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1.
Medicine (Baltimore) ; 99(4): e18866, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31977888

RESUMO

BACKGROUND: Multiple sclerosis (MS) is a demyelinating disease, affecting both the sensorimotor and cognitive systems. The typical pattern of cognitive impairment includes reduced speed of information processing, decreased phonological and semantic speech fluency, deficits in verbal and visual episodic memory, as well as attention and executive dysfunctions. We aimed to investigate the influence of the neurologic music therapy (NMT) on mood, motivation, emotion status, and cognitive functions in patients with MS. METHODS: Thirty patients with MS were randomly divided in 2 groups: the control group (CG) undergoing conventional cognitive rehabilitation (CCR), 6 times a week for 8 weeks, and the experimental group (EG) undergoing CCR 3 times a week for 8 weeks plus NMT techniques, performed 3 times a week for 8 weeks. All the participants were submitted to the same amount of treatment. Each patient was evaluated before (baseline: T0) and immediately after the end of each training (T1). MAIN OUTCOMES MEASURES: We used as main outcome measure: the brief repeatable battery of neuropsychological test to assess various cognitive abilities; and the multiple sclerosis quality of life-54 (MSQoL-54). RESULTS: Both the groups benefit from 8 weeks of CR. In particular, the EG got better results in cognitive function, with regard to selective reminding test long term storage (P < .000), long term retrieval (P = .007), and delayed recall of the 10/36 spatial recall test (P = .001), as compared with the CG. Moreover, the improvement in emotional status, motivation, mood and quality of life (with regard to the mental component; P < .000) was more evident in the EG. CONCLUSIONS: NMT could be considered a complementary approach to enhance CCR in patients affected by MS.


Assuntos
Disfunção Cognitiva/terapia , Esclerose Múltipla/terapia , Musicoterapia/métodos , Afeto , Disfunção Cognitiva/etiologia , Feminino , Humanos , Masculino , Memória , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Esclerose Múltipla/psicologia , Projetos Piloto , Qualidade de Vida , Método Simples-Cego , Resultado do Tratamento
2.
Nat Rev Neurol ; 16(1): 56-62, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31649335

RESUMO

New so-called immune reconstitution therapies (IRTs) have the potential to induce long-term or even permanent drug-free remission in people with multiple sclerosis (MS). These therapies deplete components of the immune system with the aim of allowing the immune system to renew itself. Haematopoietic stem cell transplantation, the oral formulation cladribine and the monoclonal antibodies alemtuzumab, rituximab and ocrelizumab are frequently categorized as IRTs. However, the evidence that IRTs indeed renew adaptive immune cell repertoires and rebuild a healthy immune system in people with MS is variable. Instead, IRTs might foster the expansion of those cells that survive immunosuppression, and this expansion could be associated with acquisition of new functional phenotypes. Understanding immunological changes induced by IRTs and how they correlate with clinical outcomes will be instrumental in guiding the optimal use of immune reconstitution as a durable therapeutic strategy. This Perspectives article critically discusses the efficacy and potential mechanisms of IRTs in the context of immune system renewal and durable disease remission in MS.


Assuntos
Reconstituição Imune/imunologia , Imunoterapia/tendências , Esclerose Múltipla/imunologia , Esclerose Múltipla/terapia , Humanos , Imunoterapia/métodos , Indução de Remissão/métodos
3.
Adv Exp Med Biol ; 1190: 249-256, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31760648

RESUMO

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) affecting more than two million people worldwide. As the exact etiology of MS remains elusive, the diagnosis of MS is made by referring to the McDonald diagnostic criteria, which utilizes MRI as a tool to identify "demyelinated" MS lesions. In particular, hyperintense lesions on T2-weighted images (T2WI) or so-called "T2-lesions" are considered to represent demyelinated MS lesions. T2WI, however, lacks myelin specificity, and moreover, remyelination could not be depicted by the use of such modality. For the accurate diagnosis and treatment decision-making, or for the future development of remyelination therapeutics, imaging tools to visualize myelin-specific signals are mandatory. In this chapter, the current use and the limitation of imaging modalities in MS diagnosis and treatment will be reviewed, with the introduction of new imaging method, namely q-space Myelin Map (qMM), to be used for visualization of demyelination and remyelination in MS.


