[Multiple sclerosis in the year 2000: advances in the treatment with interferon beta-1b]. / Stwardnienie rozsiane w roku 2000: postepy w leczeniu interferonem beta-1b.

The decline of millennium brings forward new challenges in therapeutic immunomodulation of relapsing-remittent multiple sclerosis (RR MS). Interferon beta-1b (Betaferon) belongs to expanding family of soluble cytokines which are capable to modify beneficially cellular immunity in RR MS. IFN beta-1b is indicated for young or middle-aged, ambulant patients with RR MS who have frequent relapses, "aggressive" brain lesions in magnetic resonance imaging and higher levels of pro-inflammatory cytokines. Betaferon reduced in people with RR MS mean annual rate and severity of relapses (34% and 49%) and lengthened median time to second relapse (to 295 days). IFN beta-1b also increased the number of relapse-free patients (31%). Although the drug diminishes weakly progression and activity (disability) it might improve slightly participation (handicap) and quality of life. The course of treatment, withdrawals from the trials, side-effects and the occurrence of neutralizing antibodies to IFN beta-1b are concisely described. Combination of IFN beta-1b with other immunotherapeutic drugs needs further clinical trials.

[Therapeutic potential of interferon beta-1b and related drugs in multiple sclerosis: comparative meta-analysis]. / Terapeutyczny potencjal interferonu beta-1b i pokrewnych leków w stwardnieniu rozsianym: porównawcza meta-analiza.

The objective of this current meta-analysis is to determine whether IFN beta-1b is substantially better than other immunomodulating, immunosuppressive or anti-inflammatory drugs in modifying the clinical course of relapsing-remitting and secondary progressive multiple sclerosis (RR MS, SP MS). A comparison shows that in 2-year treatment IFN beta-1b, beta-1a s.c., glatiramer acetate, immunoglobulin G i.v. and mitoxantrone i.v. reduced annual relapse rate (45%), increased the proportion of relapse-free patients (34%), decreased the mean level of disability (-0.23 in EDSS) and diminished the fraction of RR MS patients with sustained progression (25%); p < or = 0.05. Azathioprine demonstrated considerable delay in the onset of action and loss of efficacy in the third year of treatment. IFN beta-1b and cyclical pulses of intravenous high dose methylprednisolone decreased the annual relapse rate and slowed the progression in SP MS patients; p < or = 0.04. All drugs significantly reduced the number of new and enlarging brain lesions on GdT1 and PD/T2 images in MRI (mean -68%). Furthermore, IFN beta-1b s.c. and beta-1a s.c. evidently reversed burden of the disease (BOD) on T2 images (median -4.7%); p = 0.001. However, glatiramer acetate, immunoglobulin G i.v., IFN beta-1a i.m., methylprednisolone i.m. and possibly azathiopirine failed to diminish BOD on T2 images; p = ns. It is concluded that in most RR MS patients IFN beta-1b has similar clinical effect to other immunomodulating drugs and mitoxantrone.

[Leukotrienes B4 and C4 in cerebrospinal of patients with multiple sclerosis]. / Leukotrieny B4 i C4 w plynie mózgowo--rdzeniowym chorych na stwardnienie rozsiane.

Leukotrienes B4 and C4 have been assayed in CSF of 24 patients with the attacks or slowing-progressing course of multiple sclerosis, and in 23 patients with other noninflammatory diseases. Leukotrienes concentrations have been assayed with RIA technique with the use of commercially available kits manufactured by Amersham. Leukotrienes B4 and C4 levels in CSF of patients with multiple sclerosis have been 91.8 +/- 5.6, and 88.6 +/- 7.5 pg, and have been significantly higher than those in other neurological disorders (p < 0.01). Mean LTB4 and LTC4 levels have been significantly lower in patients with atherosclerotic dementia (69, 12.2 and 63, 02.9 pg/ml) or in patients with headache (72.7 +/- 2.8 and 64.5 +/- 8.2 pg/ml). Higher LTB4 and LTC4 levels in patients with multiple sclerosis is probably due to both increased penetration through blood-brain barrier and their synthesis in blood-brain barrier, and cerebral nervous tissue. Further investigations are necessary to show whether LTB4 and LTC4 levels may indicate a stage of inflammatory process activity and enable to draw any conclusions on efficacy of anti-inflammatory therapy.

[Serum lipid peroxides in alcoholic patients]. / Nadtlenki lipidów w surowicy osób uzaleznionych od alkoholu.

The study presents the estimations of serum lipid peroxide (LPx) concentrations in alcoholic patients during acute ethanol intoxication and in abstinence period. The increase of lipid metabolism in alcoholic drunkenness suggests that LPx plays marked role in this turnover.

[Leukotrienes in cerebrospinal fluid of patients with subacute sclerosing panencephalitis]. / Leukotrieny w plynie mózgowo-rdzeniowym chorych na podostre stwardniajace zapalenie mózgu.

In the cerebrospinal fluid of two groups of patients with subacute sclerosing panencephalitis (SSPE), the determinations of LTB4 and LTC4 leukotriene concentrations were performed by radioimmunoassay (RIA). In the first group of 10 patients with chronic SSPE (from 2 to 11 years), the LTB4 and LTC4 levels were 94.8 +/- 17.0 and 97.4 +/- 16.8 pg/ml respectively, and were significantly higher than those in six patients with discopathy, epilepsy and headache (p < 0.01). In the second group of 10 patients with beginning SSPE (disease duration from 1 to 11 months) LTB4 level was lower (was not different from that in the control group), while LTC4 concentration was 97.6 +/- 10.8 pg/ml and again was significantly raised. Higher LTB4 and LTC4 levels in the cerebrospinal fluid of patients with SSPE indicate that these compounds participate in chronic inflammatory reaction around cerebral veins.

