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1.
Int Arch Allergy Immunol ; : 1-11, 2024 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-38830344

RESUMEN

BACKGROUND: Ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), is the most frequent medication to be involved in hypersensitivity drug reactions (HDRs). Other analgesic/anti-inflammatory drugs in the arylpropionic group are also relevant, albeit to a lesser extent. Ibuprofen is widely consumed by people of all ages, both on medical prescription and over the counter; moreover, it is an organic contaminant of surface waters and foods. While numerous drugs cause HDR, ibuprofen's underlying mechanisms are more intricate and involve both specific immunological and non-immunological mediated reactions. SUMMARY: we concentrate on immediate responses, including urticaria with or without angioedema, anaphylaxis, and angioedema, classifying reactions according to whether they are caused by single or multiple NSAIDs and based on the mechanisms at play. Both groups may experience anaphylaxis, defined as an immediate, severe systemic reaction involving at least two organs, though the frequency and severity can vary. Following this classification, more clinical manifestations can be identified. Diagnosis is partly based on a detailed clinical history, including information about ibuprofen and/or other arylpropionic derivatives involved, the interval between drug intake and symptoms onset, clinical manifestations, number of episodes, and the patient's tolerance or response to other medications - mainly non-chemically related NSAID - both before and after reactions to ibuprofen and/or other arylpropionic drugs. A drug provocation test is frequently necessary to make a diagnosis. KEY MESSAGE: Because ibuprofen is the most widely prescribed NSAID, it is reasonable to assume its role as the leading cause of HDR will only become more important.

2.
Pharmacol Res ; 200: 107061, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38199278

RESUMEN

The development of Pharmacogenetics and Pharmacogenomics in Western Europe is highly relevant in the worldwide scenario. Despite the usually low institutional support, many research groups, composed of basic and clinical researchers, have been actively working for decades in this field. Their contributions made an international impact and paved the way for further studies and pharmacogenomics implementation in clinical practice. In this manuscript, that makes part of the Special Issue entitled Spanish Pharmacology, we present an analysis of the state of the art of Pharmacogenetics and Pharmacogenomics research in Europe, we compare it with the developments in Spain, and we summarize the most salient contributions since 1988 to the present, as well as recent developments in the clinical application of pharmacogenomics knowledge. Finally, we present some considerations on how we could improve translation to clinical practice in this specific scenario.


Asunto(s)
Farmacogenética , Medicina de Precisión , Europa (Continente)
3.
Int J Mol Sci ; 25(12)2024 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-38927996

RESUMEN

The pathogenesis of multiple sclerosis (MS) is not completely understood, but genetic factors, autoimmunity, inflammation, demyelination, and neurodegeneration seem to play a significant role. Data from analyses of central nervous system autopsy material from patients diagnosed with multiple sclerosis, as well as from studies in the main experimental model of multiple sclerosis, experimental autoimmune encephalomyelitis (EAE), suggest the possibility of a role of oxidative stress as well. In this narrative review, we summarize the main data from studies reported on oxidative stress markers in patients diagnosed with MS and in experimental models of MS (mainly EAE), and case-control association studies on the possible association of candidate genes related to oxidative stress with risk for MS. Most studies have shown an increase in markers of oxidative stress, a decrease in antioxidant substances, or both, with cerebrospinal fluid and serum/plasma malonyl-dialdehyde being the most reliable markers. This topic requires further prospective, multicenter studies with a long-term follow-up period involving a large number of patients with MS and controls.


Asunto(s)
Biomarcadores , Esclerosis Múltiple , Estrés Oxidativo , Humanos , Esclerosis Múltiple/metabolismo , Esclerosis Múltiple/genética , Esclerosis Múltiple/patología , Animales , Encefalomielitis Autoinmune Experimental/metabolismo , Encefalomielitis Autoinmune Experimental/genética , Encefalomielitis Autoinmune Experimental/patología , Antioxidantes/metabolismo
4.
Opt Express ; 31(4): 5625-5639, 2023 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-36823837

RESUMEN

This cross-sectional and observational study includes 50 eyes of subjects with color blindness and 50 eyes of control subjects. Visual function (visual acuity, contrast sensitivity, and color vision) and neuroretinal structure were assessed in all subjects using optical coherence tomography (OCT). Significant thinning of the retinal nerve fiber layer, ganglion cell layer, and retina were observed in the color blindness group. Significant thinning was also recorded in layers that involve photoreceptor nuclei (between the outer limiting layer and the Bruch membrane and between the outer plexiform layer and the outer limiting membrane). OCT evaluation based on retinal segmentation is a rapid (5-10 minutes) non-invasive technique and seems to be a good biomarker of color blindness.


