Use and Safety of Immunotherapeutic Management of N-Methyl-d-Aspartate Receptor Antibody Encephalitis DOI Creative Commons
Margherita Nosadini, Michael Eyre, Erika Molteni

et al.

JAMA Neurology, Journal Year: 2021, Volume and Issue: 78(11), P. 1333 - 1333

Published: Sept. 20, 2021

Overall, immunotherapy has been shown to improve outcomes and reduce relapses in individuals with N-methyl-d-aspartate receptor (NMDAR) antibody encephalitis (NMDARE); however, the superiority of specific treatments combinations remains unclear.To map use safety immunotherapies NMDARE, identify early predictors poor functional outcome relapse, evaluate changes disease over 14 years since first reports assess Anti-NMDAR Encephalitis One-Year Functional Status (NEOS) score.Systematic search PubMed from inception January 1, 2019.Published articles including patients NMDARE positive NMDAR antibodies available individual data.Individual patient data on immunotherapies, clinical characteristics at presentation, course, final (modified Rankin Scale [mRS] score) were entered into multivariable logistic regression models.The planned study 12 months onset (good, mRS score 0 2; poor, greater than 2) monophasic course (absence relapse 24 or later onset).Data 1550 652 evaluated. Of these, 1105 1508 (73.3%) female 707 1526 (46.3%) 18 younger onset. Factors event that significantly associated good included adolescent age first-line treatment therapeutic apheresis, corticosteroids plus intravenous immunoglobulin (IVIG), IVIG apheresis. 2 65 older onset, intensive care unit admission, extreme delta brush pattern electroencephalography, lack within 30 days maintenance for 6 more. nonrelapsing rituximab Adolescent was relapsing disease. Rituximab increased 13.5% (52 384; 2007 2013) 28.3% (311 1100; 2013 2019) (P < .001), concurrent a falling rate same period (22% [12 55] 2008 earlier; 10.9% [35 322] 2017 later; P = .006). Modified NEOS (including 4 5 original items) probability status 1 year (20.1% [40 199] points; 43.8% [77 176] 3 .05).Factors influencing are different need be considered independently development evidence-based optimal management guidelines NMDARE.

Language: Английский

Fecal Microbiota Transplantation in Neurological Disorders DOI Creative Commons
Karuna E.W. Vendrik, Rogier E. Ooijevaar,

Pieter R. C. de Jong

et al.

Frontiers in Cellular and Infection Microbiology, Journal Year: 2020, Volume and Issue: 10

Published: March 24, 2020

Background Several studies suggested an important role of the gut microbiota in pathophysiology neurological disorders, implying that alteration might serve as a treatment strategy. Fecal transplantation (FMT) is currently most effective intervention and accepted for recurrent Clostridioioides difficile infections. To evaluate indications FMT patients with we summarized available literature on FMT. In addition, provide suggestions future directions. Methods July 2019, five main databases were searched case descriptions disorders humans or animal models. ClinicalTrials.gov website was consulted registered planned ongoing trials. Results Of 541 identified studies, 34 included analysis. Clinical trials have been performed autism spectrum disorder showed beneficial effects symptoms. For multiple sclerosis Parkinson's disease, several positive effect FMT, supported by some reports humans. epilepsy, Tourette syndrome, diabetic neuropathy but evidence restricted to limited numbers studies. stroke, Alzheimer's disease Guillain-Barré syndrome only models identified. These potential healthy donor contrast, one study model stroke increased mortality after Whether findings from can be confirmed human diseases awaits seen. above mentioned are ongoing, well amyotrophic lateral sclerosis. Conclusions Preliminary suggests may promising option disorders. However, still scanty contrasting results observed. Limited while experiments conducted. Large double-blinded randomized controlled needed further elucidate

Language: Английский

Citations

328
Vitamin D and Immune Regulation: Antibacterial, Antiviral, Anti‐Inflammatory DOI Creative Commons
Emma L. Bishop, Aiten Ismailova, Sarah Dimeloe

et al.

JBMR Plus, Journal Year: 2020, Volume and Issue: 5(1)

Published: Aug. 22, 2020

Regulation of immune function continues to be one the most well-recognized extraskeletal actions vitamin D. This stemmed initially from discovery that antigen presenting cells such as macrophages could actively metabolize precursor 25-hydroxyvitamin D (25D) active 1,25-dihydroxyvitamin (1,25D). Parallel observation activated system expressed intracellular receptor (VDR) for 1,25D suggested a potential role localized endogenous modulator function. Subsequent studies have expanded our understanding how exerts effects on both innate and adaptive arms system. At an level, intracrine synthesis by dendritic stimulates expression antimicrobial proteins cathelicidin, well lowering iron concentrations via suppression hepcidin. By potently enhancing autophagy, may also play important in combatting pathogens

Language: Английский

Citations

274
Challenges, Progress, and Prospects of Developing Therapies to Treat Autoimmune Diseases DOI Creative Commons
Lars Fugger, Lise T. Jensen, Jamie Rossjohn

et al.