Assuntos
Esclerose Múltipla/diagnóstico por imagem , Esclerose Múltipla/terapia , Bainha de Mielina/patologia , Humanos , Imagem por Ressonância Magnética
5.
Life Sci ; 235: 116830, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31487529

RESUMO

Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system (CNS). In attempt to identify an appropriate treatment for improving the neurological symptoms and remyelination process, autologous and allogenic transplantation of mesenchymal stem cells (MSCs) have been introduced as an effective therapeutic strategy in MS. MSCs are a heterogeneous subset of pluripotent non-hematopoietic stromal cells that are isolated from bone marrow, adipose tissue, placenta and other sources. MSCs have considerable therapeutic effects due to their ability in differentiation, migration, immune-modulation and neuroregeneration. To date, numerous experimental and clinical studies demonstrated that MSCs therapy improves the CNS repair and modulates functional neurological symptoms. Here, we provided an overview of the current knowledge about the clinical applications of MSCs in MS. Furthermore, the major challenges and risks of MSCs therapy in MS patients have been elucidated.


Assuntos
Transplante de Células-Tronco Mesenquimais/métodos , Esclerose Múltipla/terapia , Animais , Humanos , Transplante de Células-Tronco Mesenquimais/efeitos adversos , Esclerose Múltipla/patologia
6.
Cell Mol Life Sci ; 76(24): 4869-4886, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31377844

RESUMO

The chemokine system mediates acute inflammation by driving leukocyte migration to damaged or infected tissues. However, elevated expression of chemokines and their receptors can contribute to chronic inflammation and malignancy. Thus, great effort has been taken to target these molecules. The first hint of the druggability of the chemokine system was derived from the role of chemokine receptors in HIV infection. CCR5 and CXCR4 function as essential co-receptors for HIV entry, with the former accounting for most new HIV infections worldwide. Not by chance, an anti-CCR5 compound, maraviroc, was the first FDA-approved chemokine receptor-targeting drug. CCR5, by directing leukocytes to sites of inflammation and regulating their activation, also represents an important player in the inflammatory response. This function is shared with CCR2 and its selective ligand CCL2, which constitute the primary chemokine axis driving the recruitment of monocytes/macrophages to inflammatory sites. Both receptors are indeed involved in the pathogenesis of several immune-mediated diseases, and dual CCR5/CCR2 targeting is emerging as a more efficacious strategy than targeting either receptor alone in the treatment of complex human disorders. In this review, we focus on the distinctive and complementary contributions of CCR5 and CCR2/CCL2 in HIV infection, multiple sclerosis, liver fibrosis and associated hepatocellular carcinoma. The emerging therapeutic approaches based on the inhibition of these chemokine axes are highlighted.


Assuntos
Quimiocina CCL2/genética , Inflamação/genética , Receptores CCR2/genética , Receptores CCR5/genética , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/terapia , Marcação de Genes , HIV/genética , HIV/patogenicidade , Infecções por HIV/genética , Infecções por HIV/terapia , Infecções por HIV/virologia , Humanos , Inflamação/terapia , Cirrose Hepática/genética , Cirrose Hepática/terapia , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/terapia , Esclerose Múltipla/genética , Esclerose Múltipla/terapia
8.
Neurosciences (Riyadh) ; 24(3): 192-198, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31380818

RESUMO

OBJECTIVE: To describe the prevalence, knowledge and attitudes about complementary and alternative medicine (CAM) use and the proportion that seek advice from their physician about CAM use. METHODS: This cross-sectional observational study was performed in multiple sclerosis (MS) clinic of King Fahd Hospital of Universityin Alkhobar, Kingdom of Saudi Arabia from January-June 2017. A total of 133 patients have completed the survey. RESULTS: The mean age of patients was 32.3+/-7.6 years and 84 (63.2%) were female. Approximately 83.5% of the patients reported the use of CAM. Among all the reported forms of CAM, vitamins were the most prevalent form, followed by cupping, special prayers and meditation. The majority of patients (62%) obtained knowledge of CAM through social media. A significant number of patients (75.6%) did not disclose the use of CAM to their physician. There was a trend for using CAM more in highly educated, older age, and female patients. The most commonly reported rationale to use CAM was overall improvement in health status. CONCLUSION: The use of CAM among Saudi patients with MS is highly prevalent, without disclosure of its use to physicians. These factors should be taken into account in the doctor-patient consultation to avoid adverse events.