Asunto(s)
Defectos de la Visión Cromática , Visión de Colores , Humanos , Estudios Transversales , Retina , Agudeza Visual , Tomografía de Coherencia Óptica/métodos
5.
Curr Neurol Neurosci Rep ; 23(7): 361-379, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37269451

RESUMEN

PURPOSE OF REVIEW: Patients with different types of choreic syndromes, specially those with Huntington's (HD) and Wilson's (WD) diseases, report frequent sleep complaints. This review focuses on the main findings of studies addressing the sleep features in these diseases, and other less frequent causes of chorea associated with sleep disorders, including a new syndrome described in the last decade associated with IgLON5 antibodies. RECENT FINDINGS: Patients with HD and WD showed a bad quality of sleep and high frequency of insomnia and excessive daytime somnolence. WD patients also showed high scores on a specific scale for rapid eye movement sleep behavior disorders. HD and WD share decreased sleep efficiency and increased REM sleep latencies, percentage of sleep stage N1, and wake after sleep onset (WASO) among their polysomnographic features. Patients with HD and WD showed a high prevalence of different sleep disorders. Patients with other causes of chorea, including neuroacanthocytosis, parasomnia with sleep breathing disorder associated with antibodies to IgLON5, Sydenham's chorea, and choreic syndromes associated to certain genetic mutations show sleep disorders as well.


Asunto(s)
Corea , Trastorno de la Conducta del Sueño REM , Trastornos del Sueño-Vigilia , Humanos , Síndrome , Corea/complicaciones , Sueño , Trastorno de la Conducta del Sueño REM/complicaciones , Trastornos del Sueño-Vigilia/complicaciones , Trastornos del Sueño-Vigilia/epidemiología , Moléculas de Adhesión Celular Neuronal
6.
Int J Mol Sci ; 25(1)2023 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-38203183

RESUMEN

To evaluate a new animal model of chronic glaucoma induced using a single injection of fibronectin-loaded biodegradable PLGA microspheres (Ms) to test prolonged therapies. 30 rats received a single injection of fibronectin-PLGA-Ms suspension (MsF) in the right eye, 10 received non-loaded PLGA-Ms suspension (Control), and 17 were non-injected (Healthy). Follow-up was performed (24 weeks), evaluating intraocular pressure (IOP), optical coherence tomography (OCT), histology and electroretinography. The right eyes underwent a progressive increase in IOP, but only induced cohorts reached hypertensive values. The three cohorts presented a progressive decrease in ganglion cell layer (GCL) thickness, corroborating physiological age-related loss of ganglion cells. Injected cohorts (MsF > Control) presented greater final GCL thickness. Histological exams explain this paradox: the MsF cohort showed lower ganglion cell counts but higher astrogliosis and immune response. A sequential trend of functional damage was recorded using scotopic electroretinography (MsF > Control > Healthy). It seems to be a function-structure correlation: in significant astrogliosis, early functional damage can be detected by electroretinography, and structural damage can be detected by histological exams but not by OCT. Males presented higher IOP and retinal and GCL thicknesses and lower electroretinography. A minimally invasive chronic glaucoma model was induced by a single injection of biodegradable Ms.


Asunto(s)
Glaucoma , Presión Intraocular , Humanos , Masculino , Animales , Ratas , Fibronectinas , Gliosis , Microesferas , Glaucoma/tratamiento farmacológico , Retina
7.
Int J Mol Sci ; 24(2)2023 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-36674807

RESUMEN

Several papers have been published suggesting a probable role of inflammatory factors in the etiopathogenesis of migraine. In this study, we investigated the possible association between common variants in the LAG3/CD4 genes (both genes, which are closely related, encode proteins involved in inflammatory and autoimmune responses) in the risk of migraine in a cohort of Caucasian Spanish participants. For this purpose, the frequencies of CD4 rs1922452, CD4 rs951818, and LAG3 rs870849 genotypes and allelic variants, using a specific TaqMan-based qPCR assay, were assessed in 290 patients diagnosed with migraine and in 300 healthy controls. The relationship of these variables with several clinical features of migraine was also analyzed. The frequencies of the analyzed LAG3/CD4 genotypes did not differ significantly between the two study groups and were not related to the sex, age at onset of migraine, family history of migraine, presence or absence of aura, or the triggering effect of ethanol on migraine episodes. These results suggest a lack of association between common variants in the LAG3/CD4 genes and the risk of developing migraine in the Caucasian Spanish population.


