Immunology of Multiple Sclerosis

Sospedra, Mireia; Martin, Roland

doi:10.1055/s-0036-1579739

Cited by 228 publications

(192 citation statements)

References 171 publications

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“…The incidence of MS is around two to three times greater among women than men. Correlation studies on racial differences in the MS prevalence rates worldwide have revealed that the Caucasians appears to have a higher risk than other populations 22 . The majority of the subjects in the present study showed the RRMS clinical form as in previous reports, which have shown approximately 80% of the patients will initially present this form 11 .…”

Section: Discussionmentioning

confidence: 99%

Validation of the Brazilian version of the neurological fatigue index for multiple sclerosis

Lopes

Lavado

Kaimen-Maciel

2016

Arq. Neuro-Psiquiatr.

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Fatigue is the most frequent and severe of symptoms causing morbidity and disability in multiple sclerosis (MS) patients. However, measuring fatigue is a difficult task. There is no clear definition; it is complex and multidimensional, and is a highly subjective symptom with many uncertainties regarding its pathophysiology. No biological or neuroimaging markers for fatigue are currently known 1 . The lack of standardization for fatigue measurement has resulted in development of several assessment instruments, but none of them is universally accepted. The Fatigue Severity Scale (FSS) 2 and Modified Fatigue Impact Scale (MFIS) 3 are the most widely used instruments for measuring MS fatigue, although limitations regarding their development and measurement properties have been reported. Moreover, they were not specifically developed for MS patients 4,5,6 . Studies using the Rasch measurement model have identified a need for certain items to be removed from the FSS [4] and MFIS [6] so that their measurements can be considered valid and reliable.In Brazil, FSS 7 and MFIS 8 have been widely used, despite the failings of their design and psychometric properties in Brazilian cross-cultural adaptation studies. These Brazilian versions did not fulfill the criteria for adequate sample size and design. Moreover, the psychometric properties of the Brazilian FSS adaptation were not assessed. Therefore, there are no Brazilian MS-specific instrument for assessing fatigue with reported methodological and psychometric properties ABstrACtThe Neurological Fatigue Index for Multiple Sclerosis (NFI-MS) is a new fatigue assessment instrument. The aim of this study was to cross-culturally adapt and assess the psychometric properties of the Brazilian version of the NFI-MS (NFI-MS/BR). Method: Two hundred and forty subjects with MS were recruited for this study. The adaptation of the NFI-MS was performed by translation and back translation methodology. In psychometric analysis was performed the administration of the questionnaires Epworth Sleep Scale, Fatigue Severity Scale, Modified Fatigue Impact Scale, Multiple Sclerosis Impact Scale-29, NFI-MS/BR and Pittsburgh Sleep Quality Index with retest of the NFI-MS/BR after 7 days. Results: Reliability was assessed (intraclass correlation coefficients between 0.77 and 0.86), and validity by testing 41 hypotheses about expected correlations between subscales and confirmed 36. The majority of correlations were demonstrated. Conclusion: The NFI-MS/BR is a cross-culturally adapted, valid, and reliable instrument for assessing MS fatigue among Brazilian subjects.Keywords: multiple sclerosis; fatigue; assessment; validation studies; psychometrics. resumo O índice neurológico de fadiga na esclerose múltipla (EM) (NFI-MS) é um novo instrumento de avaliação da fadiga. O objetivo deste estudo foi adaptar transculturalmente e avaliar as propriedades psicométricas da versão Brasileira do NFI-MS (NFI-MS/BR).Método: Duzentos e quarenta indivíduos com EM participaram deste estudo. A adaptação do NFI-MS/BR f...

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Section: Discussionmentioning

confidence: 99%

Validation of the Brazilian version of the neurological fatigue index for multiple sclerosis

Lopes

Lavado

Kaimen-Maciel

2016

Arq. Neuro-Psiquiatr.

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“…However, it is still unclear what exactly causes the disease. One of the initiators of MS is antigen from virus or bacteria that is similar to the myelin basic protein peptide [10,11] . The autoimmunity hypothesis is now being challenged since the fi nding that, like many other neurodegenerative disorders, gray matter lesions and brain atrophy are detectable before MS onset [12,13] .…”

Section: Introductionmentioning

confidence: 99%

Role of autophagy in the pathogenesis of multiple sclerosis

Liang

2015

Neurosci. Bull.

