Sarcoidosis, systemic inflammatory disease, may involve the nervous system and muscles.Typical sy... more Sarcoidosis, systemic inflammatory disease, may involve the nervous system and muscles.Typical symptoms and signs of neurological deficit suggest considering sarcoidosis in differential diagnostics of their background. The authors describe two cases, in which involvement of the nervous system or muscles contributed to the direction of further diagnostics and approaching the diagnosis of sarcoidosis.
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego, 2006
Multiple sclerosis (MS) is believed to be a T cell-mediated autoimmune disease. One of the partic... more Multiple sclerosis (MS) is believed to be a T cell-mediated autoimmune disease. One of the particularly important signals is mediated by CD40L, a costimulatory molecule which appears on activated T cell. The aim of this study was examination of the CD40L expression on freshly obtained lymphocytes T CD4+ which were ex vivo stimulated with monoclonal antibody anti CD3+rIL-2 in patients with relapsing-remitting and secondary progressive multiple sclerosis. 12 relapsing-remitting (RR) and 16 secondary progressive (SP) MS patients with long-lasting clinical remission and 24 healthy subjects were included in the study. The proportion of unstimulated and ex vivo stimulated with anti CD3+rIL-2 TCD4+ cells from peripheral blood co-expressing CD40L was studied by dual immunofluorescence method. The proportion of unstimulated and stimulated T CD4+CD40L+ cells did not differ significantly between RRMS and controls. The percentage of unstimulated TCD4+CD40L+ cells from SP patients exhibited sign...
ALCAM and CD6 may play an important role in the pathogenesis of multiple sclerosis (MS), since th... more ALCAM and CD6 may play an important role in the pathogenesis of multiple sclerosis (MS), since they are involved in the transmigration of leukocytes across the blood-brain barrier. In this study, we confirmed our previous findings about the association of the ALCAM gene with risk, development and progression of MS. Additionally, we showed that in the case of the CD6 gene (encoding receptor of ALCAM) not only polymorphisms but also mRNA expression level are associated with MS. Our analysis revealed that the risk of the disease for AA individuals in rs12360861 was almost 3.0-fold lower in comparison to GG individuals (OR=0.34; CI95%=0.12; 0.81). Moreover, we observed lower expression of CD6 mRNA in patients than in healthy individuals (T(2)2,74=6.678; p=0.002).
CD40-CD40L interaction is necessary for the activation of both humoral and cellular immune respon... more CD40-CD40L interaction is necessary for the activation of both humoral and cellular immune response and has been suggested to play a role in the pathogenesis of multiple sclerosis (MS). Therefore, we analyzed the combined influence of the CD40 and CD40L variants on MS susceptibility and progression on well-defined Polish population. Our investigation revealed that CT individuals in rs1883832 locus of CD40 possessed almost 1.5-fold higher risk for MS than CC individuals (OR = 1.44; 95%CI = 1.03-2.1; p = 0.032), while this risk for TT individuals was almost 2.5-fold higher (OR = 2.36; 95%CI = 1.19-4.78; p = 0.014). Moreover, for the first time, we observed the association of CD40 gene with MS development and progression. We observed that for the rs1883832CC individuals the age at diagnosis was on average 2 years lower than for the rs1883832CT and rs1883832TT individuals (CI95% = -3.69-(-0.29); p = 0.023). Additionally, we detected that individuals with TT and CT genotypes showed lower risk of developing secondary progressive course in comparison to those with CC genotype. For rs1883832TT individuals this risk was 4-fold lower (HR = 0.24; CI95% = 0.10-0.53; p = 0.00062). Despite the fact that CD40-CD40L pathway plays a key role in development of autoimmune diseases, we were not able to detect gene-gene interactions between CD40 and CD40L polymorphisms associated with multiple sclerosis.