Asunto(s)
Antígenos CD4 , Predisposición Genética a la Enfermedad , Proteína del Gen 3 de Activación de Linfocitos , Trastornos Migrañosos , Humanos , Genotipo , Trastornos Migrañosos/genética , Polimorfismo de Nucleótido Simple , Factores de Riesgo , Antígenos CD4/genética , Proteína del Gen 3 de Activación de Linfocitos/genética
8.
Eur J Clin Invest ; 52(11): e13847, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36224715

RESUMEN

BACKGROUND/OBJECTIVES: Several recent studies suggest a possible role of lymphocyte activation 3 (LAG3) protein. LAG3 can behave as an α-synuclein ligand, and serum and cerebrospinal fluid-soluble LAG3 levels have been proposed as a marker of Parkinson's disease (PD). In this study, we aimed to investigate whether there is an association between 3 common single-nucleotide variations (SNVs) in the LAG3 gene and its closely related CD4 molecule gene and the risk of PD in a Caucasian Spanish population. Two of them have been previously associated with the risk of PD in Chinese females. METHODS: We analysed genotypes and allele frequencies for CD4 rs1922452, CD4 951818 and LAG3 rs870849 SNVs, by using specifically designed TaqMan assays, in a cohort composed of 629 PD patients and 865 age- and gender-matched healthy controls. RESULTS: The frequencies of the CD4 rs1922452 A/A genotype, according to the dominant and recessive genetic models, and of the CD4 rs1922452/A allelic variant were significantly lower, and the frequencies of the CD4 rs951818 A/A genotype, according to the dominant genetic model, and of the CD4 rs951818/A allele, were significantly higher in PD patients than in controls. The differences were not significant after stratifying by sex. These two SNVs showed strong linkage. Regression models showed a lack of relation between the 3 SNVs studied and the age at onset of PD. CONCLUSIONS: These data suggest a possible role of CD4 rs1922452 and CD4 rs951818 polymorphisms in the risk of PD.


Asunto(s)
Antígenos CD/metabolismo , Enfermedad de Parkinson , alfa-Sinucleína , Antígenos CD4 , Estudios de Casos y Controles , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad/genética , Genotipo , Humanos , Ligandos , Nucleótidos , Enfermedad de Parkinson/genética , Polimorfismo de Nucleótido Simple , alfa-Sinucleína/genética , Proteína del Gen 3 de Activación de Linfocitos
9.
Eur J Clin Invest ; 52(6): e13757, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35113457

RESUMEN

BACKGROUND/OBJECTIVES: Histamine has shown a possible role in the etiopathogenesis of migraine. It has been reported an association between some polymorphisms in the diamine oxidase (DAO) gene and migraine, especially in women. Two studies addressing DAO activity in migraine patients showed conflicting results. We investigated the possible relationship of serum DAO activity and histamine levels and 3 polymorphisms in the DAO gene with the risk for migraine. METHODS: We studied the frequencies of DAO rs10156191, rs1049742 and rs1049793 genotypes and allelic variants in 298 migraine patients and 360 healthy controls (using a TaqMan-based qPCR assay), and serum DAO activity and histamine levels in a subset of 99 migraine patients and 115 controls with strict exclusion criteria, and analysed the relationship of these variables with several clinical features of migraine. RESULTS: The frequencies of the DAO genotypes and allelic variants analysed were similar in migraine patients and controls. Serum DAO activity was significantly higher in migraine patients (Vmax/Km 4.24 ± 2.93 vs. 3.60 ± 7.64, p < 0.001), especially in females (Vmax/Km 4.63 ± 2.96 vs. 3.18 ± 2.32, p < 0.0001), while serum histamine was similar in both study groups. CONCLUSION: Serum DAO activity was increased in patients with migraine, especially in females, while serum histamine levels were normal. None of the studied polymorphisms was associated with the risk for migraine.