Assuntos
/estatística & dados numéricos , Meditação , Esclerose Múltipla/terapia , Adulto , Feminino , Humanos , Masculino , Esclerose Múltipla/tratamento farmacológico , Esclerose Múltipla/psicologia , Relações Médico-Paciente , Religião , Arábia Saudita , Autoadministração/estatística & dados numéricos , Vitaminas/administração & dosagem , Vitaminas/uso terapêutico
9.
Neurosciences (Riyadh) ; 24(3): 221-224, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31380822

RESUMO

In the present article, we described a case of treating intractable pain from failed back surgery syndrome (FBSS) and multiple sclerosis (MS) after implantation of spinal cord stimulation (SCS) in a patient. We are reporting a case where SCS has been used for treating a patient with both FBSS and MS.


Assuntos
Síndrome Pós-Laminectomia/terapia , Esclerose Múltipla/terapia , Estimulação da Medula Espinal/métodos , Síndrome Pós-Laminectomia/complicações , Feminino , Humanos , Pessoa de Meia-Idade , Esclerose Múltipla/complicações
10.
Nervenarzt ; 90(12): 1245-1253, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31297574

RESUMO

After years of low incidence, a large increase of new tuberculosis (TB) cases has been reported in Germany since 2015. New immunotherapies for the treatment of multiple sclerosis (MS) are associated with a reduced immune competence and a potential increased risk for infections. Most neurologists lack specific experiences with TB infections. This article summarizes specific recommendations for the diagnostics and treatment of TB under MS immunotherapies with a focus on the situation in Germany. Due to low case numbers and little experience with the risk of TB under the new immunotherapies, the clinical competence network for MS (KKNMS) consensus recommendations have a low grade of evidence.


Assuntos
Esclerose Múltipla , Tuberculose , Alemanha , Humanos , Imunoterapia , Esclerose Múltipla/complicações , Esclerose Múltipla/terapia , Tuberculose/complicações , Tuberculose/diagnóstico , Tuberculose/terapia
11.
Stud Health Technol Inform ; 262: 360-363, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349342

RESUMO

This paper presents a mid-fidelity prototype of a mobile application for self-management of the chronic disease Multiple Sclerosis (MS). The study focuses on newly diagnosed young Norwegians with MS and wants to deliver IT solutions for a healthier lifestyle. An analysis of a social media platform, interview with medical staff, a social media focus group interview and one case study where utilized to gather data alongside with design iterations. A high-fidelity prototype is being implemented with main functionalities: health, training, patient notes for next medical appointment, disease related life and work issues, and a reward point system.


Assuntos
Aplicativos Móveis , Esclerose Múltipla , Autogestão , Humanos , Estilo de Vida , Esclerose Múltipla/terapia , Noruega , Adulto Jovem
12.
Int J Med Educ ; 10: 122-128, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31256072

RESUMO

Objectives: This study characterized how an online continuing education activity affected knowledge, attitudes, and practices of healthcare professionals who care for patients with multiple sclerosis (MS) and whether those changes reflected theorized translational mechanisms proposed in The Expanded Learning Model for Systems (TELMS). Methods: This preliminary study used semi-structured interviews (thematic analysis) to assess whether and how translational mechanisms underpinning the TELMS theory might be revealed in learners' attitudes and practice behavior. Eighteen participants (primarily neurologists and nurses) were interviewed by telephone or online. Thematic analysis identified relevant themes according to sensitizing concepts derived from TELMS and the recognition of emergent themes. Results: Textual interpretation of interview data revealed that MS providers act in various scenarios that validate the principles of TELMS model of learning engagement. Further, elements of translational mechanisms proposed by TELMS were consistently observed in the narrative reflections. Emergent themes included the importance of practices such as goal setting, coordination of care, systems-level MS care, and economic considerations. Practitioners particularly drew on ideas from TELMS when facing challenges in diverse cultural and sociocultural settings. Conclusions: We identified mechanisms of change reflected in the TELMS model that is useful for the design and evaluation of future educational activities. These include attitudes and beliefs about the application of evidence-aligned MS care, as well as the commitment to multidisciplinary strategies, enhanced coordination of care, and promotion of systems-based changes. Future studies are needed to further validate the TELMS model.


