Cytokine Profiling in Cerebrospinal Fluid of Patients with Newly Diagnosed Relapsing-Remitting Multiple Sclerosis (RRMS): Associations between Inflammatory Biomarkers and Disease Activity.

Cytokines regulate immune responses and are crucial to MS pathogenesis. This study evaluated pro-inflammatory and anti-inflammatory cytokine concentrations in the CSF of de novo diagnosed RRMS patients compared to healthy controls. We assessed cytokine levels in the CSF of 118 de novo diagnosed RRMS patients and 112 controls, analyzing relationships with time from symptom onset to diagnosis, MRI lesions, and serum vitamin D levels. Elevated levels of IL-2, IL-4, IL-6, IL-13, FGF-basic, and GM-CSF, and lower levels of IL-1ß, IL-1RA, IL-5, IL-7, IL-9, IL-10, IL-12p70, IL-15, G-CSF, PDGF-bb, and VEGF were observed in RRMS patients compared to controls. IL-2, IL-4, IL-12p70, PDGF, G-CSF, GM-CSF, and FGF-basic levels increased over time, while IL-10 decreased. IL-1ß, IL-1RA, IL-6, TNF-α, and PDGF-bb levels negatively correlated with serum vitamin D. TNF-α levels positively correlated with post-contrast-enhancing brain lesions. IL-15 levels negatively correlated with T2 and Gd(+) lesions in C-spine MRI, while TNF-α, PDGF-bb, and FGF-basic correlated positively with T2 lesions in C-spine MRI. IL-6 levels positively correlated with post-contrast-enhancing lesions in Th-spine MRI. Distinct cytokine profiles in the CSF of de novo diagnosed MS patients provide insights into MS pathogenesis and guide immunomodulatory therapy strategies.

BASAL CELL CARCINOMA AND SQUAMOUS CELL CARCINOMA IN A PATIENT TREATED WITH FINGOLIMOD FOR MULTIPLE SCLEROSIS - A CASE REPORT AND LITERATURE REVIEW.

OBJECTIVE: The aim: Multiple sclerosis (MS) is a disease of the central nervous system (CNS) characterized by inflammation and demyelination, which leads to chronic progressive disability. Fingolimod is the first registered oral disease-modifying drug (DMD) approved for the treatment of highly active relapsing-remitting multiple sclerosis (RRMS). Fingolimod statistically significantly reduced the number of relapses, clinical and radiological disease activity and disability progression. However, fingolimod can be associated with an increased risk of cancer. This study is aimed to underline how important is regular specialist follow-up during fingolimod therapy. PATIENTS AND METHODS: Materials and methods: The literature review was conducted using the key words: "fingolimod", "multiple sclerosis", "fingolimod and cancer", "relapsing-remitting multiple sclerosis", "fingolimod adverse effects", "basal cell carcinoma fingolimod", "squamous cell carcinoma fingolimod". The study is based on the case report of a 67-year-old male patient with metachronous skin cancer treated with fingolimod. The drug had an influence on the inhibition of clinical and radiological activity of the disease. Despite the control of the underlying disease, skin cancers occurred during treatment. Basal cell carcinoma and squamous cell carcinoma were diagnosed at an early stage when complete resection was possible and negative (R0) margin resection was achieved. CONCLUSION: Conclusions: Dermatological examination should be performed at the beginning and during treatment with fingolimod. Patients need to be informed about the risk of malignancy. Patient education are crucial during treatment, which allows achieving a good therapeutic effect, thus minimizing the risk of malignancy and enabling its early detection and cure.

THE MOST COMMON UROLOGICAL CONDITIONS IN POSTMENOPAUSAL WOMEN.

OBJECTIVE: The aim: To analyze the available literature on the most common daily urological problems in menopausal women and to evaluate the use of hormone replacement therapy for troublesome urological symptoms. PATIENTS AND METHODS: Materials and methods: Analysis of publications from PubMed databases on the most common disorders during menopause was performed and the most common urog¬ynaecological problems in postmenopausal women were selected according to literature data. Different available methods of treatment of these disorders were compared. Conclusions: During menopause, women struggle with many unpleasant symptoms from the genitourinary system. For most women, this is a very embarrassing topic and, although bothersome, underestimated. The urinary tract infections, urinary incontinence or kidney stones can lead to serious complications, if left untreated. We should strive to make women more aware of possible methods of prevention and treatment of the menopausal symptoms in the context of urological disorders.

MULTIPLE SCLEROSIS - RISK FACTORS.

Multiple sclerosis (MS) is a chronic autoimmunological condition of the central nervous system (CNS) affecting mainly young adult individuals. The prevalence ranges approximately between 50 and 300 per 100000 individuals. It is characterized by an inflammatory process, demyelination and axonal loss. Immunological mechanisms resulting in the damage to the myelin sheath effecting then in impaired nerve impulse conduction have the key role in MS pathogenesis. The role of inflammatory factors has also been proved. However, it has not been explicitly shown whether such an inflammatory process is the triggering factor or secondary to a yet unknown infectious factor or a degenerative process of the CNS. Therefore, recognition of the epigenetic risk factors, such as: geographical latitude, vitamin D level, hygiene hypothesis, Epstein-Barr virus (EBV) infection and others may contribute to better understanding of the mechanism underlying multiple sclerosis. Additionally, they may provide guidelines for more efficient therapies and better prevention of the disease. Aim of this review is to present most current data on multiple sclerosis risk factors, considering those less known.