Asunto(s)
Amina Oxidasa (conteniendo Cobre) , Trastornos Migrañosos , Amina Oxidasa (conteniendo Cobre)/genética , Femenino , Genotipo , Histamina , Humanos , Trastornos Migrañosos/genética , Polimorfismo de Nucleótido Simple
10.
Int J Mol Sci ; 23(23)2022 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-36499121

RESUMEN

According to several studies, inflammatory factors could be related to the pathogenesis of idiopathic restless legs syndrome (RLS). In addition, RLS and Parkinson's disease (PD) have shown a possible relationship, and recent studies have shown an association between CD4 rs1922452 and CD4 rs951818 single nucleotide variants (SNVs) and the risk for PD. For these reasons, we investigated the possible association between common variants in the LAG3/CD4 genes (which encoded proteins involved in inflammatory and autoimmune responses) and the risk for RLS in a Caucasian Spanish population. We assessed the frequencies of CD4 rs1922452, CD4 rs951818, and LAG3 rs870849 genotypes and allelic variants in 285 patients with idiopathic RLS and 350 healthy controls using a specific TaqMan-based qPCR assay. We also analyzed the possible influence of the genotypes' frequencies on several variables, including age at onset of RLS, gender, family history of RLS, and response to drugs commonly used in the treatment of RLS. We found a lack of association between the frequencies of genotypes and allelic variants of the 3 SNVs studied and the risk of RLS, and a weak though significant association between the CD4 rs1922452 GG genotype and an older age at onset of RLS. With the exception of this association, our findings suggest that common SNVs in the CD4/LAG3 genes are not associated with the risk of developing idiopathic RLS in Caucasian Spanish people.


Asunto(s)
Antígenos CD4 , Proteína del Gen 3 de Activación de Linfocitos , Enfermedad de Parkinson , Síndrome de las Piernas Inquietas , Humanos , Alelos , Genotipo , Enfermedad de Parkinson/genética , Polimorfismo de Nucleótido Simple , Síndrome de las Piernas Inquietas/genética , Síndrome de las Piernas Inquietas/epidemiología , Factores de Riesgo , Antígenos CD4/genética , Proteína del Gen 3 de Activación de Linfocitos/genética
11.
Int J Mol Sci ; 23(23)2022 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-36499569

RESUMEN

Several recent works have raised the possibility of the contribution of the lymphocyte activation gene 3 (LAG3) protein in the inflammatory processes of multiple sclerosis (MS). Results of studies on the possible association between LAG3 gene variants and the risk of MS have been inconclusive. In this study, we tried to show the possible association between the most common single nucleotide variants (SNVs) in the CD4 and LAG3 genes (these two genes are closely related) and the risk of MS in the Caucasian Spanish population. We studied the genotypes and allelic variants CD4 rs1922452, CD4 rs951818, and LAG3 rs870849 in 300 patients diagnosed with MS and 400 healthy patients using specific TaqMan-based qPCR assays. We analyzed the possible influence of the genotype frequency on age at the onset of MS, the severity of MS, clinical evolutive subtypes of MS, and the HLADRB1*1501 genotype. The frequencies of the CD4 rs1922452, CD4 rs951818, and LAG3 rs870849 genotypes and allelic variants were not associated with the risk of MS and were unrelated to gender, age at onset and severity of MS, the clinical subtype of MS, and HLADRB1*1501 genotype. The results of the current study showed a lack of association between the CD4 rs1922452, CD4 rs951818, and LAG3 rs870849 SNVs and the risk of developing MS in the Caucasian Spanish population.