Assuntos
Educação Continuada/métodos , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Esclerose Múltipla/terapia , Avaliação Educacional , Humanos , Entrevistas como Assunto , Aprendizagem , Modelos Educacionais
13.
NeuroRehabilitation ; 44(4): 587-597, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31256089

RESUMO

BACKGROUND: Downslope walking (DSW) is an eccentric-based exercise intervention that promotes neuroplasticity of spinal reflex circuitry by inducing depression of Soleus Hoffman (H)-reflexes in young, neurologically unimpaired adults. OBJECTIVE: The objective of the study was to evaluate the effects of DSW on spinal excitability (SE) and walking function (WF) in people with multiple sclerosis (PwMS). METHODS: Our study comprised two experiments on 12 PwMS (11 women; 45.3±11.8 years). Experiment 1 evaluated acute effects of a single 20-minute session of treadmill walking at three different walking grades on SE, 0% or level walking (LW), - 7.5% DSW, and - 15% DSW. Experiment 2 evaluated the effects of 6 sessions of DSW, at - 7.5% DSW (with second session being - 15% DSW) on SE and WF. RESULTS: Experiment 1 showed significantly greater acute % H-reflex depression following - 15% DSW compared to LW (p = 0.02) and - 7.5% DSW (p = 0.05). Experiment 2 demonstrated significant improvements in WF. PwMS who showed greater acute H-reflex depression during the - 15% DSW session also demonstrated greater physical activity, long-distance WF, and the ability to have greater H-reflex depression after DSW training. Significant changes were not observed in regards to SE. CONCLUSIONS: Though significant changes were not observed in SE after DSW training, we observed an improvement in WF which merits further investigation of DSW in PwMS.


Assuntos
Teste de Esforço/métodos , Reflexo H/fisiologia , Esclerose Múltipla/fisiopatologia , Esclerose Múltipla/terapia , Caminhada/fisiologia , Adulto , Idoso , Eletromiografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/diagnóstico , Músculo Esquelético/fisiopatologia , Plasticidade Neuronal/fisiologia , Resultado do Tratamento , Adulto Jovem
14.
Res Vet Sci ; 125: 71-81, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31152923

RESUMO

Multiple sclerosis (MS) is a progressive demyelinating disease of the central nervous system that destroys oligodendrocytes. This work aims to evaluate the treatment of experimentally induced MS in dogs using laser activated non-expanded adipose derived stem cells. The results showed amelioration of the clinical signs over time confirmed by the resolution of the previous lesions on MRI. Positive migration of the injected cells to the site of lesion, increased remyelination detected by Myelin Basic Proteins, positive differentiation into Olig2 positive oligodendrocytes, prevented the glial scar formation and restored axonal architecture. The study concluded that treatment using laser activated stem cells holds a promising therapeutic option for treatment of MS in a canine model.


Assuntos
Adipócitos/fisiologia , Tecido Adiposo/citologia , Células-Tronco Mesenquimais/fisiologia , Esclerose Múltipla/terapia , Oligodendroglia/fisiologia , Adipócitos/efeitos da radiação , Tecido Adiposo/efeitos da radiação , Animais , Diferenciação Celular , Modelos Animais de Doenças , Cães , Imuno-Histoquímica/veterinária , Lasers , Imagem por Ressonância Magnética/veterinária , Células-Tronco Mesenquimais/efeitos da radiação , Proteína Básica da Mielina , Fator de Transcrição 2 de Oligodendrócitos , Oligodendroglia/efeitos da radiação , Distribuição Aleatória , Medula Espinal/patologia , Medula Espinal/ultraestrutura
15.
Paediatr Drugs ; 21(3): 137-152, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31155694

