scholarly journals Transplantation of umbilical cord and bone marrow-derived mesenchymal stem cells in a patient with relapsing-remitting multiple sclerosis

2013 ◽  
Vol 7 (5) ◽  
pp. 404-407 ◽  
Author(s):  
Zong-liu Hou ◽  
Ying Liu ◽  
Xi-Hong Mao ◽  
Chuan-yu Wei ◽  
Ming-yao Meng ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Stem Cells ◽  
Bone Marrow ◽  
Mesenchymal Stem Cells ◽  
Umbilical Cord ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

Dimethyl fumarate–associated transient bone marrow oedema syndrome

2018 ◽  
Vol 25 (6) ◽  
pp. 876-879 ◽  
Author(s):  
James Triplett ◽  
Srimathy Vijayan ◽  
Richard Prince ◽  
Allan Kermode
Keyword(s):  
Multiple Sclerosis ◽  
Bone Marrow ◽  
Dimethyl Fumarate ◽  
Symptomatic Improvement ◽  
Bone Marrow Oedema ◽  
Related Factor ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
And Function ◽  
Relapsing Remitting Multiple Sclerosis

Background: Dimethyl fumarate (DMF) is a commonly used and effective treatment for relapsing and remitting multiple sclerosis. Its use results in impairment of the transcription factor nuclear factor erythroid-derived 2 (E2)-related factor (Nrf2), which is involved in both immunomodulation and bone health. DMF has not previously been reported to cause bone marrow complications, though other fumarates including tenofovir have. The mechanism of fumarate-associated bone toxicity remains unclear with altered osteoblastic gene expression and function suggested. Methods: We present a case of a 54-year-old female with relapsing remitting multiple sclerosis (RRMS) treated for 30 months with DMF who developed relapsing atraumatic lower limb bone pain. Results: Serial imaging revealed multifocal areas of bone marrow oedema and trabecular fractures. The patient was diagnosed with transient bone marrow oedema syndrome. Management consisted of cessation of therapy and treatment with the pro-osteobalstic agent denosumab. Conclusion: In this instance of DMF-associated bone marrow oedema, cessation of DMF and treatment with denosumab resulted in symptomatic improvement. DMF therapy may potentially result in bone marrow oedema due to inhibition of common upstream signalling pathways, including the Nrf2 signalling pathway.

scholarly journals Mesenchymal properties of SJL mice-stem cells and their efficacy as autologous therapy in a relapsing–remitting multiple sclerosis model

2014 ◽  
Vol 5 (6) ◽  
pp. 134 ◽  
Author(s):  
Carmen Marin-Bañasco ◽  
Margarita García ◽  
Issac Guerrero ◽  
Rafael Sánchez ◽  
Guillermo Estivill-Torrús ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Stem Cells ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Autologous Therapy ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Multiple Sclerosis Model

Expression of cathepsins S and D signals a distinctive biochemical trait in CD34+ hematopoietic stem cells of relapsing–remitting multiple sclerosis patients

2013 ◽  
Vol 19 (11) ◽  
pp. 1443-1453 ◽  
Author(s):  
Sabata Martino ◽  
Simona Montesano ◽  
Ilaria di Girolamo ◽  
Roberto Tiribuzi ◽  
Maria Di Gregorio ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Stem Cells ◽  
Hematopoietic Stem Cells ◽  
Specific Cell ◽  
Hematopoietic Stem ◽  
Biochemical Trait ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Multiple Sclerosis Patients ◽  
Relapsing Remitting Multiple Sclerosis

Background: The elucidation of mechanistic aspects of relapsing–remitting multiple sclerosis (RRMS) pathogenesis may offer valuable insights into diagnostic decisions and medical treatment. Results: Two lysosomal proteases, cathepsins S and D (CatS and CatD), display an exclusive pattern of expression in CD34+ hematopoietic stem cells (HSCs) from peripheral blood of acute MS (A-MS) patients ( n = 20). While both enzymes normally exist as precursor forms in the HSCs of healthy individuals ( n = 30), the same cells from A-MS patients consistently exhibit mature enzymes. Further, mature cathepsins are expressed at lower rates in stable MS subjects (S-MS, n = 15) and revert to precursor proteins after interferon-β1a treatment ( n = 5). Mature CatD and CatS were induced in HSCs of healthy donors that were either co-cultured with PBMCs of A-MS patients or exposed to their plasma, suggesting a functional involvement of soluble agents. Following HSC exposure to several cytokines known to be implicated in MS, and based on relative cytokine levels displayed in A-MS, S-MS and control individuals, we identified IL-16 as a specific cell signaling factor associated with cathepsin processing. Conclusions: These data point to an evident correlation between CatS and CatD expression and MS clinical stage, and define a biochemical trait in HSCs with functional, medical, and diagnostic relevance.

scholarly journals Severe Coombs Positive Autoimmune Hemolytic Anemia after Alemtuzumab Infusion for Relapsing Remitting Multiple Sclerosis. What Can We Learn?