Asunto(s)
Esclerosis Múltiple , Humanos , Predisposición Genética a la Enfermedad , Genotipo , Cadenas HLA-DRB1/genética , Esclerosis Múltiple/genética , Polimorfismo de Nucleótido Simple , Antígenos CD4
12.
Eur J Neurol ; 28(7): 2423-2442, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33772991

RESUMEN

BACKGROUND AND PURPOSE: The coexistence of peripheral neuropathy (PN) and restless legs syndrome (RLS) or Willis-Ekbom disease is relatively frequent, but its prevalence has shown a high variability across studies. In addition, several reports have shown data suggesting the presence of PN in patients with idiopathic RLS. METHODS: A search was undertaken using the PubMed, Embase and Web of Science Databases, from 1966 to 6 December 2020, crossing the search term 'restless legs syndrome' with 'neuropathy', 'polyneuropathy' (PNP) and 'peripheral neuropathy', and the references of interest for this topic were identified; a meta-analysis was performed, according to PRISMA guidelines, and a calculation of pooled prevalences, where appropriate, was made using standard methods. RESULTS: Restless legs syndrome has been reported in 5.2%-53.7% of patients with PN (average 21.5%; 95% confidence interval 18.6%-24.5%), and PN has been reported in 0%-87.5% of patients with RLS (average 41.8%; 95% confidence interval 39.9%-43.6%), both being significantly more frequent than in controls. The heterogeneity across studies could be due to differences in the diagnostic criteria used for both RLS and PN. RLS is a frequent clinical complaint in patients with PN of different aetiologies, mainly diabetic PN, uraemic PNP, familial amyloid PNP, Charcot-Marie-Tooth disease and chronic dysimmune inflammatory PNP. Recent neurophysiological findings suggest the presence of small sensory fibre loss in patients diagnosed with idiopathic RLS, but it remains to be determined whether RLS associated with small sensory fibre loss and idiopathic RLS are different clinical entities. CONCLUSIONS: Future studies including clinical and neurophysiological assessment and skin biopsy involving a large series of patients with PN and RLS are needed for a better understanding of the association between these two entities.


Asunto(s)
Neuropatías Amiloides Familiares , Enfermedad de Charcot-Marie-Tooth , Neuropatías Diabéticas , Polineuropatías , Síndrome de las Piernas Inquietas , Humanos , Síndrome de las Piernas Inquietas/complicaciones , Síndrome de las Piernas Inquietas/epidemiología
13.
Eur J Neurol ; 28(3): 1041-1055, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33098743

RESUMEN

BACKGROUND AND PURPOSE: Several studies suggested a role or iron in the pathogenesis or Parkinson's disease (PD), and substantia nigra iron concentrarions have been found increased in PD. However, the results on cerebrospinal (CSF) and serum/plasma iron levels in PD patients have been controversial. The aim of this systematic review and meta-analysis was to establish the CSF and serum/plasma levels of iron and iron-related proteins (ferritin, transferrin, lactoferrin, haptoglobin, and hepcidine) levels, and the urine levels of iron, in patients with PD. METHODS: Four databases (PubMed, EMBASE, MedLine, and Web of Science - Core Collection) were reviewed for studies published from 1966 to October 5, 2020. References of interest were identified. A meta-analysis of eligible studies was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines, using the R software package meta. RESULTS: A non-significant trend towards higher CSF iron levels and marginally significantly lower serum/plasma iron levels was observed in patients with PD compared with age- and sex-matched controls. CSF and serum/plasma ferritin and transferrin concentrations, and serum/plasma lactoferrin and haptoglobin concentrations did not differ significantly between PD patients and controls. CONCLUSION: The findings of this study suggest an association between decreased serum/plasma iron levels and, possibly, higher CSF iron levels with risk of PD.


Asunto(s)
Enfermedad de Parkinson , Ferritinas , Humanos , Hierro/metabolismo , Sustancia Negra/metabolismo
14.
Curr Neurol Neurosci Rep ; 21(5): 23, 2021 03 22.
Artículo en Inglés | MEDLINE | ID: mdl-33754217

RESUMEN

PURPOSE OF THE REVIEW: Patients diagnosed with essential tremor (ET) report frequent sleep complaints. This review focuses on the main findings of studies addressing sleep features in patients diagnosed with ET, updating previously reported information. Bad quality of sleep and excessive daytime somnolence are very frequent in patients with ET, although the effects of the drugs used for the therapy of ET could contribute to these complaints. REM sleep behavior disorder, restless legs, insomnia, and nocturia are frequent complaints as well. There is a lack of studies addressing polysomnographic features of ET.


