Multipl Skleroz

Year 2017, Volume: 3 Issue: 3, 137 - 147, 01.01.2017

Serra Öztürk Güneş Aytaç Ferah Kızılay Muzaffer Sindel

Abstract

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

Keywords

Multipl Skleroz, Demiyelinizasyon, Remiyelinizasyon

Multiple Sclerosis

Abstract

Multiple 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

Keywords

Multiple Sclerosis, Demyelination, Remyelination

References

• Hafler DA, Slavik JM, Anderson DE, O’Connor KC, De Jager P, Baecher-Allan C. Multiple sclerosis. Immunological Reviews 2005;204:208-31.
• Compston A, Confavreux C, Lassman H, McDonald I, Miller D, Noseworthy J. The story of multiple sclerosis. McAlpine’s Multiple Sclerosis. Philadelphia: Churchill Livingstone Elsevier, 2006:3.
• Noseworthy JH, Lucchinetti C, Rodriguez M, Weinshenker BG. Multiple sclerosis. New England Journal of Medicine 2000;343:938-52.
• Compston A, Coles A. Multiple sclerosis. Lancet 2002;359:1221-31.
• Lucchinetti C, Bruck W, Parisi J, Scheithauer B, Rodriguez M, Lassmann H. Heterogeneity of multiple sclerosis lesions: Implications for the pathogenesis of demyelination. Annals of Neurology 2000;47:707-17.
• Sospedra M, Martin R. Immunology of multiple sclerosis. Annual Review of Immunology 2005;23:683-747.
• Pasquini MC, Griffith LM, Arnold DL, Atkins HL, Bowen JD, Chen JT, Freedman MS, Kraft GH, Mancardi GL, Martin R, Muraro PA, Nash RA, Racke MK, Storek J, Saccardi R. Hematopoietic stem cell transplantation for multiple sclerosis: collaboration of the CIBMTR and EBMT to facilitate international clinical studies. Biology of blood and marrow transplantation. Journal of the American Society for Blood and Marrow Transplantation 2010;16:1076-83.
• Turk Boru U, Alp R, Sur H, Gul L. Prevalence of multiple sclerosis door-to-door survey in Maltepe, Istanbul, Turkey. Neuroepidemiology 2006;27:17-21.
• Bulut S, Kılıç H, Demir C. Yukarı Fırat Bölgesinde multipl skleroz tanısı ile izlenen hastaların klinik ve demografik özellikleri. Fırat Tıp Dergisi 2011;16:84-90.
• Paradiso S. Neuroimaging: A companion to Adams and Victor’s principles of neurology - Greenberg, JO. Am J Psychiat 1996;153:729-729..
• Nielsen NM, Westergaard T, Rostgaard K, Frisch M, Hjalgrim H, Wohlfahrt J, Koch-Henriksen N, Melbye M. Familial risk of multiple sclerosis: A nationwide cohort study. American Journal of Epidemiology 2005;162:774- 8.
• Rosati G. The prevalence of multiple sclerosis in the world: An update. Neurol Sci 2001;22:117-39.
• Sheikh A, Strachan DP. The hygiene theory: Fact or fiction? Current Opinion in Otolaryngology & Head and Neck Surgery 2004;12:232-6.
• Hayes CE. Vitamin D: A natural inhibitor of multiple sclerosis. Proceedings of the Nutrition Society 2000;59:531-5.
• Karabudak R. Klinik nöroimmünolojiye giriş. In: Karabudak R. ed, Temel ve Klinik Nöroimmünoloji. Ankara: ADA Basın Yayın Ltd. Şti., 2013:177.
• Frohman EM, Racke MK, Raine CS. Multiple sclerosis- the plaque and its pathogenesis. New England Journal of Medicine 2006;354:942-55.
• Love S, Louis D, Ellison DW. Greenfield’s Neuropathology, 2-Vol. 8th ed. USA, Taylor & Francis, 2008.
• Perry A, Brat DJ. Practical Surgical Neuropathology: A Diagnostic Approach. Churchill Livingstone/Elsevier, 2010.
• Ikeda K, Ito H, Hidaka T, Takazawa T, Sekine T, Yoshii Y, Hirayama T, Kawabe K, Kano O, Iwasaki Y. Repeated non-enhancing tumefactive lesions in a patient with a neuromyelitis optica spectrum disorder. Intern Med 2011;50:1061-4.
• Kutzelnigg A, Lucchinetti CF, Stadelmann C, Bruck W, Rauschka H, Bergmann M, Schmidbauer M, Parisi JE, Lassmann H. Cortical demyelination and diffuse white matter injury in multiple sclerosis. Brain 2005;128:2705- 12.
• Geurts JJ, Pouwels PJ, Uitdehaag BM, Polman CH, Barkhof F, Castelijns JA. Intracortical lesions in multiple sclerosis: Improved detection with 3D double inversion- recovery MR imaging. Radiology 2005;236:254-60.
• Gilmore CP, Donaldson I, Bo L, Owens T, Lowe J, Evangelou N. Regional variations in the extent and pattern of grey matter demyelination in multiple sclerosis: a comparison between the cerebral cortex, cerebellar cortex, deep grey matter nuclei and the spinal cord. Journal of Neurology, Neurosurgery and Psychiatry 2009;80:182-87.
• Wu GF, Alvarez E. The immunopathophysiology of multiple sclerosis. Neurologic Clinics 2011;29:257-78.