[Micropsia in multiple sclerosis]. / Mikropsja w stwardieniu rozsianym.

Micropsia is described in a case of remitting multiple sclerosis with left optic neuritis and spastic paraparesis. The damage to small axons in the optic nerve conducting spatial impulses from temporal and lower segments of retina might be responsible for the occurrence of transient micropsia.

[Evaluation of cerebrospinal fluid proteins in patients with subacute sclerosing panencephalitis (SSPE)]. / Ocena bialek plynu mózgowo-rdzeniowego u chorych na podostre stwardniejace zapalenie mózgu (SSPE).

CSF proteins of 62 patients with SSPE aged 6 to 26 years were analysed by polyacrylamide gel electrophoresis. The total IgG concentration in the CSF was increased to 16.8 +/- 10 mg/dl and the IgG index was raised to from 2.7 +/- 0.5 to 3.6 +/- 3.0. All SSPE patients had pathological subfractions gamma 4 and gamma 5. The per cent proportion of the gamma 1 subfraction was raised only in the youngest patients. A tendency was observed for higher values of the prealbumin:albumin index and the prealbumin: transferrin index. The youngest SSPE patients had a tendency for greater total protein concentration, lower prealbumin concentration, and highest IgG index values (3.6 +/- 3.0). In early disease period a tendency was noted for higher concentration of total protein, higher total IgG level and higher IgG index. These results suggest that SSPE patients have a constant stimulation of B-cells and variable increase of blood-brain barrier permeability.

[Nuchal-paretic sign in multiple sclerosis]. / Objaw karkowo-porazny w stwardnieniu rozsianym.

A 43-year-old patient with clinically established diagnosis of multiple sclerosis had the nuchal-paretic sign. Neck flexion caused reversible deterioration of gait and increased the weakness of the right lower extremity. Although the sign is not pathognomonic for multiple sclerosis it is a peculiar pyramidal sign suggesting demyelination especially in the cervical part of the spine. Mechanical stretching of the demyelination plaques in the cervical spine reduces probably the density of the action current generated at the nodes of the demyelinated fibres.

[Diagnosis and etiopathogenesis of retinitis in patients with multiple sclerosis]. / Diagnostyka i etiopatogeneza zapalen siatkówki u chorych na stwardnienie rozsiane.

Presented are: the incidence, symptomatology and diagnostics together with electroretinography of retinal periphlebitis as well as retinitis and maculopathy in patients with multiple sclerosis. Particular attention is called to the histopathology of the retina in this disease. The etiopathology of retinitis and maculopathy in multiple sclerosis is still unknown. Four etiopathological hypotheses are shortly discussed.

[Lipid peroxides in the sera of patients with multiple sclerosis]. / Nadtlenki lipidów w surowicy chorych na stwardnienie rozsiane.

Serum lipid peroxides (LPX) were determined in 24 patients with multiple sclerosis and in 30 healthy controls. Patients with relapses or chronic progression had significantly higher serum LPX level than healthy controls: mean 3.09 +/- 0.15 nmol/ml versus 2.30 nmol/ml, p less than 0.01. Relapsing-remitting patients showed slightly higher LPX level than slowly progressive patients. It is supposed that lipid peroxides are unspecific mediators of the inflammatory reaction in multiple sclerosis.

[The risk of multiple sclerosis development in patients with idiopathic optic neuritis: prognosis and other problems]. / Zagrozenie stwardnieniem rozsianym wsród chorych z samoistnym zapaleniem nerwu wzrokowego: zagadnienia rokownicze i inne.

The percentage of patients with idiopathic optic neuritis (ION) developing multiple sclerosis (MS) was higher in young females who had recurrent ION, especially during 4 years since the first inflammatory attack. Clinical features of ION had no prognostic value. Patients with ION developed also more frequently MS if paraclinical findings showed the occurrence of DR2, DR3, DQw1 and/or DPw4, increased CSF IgG index, CSF oligoclonal IgG, asymptomatic lesions in NMR brain images, and subclinical abnormalities in visual, brainstem auditory, somatosensory evoked potentials. The author discusses the problem whether high risk patients with ION should be given antiviral and immunomodulatory drugs which could prevent or delay the clinical onset of MS.

[Serum levels of lipid peroxides in alcoholics]. / Nadtlenki lipidów w surowicy osób uzaleznionych od alkoholu.

Serum lipid peroxidases (LPx) concentration was assayed in the following groups: 25 patients with diagnosis of acute alcohol intoxication, 20 patients during alcohol abstinence and 30 healthy control individuals. In 25 patients the assessments were carried out twice: before and on the 3-7 day of detoxification. The serum LPx had been significantly higher in all patients during the acute intoxication period (4.33 +/- 0.20 nmol/l; p less than 0.01). In 38% of them the LPx concentration was falling down after detoxication. There were no difference in LPx concentration between the group of abstinents and the healthy controls. The results point to dependence between clinical state of alcoholics and serum LPx level.

[Symptomatology of infrequent visual disturbances in multiple sclerosis patients]. / Symptomatologia rzadszych zaburzen wzrokowych u chorych na stwardnienie rozsiane.

Two cases of clinically certain multiple sclerosis were observed in whom rather infrequently occurring symptoms of damage to the visual pathways were noted. In one case during right-sided optic neuritis cyanopsia developed, followed after five months by left-sided alternatively darkening and lightening of vision. In another case with bilateral retrobulbar optic neuritis attacks of fading-out vision appeared when the patient fixed an object. Two years later the patient had episodes of chloropsia.