Asunto(s)
Trastornos de Somnolencia Excesiva , Temblor Esencial , Trastorno de la Conducta del Sueño REM , Síndrome de las Piernas Inquietas , Trastornos del Sueño-Vigilia , Temblor Esencial/complicaciones , Temblor Esencial/epidemiología , Humanos , Trastorno de la Conducta del Sueño REM/epidemiología , Trastorno de la Conducta del Sueño REM/etiología , Síndrome de las Piernas Inquietas/complicaciones , Síndrome de las Piernas Inquietas/tratamiento farmacológico , Síndrome de las Piernas Inquietas/epidemiología , Trastornos del Sueño-Vigilia/epidemiología , Trastornos del Sueño-Vigilia/etiología
15.
Optom Vis Sci ; 98(10): 1177-1182, 2021 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-34678837

RESUMEN

SIGNIFICANCE: Glaucoma patients treated with topical hypotensive eye drops often experience changes in the ocular surface, including the lid margin and the meibomian glands. In this study, the clinical parameters of the ocular surface have been analyzed to detect the presence of meibomian gland dysfunction-related dry eye disease. PURPOSE: This study aimed to evaluate the meibomian gland dysfunction in glaucoma patients secondary to topical antiglaucomatous treatment. METHODS: A total of 131 eyes from different patients with open-angle glaucoma treated with topical medication and 92 eyes from different patients with untreated ocular hypertension were consecutively and prospectively enrolled. The structure of the meibomian glands was assessed using noncontact meibography (Keratograph 5M; Oculus, Wetzlar, Germany), and their function was evaluated by measurement of meibomian glands expressibility, the duct appearance, and the Marx line location. Moreover, tear osmolarity measurement, corneal staining score (Oxford scale), and ocular symptom assessment (Ocular Surface Disease Index questionnaire) were performed. We also compared these variables in the glaucoma group according to the presence (or not) of preservative in topical treatment. RESULTS: Meibomian gland depletion was higher in glaucoma patients with topical medication (P < .001). Furthermore, the quantity of meibomian glands and expressibility of meibum in these patients were altered compared with the control group (P < .001 in both cases). In addition, the glaucoma group presented a higher degree of corneal staining as measured with the Oxford scale (P < .001). The Marx line location score was higher (P < .001 in central Marx line and P < .003 in temporal Marx line) in patients using drugs containing preservative than in those having preservative-free treatment. Logistical regression found that Marx line central, Marx line temporal, quantity of meibum expression, and quality of meibum expression have predictive ability to detect meibomian gland dysfunction-related dry eye disease. CONCLUSIONS: Glaucoma topical treatments produce meibomian gland dysfunction altering their structure and function, and this condition can be worsened using topical treatments containing preservative.


Asunto(s)
Síndromes de Ojo Seco , Enfermedades de los Párpados , Glaucoma de Ángulo Abierto , Disfunción de la Glándula de Meibomio , Síndromes de Ojo Seco/diagnóstico , Síndromes de Ojo Seco/tratamiento farmacológico , Enfermedades de los Párpados/diagnóstico , Enfermedades de los Párpados/tratamiento farmacológico , Glaucoma de Ángulo Abierto/diagnóstico , Glaucoma de Ángulo Abierto/tratamiento farmacológico , Humanos , Glándulas Tarsales/diagnóstico por imagen , Lágrimas
16.
J Neuroophthalmol ; 41(4): e415-e423, 2021 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-34788241

RESUMEN

BACKGROUND: To evaluate the effect of fingolimod in visual function and neuroretinal structures in patients with multiple sclerosis (MS) for a period of 1 year. METHODS: This longitudinal and observational cohort study included 78 eyes of 78 patients with MS treated with fingolimod. All subjects were evaluated every 3 months during 12 months and compared with 32 patients treated with interferon beta. All patients were examined for high-contrast and low-contrast (2.5% and 1.25%) visual acuity (VA), contrast sensitivity vision (CSV) (using Pelli-Robson and CSV-1000E tests), color vision (Farnsworth D-15 and L'Anthony D-15 desaturated tests), and retinal structural measurements (retinal nerve fiber layer [RNFL] and ganglion cell layer [GCL] thickness) using optical coherence tomography (OCT) technology. RESULTS: Patients with MS treated with fingolimod for a period of 1 year showed significant reduction in 100% and 1.25% contrast VA (P = 0.009 and 0.008, respectively), an alteration of contrast sensitivity and color perception (Pelli-Robson test, CSV-1000E test, Farnsworth D-15 desaturated test, and L'Anthony D-15 desaturated test; P < 0.001), GCL thickness reduction (P = 0.007), and an average macular central thickness increase of 2.6 µm (P = 0.006). Patients with MS treated with interferon beta did not show significant changes in visual function tests neither in macular thickness measurements, but they showed a significant reduction in GCL and RNFL thicknesses. The reduction in neuroretinal structures observed by OCT was significantly higher in the interferon-beta group, but patients treated with fingolimod showed a significant increase in macular central thickness and a reduction in low contrast vision (P < 0.001). CONCLUSIONS: Patients with MS treated with fingolimod and with no clinically observable macular edema show a significant change in visual function parameters and average macular central thickness increase compared with those treated with interferon beta. These findings are probably due to subclinical macular edema produced by fingolimod, which might be considered as an indicator for pharmacovigilance of sphingosine-1-phosphate inhibitors to be improved.


