The Oculobulbar Facial Respiratory score is a tool to assess bulbar function in myasthenia gravis patients.

The Oculobulbar Facial Respiratory (OBFR) score is a tool that objectively measures bulbar function in myasthenia gravis (MG). In this study, we analyzed the relation between the OBFR and the MG Activities of Daily Living (MG-ADL) score, and also with the more recently described MG Composite and 15-item MG Quality-of-Life (MG-QOL15) scales. We recruited 42 patients from two centers and assessed them on two occasions, approximately 6 months apart, using the OBFR, MG Composite, MG-ADL, and MG-QOL15 scales. The 'modified' OBFR score was derived from the original OBFR score. The OBFR score correlated significantly with the MG Composite, MG-ADL, and MG-QOL15 scores for both assessments, and with the sum of the bulbar items for all three scores. It also correlated strongly with the individual bulbar-related items of all three scores. The 'modified' OBFR score also correlated significantly with all the aforementioned scores. This study confirmed construct validity of the OBFR and 'modified' OBFR scores.

Suppressive effect of IL-27 on encephalitogenic Th17 cells and the effector phase of experimental autoimmune encephalomyelitis.

IL-27 has been shown to play a suppressive role in experimental autoimmune encephalomyelitis (EAE) as demonstrated by more severe disease in IL-27R-deficient (WSX-1(-/-)) mice. However, whether IL-27 influences the induction or effector phase of EAE is unknown. This is an important question as therapies for autoimmune diseases are generally started after autoreactive T cells have been primed. In this study, we demonstrate maximal gene expression of IL-27 subunits and its receptor in the CNS at the effector phases of relapsing-remitting EAE including disease peak and onset of relapse. We also show that activated astrocyte cultures secrete IL-27p28 protein which is augmented by the endogenous factor, IFN-gamma. To investigate functional significance of a correlation between gene expression and disease activity, we examined the effect of IL-27 at the effector phase of disease using adoptive transfer EAE. Exogenous IL-27 potently suppressed the ability of encephalitogenic lymph node and spleen cells to transfer EAE. IL-27 significantly inhibited both nonpolarized and IL-23-driven IL-17 production by myelin-reactive T cells thereby suppressing their encephalitogenicity in adoptive transfer EAE. Furthermore, we demonstrate a strong suppressive effect of IL-27 on active EAE in vivo when delivered by s.c. osmotic pump. IL-27-treated mice had reduced CNS inflammatory infiltration and, notably, a lower proportion of Th17 cells. Together, these data demonstrate the suppressive effect of IL-27 on primed, autoreactive T cells, particularly, cells of the Th17 lineage. IL-27 can potently suppress the effector phase of EAE in vivo and, thus, may have therapeutic potential in autoimmune diseases such as multiple sclerosis.