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2331-2331 ◽  
Author(s):  
Parth Anil Desai ◽  
Chase Mathew Romere ◽  
Linda Nguyen ◽  
Annapurna Saksena ◽  
Siddiqui J Abdullah ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Bone Marrow ◽  
Aplastic Anemia ◽  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Recovery Period ◽  
Conditioning Regimen ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

Abstract Background: Alemtuzumab (LemtradaTM) is a recombinant humanized anti-CD52 monoclonal antibody that targets T and B lymphocytes, monocytes and eosinophils. It is a Food and Drug administration (FDA) approved drug (approved in November 2014) for relapsing remitting multiple sclerosis (RRMS). Alemtuzumab is also being used occasionally for immune disorders like graft versus host disease (GVHD) and aplastic anemia as well as for B- chronic lymphocytic leukemia (B-CLL) (FDA approved) and sometimes as a part of conditioning regimen for solid and bone marrow transplantations (Campath-1H®). As an interesting paradox to its anti-immune effects, the most serious adverse effects of Alemtuzumab apart from infections are autoimmune effects (AE) (black box warning issued by FDA), affecting various organs mainly thyroid and bone marrow (mainly immune thrombocytopenia). Rare singular cases are emerging of autoimmune hemolytic anemia (AIHA) occurring months after Alemtuzumab infusion; therefore, herein we present the first case series along with review of all the reported cases of AIHA after Alemtuzumab infusion used for treatment of RRMS. Methods: We did a retrospective chart review of 4 cases of AIHA developing after Alemtuzumab infusion which included 3 cases from the CARE MS-I/II and CARE MS Extension trials (Randomized controlled trials comparing Alemtuzumab versus Interferon beta 1a) (courtesy Sanofi/Genzyme) and 1 case encountered at UT health San Antonio. Simultaneously, we did a literature search using multiple available online databases (PubMed, Ovid, MEDLINE and Cochrane Library) from January 1, 2010 to May 1, 2018 for AIHA associated with Alemtuzumab infusion and found additional 3 reported cases. All of the cases were Direct Antiglobulin test (DAT/Coombs) positive and no other cause of hemolysis was identified. All the analysis was descriptive and exploratory. Results & Discussion: Out of the total 7 cases reviewed, there were 4 males and 3 females. The common theme amongst all the cases was presence of coombs positive autoimmune intravascular hemolysis occurring 3-15 months (Mean±SD=10±3 months) after the last dose of Alemtuzumab (table 1). In 71% (5/7) of the cases hemoglobin dipped below 5gm/dl requiring multiple transfusions with 1 reported death due to multiorgan failure from complication of severe AIHA. 70% (4/6) cases where steroids were used were not responsive to them requiring the use of some other therapeutic interventions such as Intravenous Immunoglobulin (IVIG), plasmapheresis and second line agents like Rituximab. Interestingly, Alemtuzumab has also been successfully used as a 2nd line agent to treat AIHA especially associated with B-CLL and other immune phenomenon (GVHD, aplastic anemia, conditioning regimen for transplantations) immediate and sustained lymphopenia effect. The proposed mechanism for this "paradoxical" AE related to Alemtuzumab is the reduced diversity and increased regeneration of "self-reactive" T cells during delayed time frame of the "recovery period" of lymphocytes. The reported post marketing incidence of AIHA for Alemtuzumab in RRMS is around 0.13%. Alemtuzumab associated AIHA when used for B-CLL has also been rarely reported. Conclusion: Severe coombs positive AIHA is a rare life-threatening complication that can occur after Alemtuzumab infusion for RRMS. It can be rapidly progressive, intravascular, severe (hemoglobin frequently reaching to <5gm/dl) and frequently refractory to steroids. It usually occurs between 3-15 months after the Alemtuzumab infusion and can be fatal (with 1 reported death so far). Higher level of awareness is needed by the consulting hematologists of such a rare serious adverse effect that can occur specifically few months after Alemtuzumab infusion and calls for a closer monitoring of patient's hematological status during this recovery period. Disclosures No relevant conflicts of interest to declare.

Effects of relapsing-remitting multiple sclerosis on the stomatognathic system: preliminary findings

2020 ◽  
Vol 179 (6) ◽  
Author(s):  
Gabriel Pádua da Silva ◽  
Marcelo Palinkas ◽  
Robson F. Tosta Lopes ◽  
Saulo C. Vallin Fabrin ◽  
Bruno Ferreira ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Stomatognathic System ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis
Sign in / Sign up

Export Citation Format

Share Document