• Chastain EM, Duncan DS, Rodgers JM, Miller SD. The role of antigen presenting cells in multiple sclerosis. Biochimica et Biophysica Acta 2011;1812:265-74.
• Ferguson B, Matyszak MK, Esiri MM, Perry VH. Axonal damage in acute multiple sclerosis lesions. Brain 1997;120 (Pt 3):393-9.
• Ünal A, Mavioğlu H, Emre U. Multipl Sklerozda Tanı ve Tedavi Kılavuzu. Multipl Skleroz. İstanbul: Galenos Yayınevi, 2013.
• Oh S, Cudrici C, Ito T, Rus H. B-cells and humoral immunity in multiple sclerosis. Implications for therapy. Immunologic Research 2008;40:224-34.
• Trapp BD, Peterson J, Ransohoff RM, Rudick R, Mork S, Bo L. Axonal transection in the lesions of multiple sclerosis. New England Journal of Medicine 1998;338:278-85.
• Bielekova B, Martin R. Development of biomarkers in multiple sclerosis. Brain 2004;127:1463-78.
• Berkovich R. Treatment of acute relapses in multiple sclerosis. Neurotherapeutics: Journal of the American Society for Experimental Neuro Therapeutics 2013;10:97- 105.
• Schweingruber N, Reichardt SD, Luhder F, Reichardt HM. Mechanisms of glucocorticoids in the control of neuroinflammation. J Neuroendocrinol 2012;24:174-82.
• Frohman EM, Shah A, Eggenberger E, Metz L, Zivadinov R, Stuve O. Corticosteroids for multiple sclerosis: I. Application for treating exacerbations. Neurotherapeutics 2007;4:618-26.
• Gedizlioglu M. Nörolojik Hastalıklarda IVIG Kullanımı ve Plazma Değişimi. Karabudak R ed. Temel ve Klinik Nöroimmünoloji, Ankara: ADA Basın Yayın, Sincan Matbaası 2013;429.
• Ingwersen J, Aktas O, Hartung HP. Advances in and Algorithms for the treatment of relapsing-remitting multiple sclerosis. Neurotherapeutics 2016;13:47-57.
• Michel L, Larochelle C, Prat A. Update on treatments in multiple sclerosis. Presse Med 2015;44:e137-51.
• Ziemssen T, De Stefano N, Pia Sormani M, Van Wijmeersch B, Wiendl H, Kieseier BC. Optimizing therapy early in multiple sclerosis: An evidence-based view. Mult Scler Relat Disord 2015;4:460-9.
• Torkildsen O, Myhr KM, Bo L. Disease-modifying treatments for multiple sclerosis - a review of approved medications. European Journal of Neurology 2016;23 Suppl 1:18-27.
• Dubey D, Cano CA, Stuve O. Update on monitoring and adverse effects of approved second-generation disease-modifying therapies in relapsing forms of multiple sclerosis. Current Opinion in Neurology 2016;29:278-85.
• Prosperini L, Pontecorvo S. Dimethyl fumarate in the management of multiple sclerosis: Appropriate patient selection and special considerations. Therapeutics and Clinical Risk Management 2016;12:339-50.
• Khatri BO. Fingolimod in the treatment of relapsing- remitting multiple sclerosis: Long-term experience and an update on the clinical evidence. Therapeutic Advances in Neurological Disorders 2016;9:130-47.
• Thone J, Linker RA. Laquinimod in the treatment of multiple sclerosis: A review of the data so far. Drug Des Dev Ther 2016;10:1111-8.
• Plavina T, Subramanyam M, Bloomgren G, Richman S, Pace A, Lee S, Schlain B, Campagnolo D, Belachew S, Ticho B. Anti-JC virus antibody levels in serum or plasma further define risk of natalizumab-associated progressive multifocal leukoencephalopathy. Annals of Neurology 2014;76:802-12.
• Babij R, Perumal JS. Comparative efficacy of alemtuzumab and established treatment in the management of multiple sclerosis. Neuropsychiatric Disease and Treatment 2015;11:1221-9.
• Palavra F. Monoclonal antibodies for multiple sclerosis treatment. Acta Medica Portuguesa 2015;28:640-51.
• de Sa JC, Airas L, Bartholome E, Grigoriadis N, Mattle H, Oreja-Guevara C, O’Riordan J, Sellebjerg F, Stankoff B, Vass K, Walczak A, Wiendl H, Kieseier BC. Symptomatic therapy in multiple sclerosis: A review for a multimodal approach in clinical practice. Therapeutic Advances in Neurological Disorders 2011;4:139-68.
• Terzioglu G. Multiple skleroz kuprizon fare modelinde gen ekspresyonlarındaki değişikliklerin gerçek zamanlı (qRT) PCR yöntemi ile tayin edilmesi. İstanbul: İstanbul Teknik Üniversitesi, 2012:73.
• Paus T, Zijdenbos A, Worsley K, Collins DL, Blumenthal J, Giedd JN, Rapoport JL, Evans AC. Structural maturation of neural pathways in children and adolescents: In vivo study. Science 1999;283:1908-11.
• Baker D, Jackson S. Models of multiple sclerosis. ACNR 2007;6:10-2.
• Brok HP, Bauer J, Jonker M, Blezer E, Amor S, Bontrop RE, Laman JD, t Hart BA. Non-human primate models of multiple sclerosis. Immunological Reviews 2001;183:173- 85.