Cell, Journal Year: 2020, Volume and Issue: 181(1), P. 63 - 80

Published: April 1, 2020

Language: Английский

Citations

273
Environmental and genetic risk factors for MS: an integrated review DOI
Emmanuelle Waubant, Robyn Lucas, Ellen M. Mowry

et al.

Annals of Clinical and Translational Neurology, Journal Year: 2019, Volume and Issue: 6(9), P. 1905 - 1922

Published: Aug. 7, 2019

Abstract Recent findings have provided a molecular basis for the combined contributions of multifaceted risk factors onset multiple sclerosis (MS). MS appears to start as chronic dysregulation immune homeostasis resulting from complex interactions between genetic predispositions, infectious exposures, and that lead pro‐inflammatory states, including smoking, obesity, low sun exposure. This is supported by discovery gene–environment (GxE) epigenetic alterations triggered environmental exposures in individuals with particular make‐ups. It notable several these not emerged strong prognostic indicators. Biological processes at play during relapsing phase disease may result initial inflammatory‐mediated injury, while later MS, which weighted toward neurodegeneration, are yet well defined. integrated review current evidence guides recommendations clinical practice highlights research gaps.

Language: Английский

Citations

265
Vitamin D and multiple sclerosis: An update DOI

Charles Pierrot‐Deseilligny,

Jean-Claude Souberbielle

Multiple Sclerosis and Related Disorders, Journal Year: 2017, Volume and Issue: 14, P. 35 - 45

Published: March 29, 2017

Language: Английский

Citations

226
Exercise as Medicine in Multiple Sclerosis—Time for a Paradigm Shift: Preventive, Symptomatic, and Disease-Modifying Aspects and Perspectives DOI
Ulrik Dalgas, Martin Langeskov‐Christensen, Egon Stenager

et al.

Current Neurology and Neuroscience Reports, Journal Year: 2019, Volume and Issue: 19(11)

Published: Nov. 1, 2019

Language: Английский

Citations

226
The Genetics of Multiple Sclerosis: From 0 to 200 in 50 Years DOI
Sergio E. Baranzini, Jorge R. Oksenberg

Trends in Genetics, Journal Year: 2017, Volume and Issue: 33(12), P. 960 - 970

Published: Oct. 11, 2017

Language: Английский

Citations

210
Environmental Control of Astrocyte Pathogenic Activities in CNS Inflammation DOI Creative Commons
Michael A. Wheeler, Merja Jaronen, Ruxandra Covacu

et al.

Cell, Journal Year: 2019, Volume and Issue: 176(3), P. 581 - 596.e18

Published: Jan. 1, 2019

Language: Английский

Citations

194
HLA-DR15 Molecules Jointly Shape an Autoreactive T Cell Repertoire in Multiple Sclerosis DOI Creative Commons
Jian Wang, Ivan Jelčić,

Lena Mühlenbruch

et al.

Cell, Journal Year: 2020, Volume and Issue: 183(5), P. 1264 - 1281.e20

Published: Oct. 21, 2020

The HLA-DR15 haplotype is the strongest genetic risk factor for multiple sclerosis (MS), but our understanding of how it contributes to MS limited. Because autoreactive CD4+ T cells and B as antigen-presenting are involved in pathogenesis, we characterized immunopeptidomes two allomorphs DR2a DR2b human primary monocytes, thymus, brain tissue. Self-peptides from HLA-DR molecules, particularly themselves, abundant on thymic cells. Furthermore, identified cell clones that can cross-react with HLA-DR-derived self-peptides (HLA-DR-SPs), peptides MS-associated foreign agents (Epstein-Barr virus Akkermansia muciniphila), autoantigens presented by DR2b. Thus, both jointly shape an repertoire serving structures epitope sources presenting same MS.

Language: Английский

Citations

194
Outdoor Ambient Air Pollution and Neurodegenerative Diseases: the Neuroinflammation Hypothesis DOI
Richard L. Jayaraj, Eric Rodríguez, Yi Wang

et al.

Current Environmental Health Reports, Journal Year: 2017, Volume and Issue: 4(2), P. 166 - 179

Published: April 25, 2017

Language: Английский

Citations

185