RESUMO

Pediatric-onset multiple sclerosis (MS) comprises 2-5% of MS cases, and is known to be associated with high disease activity and the accumulation of disability at an earlier age than their adult-onset counterparts. Appropriate therapy leading to disease control has the potential to alter the known trajectory of adverse long-term physical, cognitive, and psychosocial outcomes in this population. Thus, optimizing treatment for children and adolescents with MS is of paramount importance. The last decade has seen a growing number of disease-modifying therapies approved for relapsing MS in adults, and available agents now include oral, injectable, and infusion therapies. Recently, the development of randomized controlled MS trials in youth has led to the first agent approved by the US FDA for the treatment of pediatric MS-fingolimod. With this, we have entered a new era of knowledge and treatment in this population and ongoing pediatric trials are expected to further inform clinical management. With the emergence of highly effective therapies targeting the inflammatory component of the disease, there has been increased interest in identifying treatment strategies that instead target mechanisms such as remyelination/repair, neuroprotection, or rehabilitation. The potential role for such emerging therapies in the treatment of pediatric MS remains an important area of study. In this review, we discuss current evidence for MS therapies in children including the treatment of acute relapses, disease-modifying therapies, and symptomatic management. We will also discuss evidence for emerging therapies, including remyelinating and neuroprotective agents.


Assuntos
Esclerose Múltipla/terapia , Fármacos Neuroprotetores/uso terapêutico , Adolescente , Feminino , Humanos , Masculino , Esclerose Múltipla/patologia , Fármacos Neuroprotetores/farmacologia , Resultado do Tratamento
17.
Continuum (Minneap Minn) ; 25(3): 815-844, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31162318

RESUMO

PURPOSE OF REVIEW: This article reviews the clinical features, diagnostic approach, treatment, and prognosis of central nervous system inflammatory diseases that mimic multiple sclerosis (MS), including those defined by recently discovered autoantibody biomarkers. RECENT FINDINGS: The discovery of autoantibody biomarkers of inflammatory demyelinating diseases of the central nervous system (aquaporin-4 IgG and myelin oligodendrocyte glycoprotein IgG) and the recognition that, despite some overlap, their clinical phenotypes are distinct from MS have revolutionized this field of neurology. These autoantibody biomarkers assist in diagnosis and have improved our understanding of the underlying disease pathogenesis. This has allowed targeted treatments to be translated into clinical trials, three of which are now under way in aquaporin-4 IgG-seropositive neuromyelitis optica (NMO) spectrum disorder. SUMMARY: Knowledge of the clinical attributes, MRI findings, CSF parameters, and accompanying autoantibody biomarkers can help neurologists distinguish MS from its inflammatory mimics. These antibody biomarkers provide critical diagnostic and prognostic information and guide treatment decisions. Better recognition of the clinical, radiologic, and laboratory features of other inflammatory MS mimics that lack autoantibody biomarkers has allowed us to diagnose these disorders faster and initiate disease-specific treatments more expeditiously.


Assuntos
Fatores Imunológicos/administração & dosagem , Mielite Transversa/diagnóstico por imagem , Mielite Transversa/terapia , Neuromielite Óptica/diagnóstico por imagem , Neuromielite Óptica/terapia , Doenças do Sistema Nervoso Central/líquido cefalorraquidiano , Doenças do Sistema Nervoso Central/diagnóstico por imagem , Doenças do Sistema Nervoso Central/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/líquido cefalorraquidiano , Esclerose Múltipla/diagnóstico por imagem , Esclerose Múltipla/terapia , Mielite Transversa/líquido cefalorraquidiano , Neuromielite Óptica/líquido cefalorraquidiano , Troca Plasmática/métodos , Rituximab/administração & dosagem
18.
Pract Neurol ; 19(4): 342-349, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31243138

RESUMO

Long-term outcomes in multiple sclerosis (MS) are highly varied and treatment with disease-modifying therapies carries significant risks. Finding tissue biomarkers that can predict clinical outcomes would be valuable in individualising treatment decisions for people with MS. Several candidate biomarkers-reflecting inflammation, neurodegeneration and glial pathophysiology-show promise for predicting outcomes. However, many candidates still require validation in cohorts with long-term follow-up and evaluation for their independent contribution in predicting outcome when models are adjusted for known demographic, clinical and radiological predictors. Given the complexity of MS pathophysiology, heterogeneous panels comprising a combination of biomarkers that encompass the various aspects of neurodegenerative, glial and immune pathology seen in MS, may enhance future predictions of outcome.


