RECIMUNDO

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La esclerosis múltiple (EM) es una enfermedad inflamatoria crónica del sistema nervioso central (SNC), con carácter autoinmune, desmielinizante, que impide el funcionamiento normal de la sinapsis. Lo que acarrea déficits motores y sensitivos que pueden durar días o semanas y ser total o parcialmente reversibles. La presente investigación se enmarca dentro de una metodología de tipo bibliográfica documental. Ya que es un proceso sistematizado de recolección, selección, evaluación y análisis de la información, que se ha obtenido mediante medios electrónicos en diferentes repositorios y buscadores tales como Google Académico, Science Direct, Pubmed, entre otros, empleando para ellos los diferentes operadores booleanos y que servirán de fuente documental, para el tema antes planteado. Por ser la esclerosis múltiple una patología autoinmune, necesita un tratamiento focalizado en la persona, con el objetivo de lograr el mayor bienestar posible, ya que la esclerosis múltiple puede presentarse de 4 formas diferentes y no necesariamente el manejo debe ser el mismo, ya que también hay que considerar las comorbilidades que ya tenga el paciente, el tratamiento puede estar enfocado en inmunosupresores, AINES, corticoesteroides, entre otros. En cuanto al diagnóstico los criterios de McDonald son los universalmente aceptados, la sintomatología puede ser diversa, pudiendo generar fatiga, problemas cognitivos, problema de visión, dolor en articulaciones, entre otros.

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Section: Complicaciones Y Pronósticounclassified

Esclerosis múltiples

Morales Coloma,

Prieto Ulloa,

Naranjo Guerrero

et al. 2023

RECIMUNDO

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“…Cells of both the adaptive and the innate immune response have been claimed to play a crucial role in the initiation and the progression of the disease [for an exhaustive description, we refer the reader to (10)]. Although the reasons for the expansion of autoreactive lymphocytes in lymphoid tissues in MS is still a matter of investigation and debate (2), the disease is likely triggered by the infiltration of helper CD4+, cytotoxic CD8+ T cells, and B lymphocytes, members of the adaptive immune system, into the CNS. This step is followed by the involvement of cells of the innate immune system: the activation of resident microglia and the recruitment of monocyte-derived macrophages, together with reactive astrocytes, contribute to amplify the inflammatory response, for example by releasing pro-inflammatory cytokines.…”

Section: Immune Players In Ms Pathogenesismentioning

confidence: 99%

“…Disease modifying therapies (DMTs) for MS are immunomodulatory or immunosuppressive agents designed to dampen the immune reaction that is the main trigger of the disease. Indeed, MS is likely caused by the loss of immune tolerance against myelin epitopes, leading to autoimmune attack against myelin with the consequence of demyelination, axonal damage, and neuronal loss in several brain areas through intermingled and parallel processes (2, 3). This, in turn, explains the heterogeneity of symptoms and clinical phenotypes of MS, which include two main subgroups, Relapsing Remitting (RRMS) and Progressive MS (PMS).…”

Section: Introductionmentioning

confidence: 99%

Immunomodulatory Effects of Exercise in Experimental Multiple Sclerosis

et al. 2019

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Multiple Sclerosis (MS) is a demyelinating and neurodegenerative disease. Though a specific antigen has not been identified, it is widely accepted that MS is an autoimmune disorder characterized by myelin-directed immune attack. Pharmacological treatments for MS are based on immunomodulatory or immunosuppressant drugs, designed to attenuate or dampen the immune reaction, to improve neurological functions. Recently, rehabilitation has gained increasing attention in the scientific community dealing with MS. Engagement of people with MS in exercise programs has been associated with a number of functional improvements in mobility, balance, and motor coordination. Moreover, several studies indicate the effectiveness of exercise against fatigue and mood disorders that are frequently associated with the disease. However, whether exercise acts like an immunomodulatory therapy is still an unresolved question. A good tool to address this issue is provided by the study of the immunomodulatory effects of exercise in an animal model of MS, including the experimental autoimmune encephalomyelitis (EAE), the Theiler's virus induced-demyelinating disease (TMEV-IDD) and toxic-demyelinating models, cuprizone (CPZ), and lysolecithin (LPC). So far, despite the availability of different animal models, most of the pre-clinical data have been gained in EAE and to a lesser extent in CPZ and LPC. These studies have highlighted beneficial effects of exercise, suggesting the modulation of both the innate and the adaptive immune response in the peripheral blood as well as in the brain. In the present paper, starting from the biological differences among MS animal models in terms of immune system involvement, we revise the literature regarding the effects of exercise in EAE, CPZ, and LPC, and critically highlight the advantages of either model, including the so-far unexplored TMEV-IDD, to address the immune effects of exercise in MS.

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“…The role of chronic hypoxia in axonal demyelination is of particular interest in demyelinating disease like multiple sclerosis (MS) 69 . Unlike ALS and SMA, the causes of MS are far from clear, but are thought to be a mix of complex genetic factors and external factors like Epstein–Barr virus infecton 70,71 . Research done in MS shows that not only can hypoxia result in damage following a similar pattern to the lesions in early disease, but that an animal model would show less damage under the same conditions if supplied with highly oxygenated breathing air (80–95% oxygen) 72,73 .…”

Section: Role Of Chronic Hypoxia In Motor Neurone Disease and Musculamentioning

confidence: 99%

A role for spinal cord hypoxia in neurodegeneration

2019

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The vascular system of the spinal cord is particularly complex and vulnerable. Damage to the main vessels or alterations to the regulation of blood flow will result in a reduction or temporary cessation of blood supply. The resulting tissue hypoxia may be brief: acute, or long lasting: chronic. Damage to the vascular system of the spinal cord will develop after a traumatic event or as a result of pathology. Traumatic events such as road traffic accidents, serious falls and surgical procedures, including aortic cross-clamping, will lead to an immediate cessation of perfusion, the result of which may not be evident for several days, but may have long-term consequences including neurodegeneration. Pathological events such as arterial sclerosis, venous occlusion and spinal cord compression will result in a progressive reduction of blood flow, leading to chronic hypoxia. While in some situations the initial pathology is exclusively vascular, recent research in neurodegenerative disease has drawn attention to concomitant vascular anomalies in disorders, including amyotrophic lateral sclerosis, spinal muscular atrophy and muscular sclerosis. Understanding the role of, and tissue response to, chronic hypoxia is particularly important in these cases, where inherent neural damage exacerbates the vulnerability of the nervous system to stressors including hypoxia.

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Esclerosis múltiple

Cited by 5 publications

References 21 publications

Esclerosis múltiples

Esclerosis múltiples

Immunomodulatory Effects of Exercise in Experimental Multiple Sclerosis

A role for spinal cord hypoxia in neurodegeneration

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