Safety and efficacy of autologous hematopoietic stem-cell transplantation following natalizumab discontinuation in aggressive multiple sclerosis.

BACKGROUND AND PURPOSE: Natalizumab (NTZ) is a highly effective treatment for relapsing-remitting multiple sclerosis (MS), but its withdrawal is often followed by disease reactivation or rebound, even if other disease-modifying treatments (DMTs) are administered. In this study, for the first time, the safety and efficacy of autologous hematopoietic stem-cell transplantation (aHSCT) performed following NTZ discontinuation were retrospectively compared with conventional DMTs. METHODS: Patients with relapsing-remitting MS treated with NTZ who discontinued the drug after at least six administrations and with at least 6 months of follow-up were included. Patients underwent aHSCT after a minimum of 6 months following NTZ withdrawal, receiving meanwhile cyclophosphamide or corticosteroids, or other DMTs approved for MS (control group) after an adequate wash-out period. Both hematological and neurological follow-up were assessed according to standard policies. RESULTS: A total of 52 patients were included, 11 who received aHSCT and 41 who received DMTs. Baseline clinical and demographic characteristics were similar between the two groups. No fatality or life-threatening complications, including progressive multifocal leukoencephalopathy, were observed. At 3 years following NTZ discontinuation, no evidence of disease activity was reported in 54.5% of the patients in the aHSCT group compared with 11.5% of those in the DMT group (P = 0.0212). Disease reactivation in the patients with aHSCT was observed only during wash-out/bridging therapy and 100% of the cases were free from disease activity after aHSCT. CONCLUSIONS: These data suggest that an aggressive therapy should be established after NTZ with the shortest possible wash-out period. aHSCT after 6 months from NTZ withdrawal appears to be safe.

Egg yolk fatty acid profile of avian species--influence on human nutrition.

Lipids are an important nutritional component of the avian egg. A review of the literature was completed to determine the fatty acid compositions in egg yolk from some avian species. Additionally, the nutritional influence of lipid and lipoprotein content on the plasma of male participants during 30-day feeding was discussed. The ostrich eggs had the highest unsaturated fatty acid and the lowest cholesterol content in relation to other avian species. Ostrich had a higher proportion of 18:3n-3 (p < 0.01) compared with other species. Chicken yolk numerically contained much higher levels of 22:6n-3 than those found in turkeys, quails and geese, but the amount of 22:6n-3 in ostrich egg was lower by comparison with other species (p < 0.01). After the storage of eggs at the room temperature, there was a notable loss of vitamin E (vitE) in the yolks of all species and this decrease was marginal (p < 0.01) in ostrich compared with other species. There were significant (p < 0.05) increases in plasma low-density lipoprotein (LDL) level in all male subjects. Plasma high-density lipoprotein (HDL) level decreased (p < 0.05) only in men who were fed chicken or ostrich eggs daily. Consumption of different species' eggs had no influence on the total male plasma cholesterol and triglyceride levels. LDL-C:HDL-C ratio increased (p < 0.05) after goose and turkey egg consumption. Consumption of one egg/month by healthy human subjects had no effect on serum total cholesterol and triglyceride. The LDL-C:HDL-C ratio (which is a strong predictor of coronary heart disease risk) increased, although non-significantly, by consuming chicken, quail and ostrich eggs.

The influence of the entry region on the instability of a coflowing injector device.

The occurrence of dripping and jetting regimes in a microfluidic coflowing injector device has been related recently to the spatio-temporal stability properties of the developed velocity profile. Dripping corresponds to an absolutely unstable flow while jetting is observed when the Rayleigh-Plateau instability of the core-annular jet is convective. In this work we take into account the effect of the entry region on the dripping to jetting transition by carrying out a global stability analysis of the steady two-phase base flow. We show that, depending on the flow parameters, the entry region can affect significantly the transition between the two regimes.

Studies of cell-mediated immunity in patients with Crohn's disease.

A defect of cell-mediated immunity was reported in patients with Crohn's disease. In attempting to evaluate the possible role of serum factor(s) in the pathogenesis of this defect we studied the effect of sera from patients with Crohn's disease on normal lymphocyte E rosette formation and in vitro PHA responsiveness. An impairment of E rosette formation and PHA response was detected when normal donor lymphocytes were incubated with patients' sera. We concluded that the defect of cell-mediated immunity in Crohn's disease may be due to the presence of serum inhibitory factor(s) and of nutrient serum deficiencies. This defect is not correlated with clinical parameters and the duration of the disease; it is not affected by surgical resection.