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Autophagy plays an important role in maintaining the cellular homeostasis. One of its functions is to degrade unnecessary organelles and proteins for energy recycling or amino-acids for cell survival. Ablation of autophagy leads to neurodegeneration. Multiple sclerosis (MS), a permanent neurological impairment typical of chronic inflammatory demyelinating disorder, is an auto-immune disease of the central nervous system (CNS). Autophagy is tightly linked to the innate and adaptive immune systems during the autoimmune process, and several studies have shown that autophagy directly participates in the progress of MS or experimental autoimmune encephalomyelitis (EAE, a mouse model of MS). Dysfunction of mitochondria that intensively infl uences the autophagy pathway is one of the important factors in the pathogenesis of MS. Autophagy-related gene (ATG) 5 and immune-related GTPase M (IRGM) 1 are increased, while ATG16L2 is decreased, in T-cells in EAE and active relapsing-remitting MS brains. Administration of rapamycin, an inhibitor of mammalian target of rapamycin ( mTOR), ameliorates relapsing-remitting EAE. Infl ammation and oxidative stress are increased in MS lesions and EAE, but Lamp2 and the LC3-II/LC3-I ratio are decreased. Furthermore, autophagy in various glial cells plays important roles in regulating neuro-infl ammation in the CNS, implying potential roles in MS. In this review, we discuss the role of autophagy in the peripheral immune system and the CNS in neuroinfl ammation associated with the pathogenesis of MS. Keywords: autophagy; multiple sclerosis; neuro-infl ammation ·Review· IntroductionAutophagy, a lysosome-dependent degradation pathway, contributes to maintaining cellular homeostasis. Clearance of long-lived proteins, unnecessary organelles, and aggregate-prone proteins is mainly executed by autophagy for recycling cellular materials [1] . There are three subtypes of autophagy, macroautophagy, chaperone-mediated autophagy (CMA), and mitophagy. Macroautophagy is the major type for selective degradation of protein aggregates or misfolded proteins. The ubiquitin-labeled proteins are recognized by autophagy receptors, such as p62, neighbor of BRCA1 gene 1 (NBR1), and NIP3-like protein X (NIX), to form autophagosomes that then fuse with lysosomes for degradation. Many autophagy-related genes function during this process, such as Unc51-like kinase (ULK1) and autophagy-related gene (ATG) 5. Mammalian target of rapamycin (mTOR) represses autophagy by regulating ULK1 phosphorylation, while AMPK activates this process.CMA mediates the degradation of large molecular-weight proteins containing the KFERQ motif recognized by heat shock cognate protein of 70 kDa (HSC70). The substrate is then escorted to lysosome-associated membrane protein 2 (LAMP2A) for lysosomal degradation. Mitophagy is responsible for the degradation of damaged mitochondria.Parkin and PINK1 play critical roles in this process [2] . More Neurosci Bull August 1, 2015, 31(4): 435-444 436 attention has been paid to autophagy in the path...

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“…MS hastalığında CD4+ T helper (Th) 1 ve Th17 hücreleri miyelin kılıf bileşenlerini yabancı antijen olarak algılarlar ve miyeline karşı otoreaksiyon geliştirirler (1,6).…”

Section: Klinik Bulgularunclassified

Multiple Sclerosis

ÖZTÜRK¹,

AYTAÇ²,

KIZILAY³

et al. 2017

Akd Med J

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ÖZMultipl Skleroz (MS), genelde genç erişkinlerde santral sinir sistemini etkileyen, kronik, otoimmün ve demiyelinizan bir hastalıktır. Miyelin kılıflar, oligodendrositler ve daha az oranda aksonların ve nöronların hasarlandığı bir hastalıktır. Avrupa ve Amerika Birleşik Devletleri'nde görülme sıklığı, her 1000 genç yetişkinde 1'dir. Türkiye'de ise gerçekleştirilen epidemiyolojik çalışmalarda, MS prevelansı 1000 genç yetişkinde 0,4-1 arasında izlenmiştir. MS 20. yüzyılın başlarında nörolojide en sık görülen hastalıklardan biri haline gelmiştir. Günümüzde dünyada 2,5 milyon MS hastası vardır. Bu hastaların tedavisi ve bakımı milyarlarca dolara mal olmaktadır. Bugüne kadar MS patofizyolojisinde genetik ve çevresel risk faktörlerinin önemli rol oynadığı düşünülmesine rağmen MS için spesifik bir patogenez tanımlanmamıştır. Bu bağlamda MS hayvan modelleri hastalığın başlangıcı ve progresyonunun anlaşılmasında ve hastalık için yeni tedavi yaklaşımlarının test edilmesinde önemli rol oynamaktadır. Anahtar Sözcükler: Multipl Skleroz, Demiyelinizasyon, Remiyelinizasyon ABSTRACTMultiple sclerosis (MS) is a chronic autoimmune, demyelinating disease that affects the central nervous system, usually in young adults. Mostly the myelin sheaths and oligodendrocytes, and to a smaller extent the axons and neuron cells are damaged in MS. In Europe and the United States of America, the prevalence is 1 in a thousand young adults. In Turkey, epidemiological studies have shown that the MS prevalence is 0.4-1 per thousand. In the early 20th century, MS became one of the most common neurological disorders. Nowadays 2.5 million people have MS. Treatment and maintenance of these patients costs billions of dollars. Even though genetics and environmental factors are thought to play an important role in MS pathophysiology, an MS-specific pathogenesis is not yet described. In this context, understanding the onset and progression of this disease and testing new treatment approaches for MS animal models play an important role.

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Immunology of Multiple Sclerosis

Cited by 228 publications

References 171 publications

Validation of the Brazilian version of the neurological fatigue index for multiple sclerosis

Validation of the Brazilian version of the neurological fatigue index for multiple sclerosis

Role of autophagy in the pathogenesis of multiple sclerosis

Multiple Sclerosis

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