Association between tumor necrosis factor-alpha and disease progression in patients with multiple sclerosis

Article Abstract:

Multiple sclerosis is a chronic disease in which myelin, the protective and insulating material that surrounds nerves, is slowly lost. Plaques that form in the brains of multiple sclerosis patients contain T cells (a type of white blood cell) and macrophages (scavenger cells), both of which secrete a substance called cachectin, or tumor necrosis factor-alpha (TNF-a). TNF-a can damage myelin, and is thought to be activated in several inflammatory disorders that affect the central nervous system. To learn more about the levels of TNF-a among patients with multiple sclerosis of varying degrees of severity, a study was carried out of 32 patients with chronic progressive multiple sclerosis, 20 patients with stable multiple sclerosis, and 85 patients with other neurologic diseases (controls). The severity of disability was assessed using a standard scale (the expanded disability status scale, or EDSS) that provides scores ranging from zero (normal) to 10 (death due to multiple sclerosis). Initially, patients' scores ranged between three and six; they were evaluated again after 24 months to determine the extent of disease progression. TNF-a levels were measured in cerebrospinal fluid and blood at the study's beginning and end. Results showed that the levels of TNF-a were elevated in 17 of the patients with chronic progressive multiple sclerosis (53 percent) and in none of the patients with stable multiple sclerosis. Six patients in the control group had high levels of TNF-a in cerebrospinal fluid and blood. The level of TNF-a was correlated with the absolute EDSS score, the change in EDSS scores that took place during the study interval, and an index of disease progression. In general, high levels were associated with a poor prognosis. It is possible that a test that analyzes cerebrospinal fluid for levels of TNF-a could be useful for predicting disease progression. It is also possible that reducing the levels of TNF-a, or its effect, could help patients with chronic progressive multiple sclerosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Tumor necrosis factor

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Rate of pregnancy-related relapse in multiple sclerosis

Article Abstract:

Women with multiple sclerosis may experience fewer relapses during pregnancy but more in the few months after. This was the conclusion of a study of 254 pregnant women with multiple sclerosis. The average relapse rate was 0.7 per woman per year before pregnancy, dropping to 0.5 in the first trimester, 0.6 in the second and 0.2 in the third. In the first three months following childbirth, the rate increased to 1.2, then dropped back down to pre-pregnancy levels.

Health aspects, Pregnancy

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Relapse, remission, and progression in multiple sclerosis

Article Abstract:

Many patients with multiple sclerosis can go into remission because the initial inflammation of the nerve resolves. Relapse can occur if the nerve becomes inflamed again. Long-term progression is probably caused by loss of nerve tissue.

Editorial

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