Asunto(s)
Clorhidrato de Fingolimod , Esclerosis Múltiple , Clorhidrato de Fingolimod/uso terapéutico , Humanos , Esclerosis Múltiple/complicaciones , Esclerosis Múltiple/tratamiento farmacológico , Retina/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Agudeza Visual
17.
Sensors (Basel) ; 22(1)2021 Dec 27.
Artículo en Inglés | MEDLINE | ID: mdl-35009710

RESUMEN

BACKGROUND: The aim of this paper is to implement a system to facilitate the diagnosis of multiple sclerosis (MS) in its initial stages. It does so using a convolutional neural network (CNN) to classify images captured with swept-source optical coherence tomography (SS-OCT). METHODS: SS-OCT images from 48 control subjects and 48 recently diagnosed MS patients have been used. These images show the thicknesses (45 × 60 points) of the following structures: complete retina, retinal nerve fiber layer, two ganglion cell layers (GCL+, GCL++) and choroid. The Cohen distance is used to identify the structures and the regions within them with greatest discriminant capacity. The original database of OCT images is augmented by a deep convolutional generative adversarial network to expand the CNN's training set. RESULTS: The retinal structures with greatest discriminant capacity are the GCL++ (44.99% of image points), complete retina (26.71%) and GCL+ (22.93%). Thresholding these images and using them as inputs to a CNN comprising two convolution modules and one classification module obtains sensitivity = specificity = 1.0. CONCLUSIONS: Feature pre-selection and the use of a convolutional neural network may be a promising, nonharmful, low-cost, easy-to-perform and effective means of assisting the early diagnosis of MS based on SS-OCT thickness data.


Asunto(s)
Esclerosis Múltiple , Tomografía de Coherencia Óptica , Diagnóstico Precoz , Humanos , Redes Neurales de la Computación , Retina
18.
Pharmacogenomics J ; 20(3): 426-432, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-31792366

RESUMEN

Because nitric oxide could play an important role in the pathogenesis of migraine (suggested by experimental, neuropathological, biochemical, and pharmacological data), and a recent meta-analysis showed an association between the single-nucleotide polymorphism (SNP) rs2070744 in the endothelial nitric oxide synthase (eNOS or NOS3) gene (chromosome 7q36.1) and the risk for migraine in Caucasians, we attempted to replicate the possible association between this SNP and the and the risk for migraine in the Caucasian Spanish population. The frequencies for the NOS3 rs2070744 genotypes and allelic variants were assessed in 283 migraine patients and 287 healthy controls with a TaqMan-based qPCR Assay. The putative influence on genotype frequency of age at onset of migraine attacks, gender, family history of migraine, absence or presence of aura, and triggering of migraine attacks by ethanol, were also analyzed. The frequencies of NOS3 rs2070744 genotypes and allelic variants were not associated with the risk for migraine (OR [95%] CI for the minor allele = 0.91 [0.72-1.15]) and were not influenced by age at onset of migraine, gender, presence of aura, or triggering of migraine attacks by ethanol. NOS3 rs2070744CC genotypes were significantly more frequent in patients with a family history of migraine. NOS3 rs2070744 SNP is not associated with the risk for migraine in Caucasian Spanish people although it might be related to family history.


