Review on Recent Advances in Multiple Sclerosis and Related Disorders

Abstract

The scientific world of central nervous system (CNS) neuroinflammatory disorders in general and multiple sclerosis (MS) in particular continues to expand, and 2013 has witnessed interesting advances in many aspects of research. In this review we will discuss research discoveries and results that have contributed to expand our knowledge in diverse areas of the MS field, including new environmental and genetic risk factors, new lines of treatment, and biomarkers of treatment response. Finally, new data on diagnostic biomarkers for neuromyelitis optica (NMO) have emerged, in addition to advances in NMO treatment.Keywords: Multiple sclerosis; Environmental risk factors; Biomarker; Monoclonal antibodies; Neuromyelitis optica; MOG antibodies; AQP4 antibodies; MS treatment; NMO treatment ReviewImportant advances in many aspects of multiple sclerosis (MS) research have been presented during 2013. In this review we will discuss results from a selected group of studies, evaluating their major contribution to MS research.Epidemiological studies have shown that environmental exposures seem to be crucial for the development of MS. Vitamin D insufficiency, remote infection with EBV, and exposure to cigarette smoke have already been proposed as environmental risk factors for both pediatric-and adult-onset MS. In 2013 new published data suggested that components of the daily diet could be considered additional risk factors for MS. Results from two independent studies suggest that high salt intake could trigger tissue inflammation and autoimmune disease. One study investigated environmental factors that directly influence TH17 cells, a newly identified population of interleukin (IL)-17-producing CD4 (+) helper T cells, highly pro-inflammatory cells with a key role in the development of experimental autoimmune encephalomyelitis (EAE), an animal model for MS [1]. The authors found that increases in sodium chloride concentrations markedly promoted the induction of murine and human TH17 cells. In animal models of MS, the TH17 cells generated under high-salt conditions displayed a highly pathogenic and stable phenotype characterized by the up-regulation of pro-inflammatory cytokines. The authors also found that mice fed with a high-salt diet developed a more severe form of EAE, with an increased number of TH17 cells peripherally induced and infiltrating the CNS. The second study showed that even a modest increase in salt concentration enhances TH17 cell differentiation in vitro and in vivo, accelerating the development of autoimmunity by inducing the expression of serum glucocorticoid kinase 1(SGK 1), which has a critical role in the regulation of IL-23R expression, reinforcing the TH17 phenotype [2]. According to these findings, a high-salt diet might represent an environmental risk factor for the development of autoimmune diseases by triggering TH17 cell differentiation and promoting tissue inflammation. Even though the causal association of these preliminary findings should be confirmed, they could be opening an interestin...

Benefits of Static Stretching, Pliates® and Elastic Bands Resistance Training on Patients with Relapsing-Remitting Multiple Sclerosis: A Longitudinal Study

“…Indeed, physiotherapy may be an effective form of rehabilitation, especially in the presence of progressive MS [3]. Environmental factors, such as exposure to cigarette smoke or vitamin D deficits seem to be associated with both pediatric and adult onset of MS [4]. One of the most debilitating consequences of MS is muscle spasticity, which is a disorder in neuromuscular reciprocal inhibition with a greater excitation of the muscle-tendon strain reflex that accounts for arrhythmic movements of the musculoskeletal system by affecting ambulation, decreasing muscle strength and increasing the risk of falls [5].…”