Pain in neuromyelitis optica and its effect on quality of life

Kanamori, Yoko; Nakashima, Ichiro; Tokura, Y.; Nishiyama, Shuhei; Kuroda, Hiroshi; Takahashi, Toshiyuki; Kanaoka-Suzuki, C; Misu, Tatsuro; Fujihara, Kazuo; Itoyama, Yasuto

doi:10.1212/wnl.0b013e318229e694

Cited by 109 publications

(114 citation statements)

References 41 publications

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“…Pain is experienced by more than 80% of patients and affects the trunk and legs in particular 39 . Pain is strongly associated with antibodies against aquaporin 4 (AQP4); such autoantibodies are present in approximately 75% of NMO cases 40 .…”

Section: Fc Receptorsmentioning

confidence: 99%

Crosstalk between the nociceptive and immune systems in host defence and disease

2015

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Nociceptors and immune cells both protect the host from potential threats to homeostasis. There is growing evidence for bidirectional signalling between these two systems, and the underlying mechanisms are beginning to be elucidated. An understanding is emerging of how both the adaptive and innate immune systems can activate and sensitize nociceptors, and, reciprocally, how nociceptors modulate immune cells. In this Review, we discuss how these interactions can be adaptive and useful to the organism but also consider when such signalling might be maladaptive and pathophysiological, contributing to immune-mediated diseases and persistent pain states.

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Section: Fc Receptorsmentioning

confidence: 99%

Crosstalk between the nociceptive and immune systems in host defence and disease

2015

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“…Neuropathic pain is a frequent and often intractable symptom of NMOSD [123,124]. Among other pleiotropic effects of IL-6, direct modulation of nociceptive neurons is likely, because deletion of its signal transducing receptor gp130 in peripheral neurons significantly reduced pain in mice [125].…”

Section: Il-6 Receptor Inhibitionmentioning

confidence: 99%

Present and Future Therapies in Neuromyelitis Optica Spectrum Disorders

Kleiter

Gold

2016

Neurotherapeutics

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Neuromyelitis optica spectrum disorders (NMOSD) are important evolving entities, which have reached much attention in the recent years. NMOSD are characterized by inflammatory lesions in the optic nerves, spinal cord, and central parts of the brain, as well as an autoimmune process directed against aquaporin-4. As disability in NMOSD accumulates by inflammatory damage from attacks, both the treatment and prevention of attacks are decisive for the long-term outcome. NMOSD attacks are treated with highdose intravenous corticosteroids and apheresis therapies, in particular therapeutic plasma exchange. In cases of incomplete remission, escalation of attack treatment is recommended. Preventive therapy is immunosuppressive and should by commenced as early as possible. Apart from classical immunosuppressants such as azathioprine and mycophenolate mofetil, repurposed biologicals are increasingly used. B-cell depletion with rituximab and other agents, inhibition of the interleukin-6 receptor with tocilizumab, and blockade of complement-mediated damage by eculizumab all are promising therapeutic strategies evaluated in randomized controlled trials. In this review, we will discuss present and future immunotherapies for NMOSD and also consider combination of treatments, plasma, cellular and other therapies. Current advances in immunopathological knowledge are translated into innovative concepts and begin a new era of NMOSD therapy.

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“…Bilateral hypothalamic lesions seems also to be something only found in NMOSD patients, and these lesions may cause sleep disturbances such as narcolepsy and may be associated with low hypocretin levels in the cerebrospinal fluid (CSF 24 ). Painful tonic spasms during myelitis recovery and severe pain are found in NMOSD more commonly than in MS 25,26 . Neuropathic pruritus (itch) has also been recently reported in NMOSD patients during myelitis attacks 27 .…”

Section: The Differential Diagnosis Of Nmosdmentioning

confidence: 99%

Seronegative Neuromyelitis Optica Spectrum - The challenges on disease definition and pathogenesis

Sato

Callegaro

Lana-Peixoto

et al. 2014

Arq. Neuro-Psiquiatr.

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Neuromyelitis optica spectrum disorders (NMOSD) are characterized by severe optic neuritis and/or longitudinally extensive transverse myelitis, and some brain lesions are also unique to NMOSD. Serum autoantibodies against aquaporin-4 (AQP4) are detected in most cases of NMOSD. However, some patients with NMOSD remain seronegative despite repetitive testing during attacks with highly sensitive cellbased assays. The differential diagnosis of NMOSD is not restricted to multiple sclerosis and it includes many diseases that can produce longitudinally extensive myelitis and/or optic neuritis. We review the clinical features, imaging, and laboratory findings that can be helpful on the diagnostic work-up, discuss the differences between AQP4 antibody positive and negative patients with NMOSD, including features of NMOSD with antibodies against myelin oligodendrocyte glycoprotein.Keywords: neuromyelitis optica, aquaporin-4, myelin oligodendrocyte glycoprotein, antibody, myelitis, optic neuritis, differential diagnosis. RESUMOO espectro da neuromielite óptica (NMOSD) é caracterizado por ataques graves de neurite óptica e mielite. Anticorpos séricos contra a aquaporina-4 (AQP4) são usualmente presentes nestes pacientes. Entretanto, alguns pacientes com NMOSD são seronegativos mesmo com testes repetidos em amostras obtidas durante ataques usando métodos altamente sensíveis baseados em células. O diagnóstico diferencial não é restrito à esclerose múltipla e inclui muitas doenças que podem produzir mielite longitudinalmente extensa e/ou neurite óptica. São abordadas as características clínicas, de imagem e de laboratório que podem ser úteis no diagnóstico, as diferenças entre os pacientes positivos para o anticorpo anti-AQP4 e os negativos, incluindo as características dos pacientes com NMOSD que possuem anticorpos contra a glicoproteína associada ao oligodendrócito.Palavras-chave: neuromielite óptica, aquaporina-4, glicoproteína associada ao olidendrócito, mielite, neurite óptica, diagnóstico diferencial.

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Pain in neuromyelitis optica and its effect on quality of life

Abstract: Our study showed that pain in NMO is more frequent and severe than in MS and that pain has a grave impact on NMO patients' daily life and HRQOL. Therapy to relieve pain is expected to improve their HRQOL.

Cited by 109 publications

References 41 publications

Crosstalk between the nociceptive and immune systems in host defence and disease

Crosstalk between the nociceptive and immune systems in host defence and disease

Present and Future Therapies in Neuromyelitis Optica Spectrum Disorders

Seronegative Neuromyelitis Optica Spectrum - The challenges on disease definition and pathogenesis

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