Asunto(s)
Predisposición Genética a la Enfermedad/genética , Variación Genética/genética , Trastornos Migrañosos/genética , Óxido Nítrico Sintasa de Tipo III/genética , Adolescente , Adulto , Anciano , Femenino , Estudios de Asociación Genética/métodos , Humanos , Masculino , Persona de Mediana Edad , Trastornos Migrañosos/enzimología , Factores de Riesgo , Adulto Joven
19.
Exp Eye Res ; 200: 108208, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32882213

RESUMEN

The processes involved in neurodevelopment and aging have not yet been fully discovered. This is especially challenging in premorbid or borderline situations of neurodegenerative diseases such as Alzheimer's or glaucoma. The retina, as part of the central nervous system, can be considered the easiest and most accessible neural structure that can be analyzed using non-invasive methods. Animal studies of neuroretinal tissue in situations of health and under controlled conditions allow the earliest sex- and aging-induced changes to be analyzed so as to differentiate them from the first signs occurring in manifested disease. This study evaluates differences by age and sex based on intraocular pressure (IOP) and neuroretinal function and structure in healthy young and adult rats before decline due to senescence. For this purpose, eighty-five healthy Long-Evans rats (31 males and 54 females) were analyzed in this 6-month longitudinal study running from childhood to adulthood. IOP was measured by tonometer (Tonolab; Tiolat Oy Helsinki, Finland), neuroretinal function was recorded by flash scotopic and light-adapted photopic negative response electroretinography (ERG) (Roland consult® RETIanimal ERG, Germany) at 4, 16 and 28 weeks of age; and structure was evaluated by in vivo optical coherence tomography (OCT) (Spectralis, Heidelberg® Engineering, Germany). Analyzing both sexes together, IOP was below 20 mmHg throughout the study; retina (R), retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thicknesses measured by OCT decreased over time; an increase in ERG signal was recorded at week 16; and no differences were found between right and left eyes. However, analyzing differences by sex revealed that males had higher IOP (even reaching ocular hypertension [>20 mmHg] by the end of the study [7 months of age]), exhibited greater neuroretinal thickness but higher structural percentage loss, and had worse dark- and light-adapted function as measured by ERG than females. This study concludes that age and sex influenced neurodevelopment and neurodegeneration. Different structural and functional degenerative patterns were observed by sex; these occurred earlier and more intensely in males than in age-matched females.


Asunto(s)
Envejecimiento , Glaucoma/patología , Presión Intraocular/fisiología , Degeneración Retiniana/patología , Células Ganglionares de la Retina/patología , Factores de Edad , Animales , Modelos Animales de Enfermedad , Electrorretinografía/métodos , Femenino , Glaucoma/complicaciones , Glaucoma/fisiopatología , Masculino , Fibras Nerviosas/patología , Ratas Long-Evans , Valores de Referencia , Degeneración Retiniana/etiología , Degeneración Retiniana/fisiopatología , Factores Sexuales , Tomografía de Coherencia Óptica
20.
J Neural Transm (Vienna) ; 127(8): 1167-1175, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32449012

RESUMEN

The possible role of oxidative stress and nitric oxide (NO) in the pathogenesis of multiple sclerosis (MS) has been suggested by several neuropathological, biochemical, and experimental data. Because the single-nucleotide polymorphism (SNP) rs2070744 in the endothelial nitric oxide synthase (eNOS or NOS3) gene (chromosome 7q36.1) showed association with the risk for MS in Iranians, we attempted to replicate the possible association between this SNP and the risk for MS in the Caucasian Spanish population. The frequencies of NOS3rs2070744 genotypes and allelic variants in 300 patients diagnosed with MS and 380 healthy controls were assessed with a TaqMan-based qPCR assay. The possible influence of the genotype frequency on age at onset of MS, the severity of MS, clinical evolutive subtypes of MS, and HLA-DRB1*1501 genotype were also analyzed. The frequencies of rs2070744 genotypes and allelic variants were not associated with the risk of developing MS and were not influenced by gender, age at onset and severity of MS, the clinical subtype of MS or the HLA-DRB1*1501 genotype. This study found a lack of association between NOS3 rs2070744 SNP and the risk for MS in Caucasian Spanish people.


Asunto(s)
Esclerosis Múltiple , Óxido Nítrico Sintasa de Tipo III , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Irán , Esclerosis Múltiple/genética , Óxido Nítrico , Óxido Nítrico Sintasa de Tipo III/genética , Polimorfismo de Nucleótido Simple
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