Assuntos
Mediadores da Inflamação/sangue , Esclerose Múltipla/sangue , Esclerose Múltipla/diagnóstico , Biomarcadores/sangue , Humanos , Esclerose Múltipla/terapia , Prognóstico , Resultado do Tratamento
19.
Trials ; 20(1): 379, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234904

RESUMO

BACKGROUND: The relationship between gut dysbiosis and inflammatory diseases including multiple sclerosis (MS) is presently recognized as an important health issue. It has been established that some bacterial probiotic strains are effective in treating MS. This study will investigate the effect of yeast probiotic Saccharomyces boulardii (SB) supplements on mental health, quality of life, fatigue, pain, and indices of inflammation and oxidative stress in MS patients. METHODS/DESIGN: In this double-blind randomized controlled two-group parallel trial, 50 MS patients who meet the inclusion criteria will be recruited from outpatient settings. They will be randomly allocated to 4 months of daily placebo or the SB probiotic intervention. Blood samples will be taken from each participant at the baseline and after the intervention period to assess inflammation and oxidative stress. The primary endpoint will be the changes in their mental health evaluated by the 28-item General Health Questionnaire. The secondary endpoints include changes in: (1) quality of life, evaluated by the 36-item Short Form Questionnaire, (2) fatigue, evaluated by the Fatigue Severity Scale, (3) pain, evaluated by a visual analogue scale, and (4) serum levels of indices of inflammatory stress (high-sensitivity C-reactive protein) and oxidative stress (malondialdehyde and total antioxidant capacity). Moreover, any adverse events and side effects due to the intervention will be documented. DISCUSSION: There is a need to discover safe and practical methods for managing the symptoms of MS. This trial will gather evidence on the effects of a probiotic. TRIAL REGISTRATION: Iranian Clinical Trial Registry, IRCT20161022030424N1 . Registered on 9 April 2018.


Assuntos
Saúde Mental , Esclerose Múltipla/terapia , Estresse Oxidativo , Probióticos/administração & dosagem , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Saccharomyces boulardii , Adolescente , Adulto , Proteína C-Reativa/análise , Suplementos Nutricionais , Método Duplo-Cego , Fadiga/prevenção & controle , Humanos , Pessoa de Meia-Idade , Esclerose Múltipla/sangue , Esclerose Múltipla/psicologia , Dor/prevenção & controle , Estudos Prospectivos , Adulto Jovem
20.
Autoimmun Rev ; 18(8): 814-824, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31176875

RESUMO

The heritable genetic variation that explains phenotypic differences in a population fluctuates for different autoimmune disorders. Particularly in multiple sclerosis (MS) etiology, modest genetic and major environmental effects emerge. Increasingly recognized as a major environmentally shaped contributor to disease and treatment outcomes are gut microbiota. As discussed here, the observed impact of gut microbiome on MS pathophysiology, involves both quantitative and functional changes in composition, metabolism, gut permeability, homeostasis and modulation of the immune system. Although the first supplementary therapeutic interventions have been approached in general autoimmune disorders they are relatively cruder and a translation of knowledge from other pathologies is valuable but still required. Consequently initial therapeutic interventions with microbiota for autoimmune disorders could be correspondingly improved.


Assuntos
Microbioma Gastrointestinal , Esclerose Múltipla/microbiologia , Animais , Bactérias/classificação , Homeostase , Humanos , Melanoma/terapia , Esclerose Múltipla/genética , Esclerose Múltipla/imunologia , Esclerose Múltipla/terapia , Probióticos/uso terapêutico , RNA Ribossômico 16S
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