The influence of cerebral atrophy and leukoaraiosis (LA) on the degree and profile of cognitive i... more The influence of cerebral atrophy and leukoaraiosis (LA) on the degree and profile of cognitive impairment remains unclear. The aim of the study was to assess neuropsychological features of cognitive performance and parameters of event-related potentials (ERP) in subjects with generalised cerebral atrophy and LA. Department of Neurology, University of Medicine. Forty-two patients with LA and/or cerebral atrophy and twenty controls. Neuropsychological testing (NT) included Mini Mental State Examination (MMSE), Auditory Verbal Learning Test (AVLT) and Trail Making Test (TMT). Auditory ERPs were performed and parameters of the N2 and P3 components were compared in the patients and controls. Relationships were analysed between radiological indices of atrophy and LA, and NT and ERP results. Results of NT suggested generalised mild cognitive impairment in all the patients. P3 and N2 latencies were longer in the patients than in controls, especially in the LA subgroup. Correlations were found for indices of atrophy, AVLT and ERP parameters. There was a predominant influence of age upon ERP parameters and radiological indices. Cerebral atrophy and LA result in deficits in memory and attention. NT and ERP may be used as complementary methods in the assessment of cognitive impairment in patients with cerebral atrophy and LA.
The prevalence of autoantibodies in multiple sclerosis (MS) patients and their clinical associati... more The prevalence of autoantibodies in multiple sclerosis (MS) patients and their clinical associations differ between various studies. This study investigated antiphospholipid and antinuclear antibodies in 85 patients with multiple sclerosis (MS) and clinically isolated syndrome (CIS) with regard to their association with demographic features, MS specific clinical features and symptoms of connective tissue diseases. Autoantibodies tested included antinuclear antibodies (ANA) with their specificities and anticardiolipin (aCL) and anti-beta-2-glycoprotein I (anti-β2GPI) antibodies. Antinuclear antibodies were more prevalent in MS patients than in controls (63.5% vs. 3.3%; p < 0.01) and in 19% of patients specific antinuclear antibodies were detected. Anti-β2GPI IgM antibodies were more frequent in MS patients than in the control group (20% vs. 3.3%; p < 0.05). The frequency of anticardiolipin antibodies did not differ between MS patients and controls. MS patients seropositive for ANA and extractable nuclear antigens (ENA) had significantly shorter disease duration than seronegative patients (p < 0.05) and a lower disability score (Expanded Disability Status Score; EDSS) (p < 0.05). Anti-β2GPI antibodies were more frequent in patients with secondary progressive MS (SP-MS) and specific ANA antibodies were more frequent in patients with clinically isolated syndrome (CIS) (p < 0.05). The presence of autoantibodies was not associated with the predominant site of neurological involvement or the clinical features of connective tissue diseases.
Twenty-two neuropsychiatric (NPSLE) and 13 systemic lupus erythematosus (SLE) patients with a nor... more Twenty-two neuropsychiatric (NPSLE) and 13 systemic lupus erythematosus (SLE) patients with a normal appearing brain on plain magnetic resonance (MR) as well as 20 age-matched healthy controls underwent MR spectroscopy (MRS), perfusion-weighted (PWI) and diffusion-tensor imaging (DTI). In MRS NAA/Cr, Cho/Cr and mI/Cr ratios were calculated from the posterior cingulate cortex and left parietal white matter. In PWI, values of cerebral blood volume (CBV) were assessed from 14 regions, including gray and white matter. In DTI fractional anisotropy (FA) values were obtained from 14 white matter tracts including projection, commissural and association fibers. All MR measurements were correlated with clinical data. SLE and NPSLE patients showed significantly (p < 0.05) lower NAA/Cr ratios within both evaluated regions and FA values within the cingulum, as well as a tendency to cortical hypoperfusion. Compared to SLE, NPSLE subjects revealed lower FA values within a wide range of association fibers and corpus callosum. Advanced MR techniques are capable of in vivo detection of complex microstructural brain damage in SLE and NPSLE subjects regarding neuronal loss, mild hypoperfusion and white matter disintegrity. MRS and DTI seem to show the highest usefulness in depicting early changes in normal appearing gray and white matter in SLE patients.
The aim of the study was to evaluate the stimulated production of interferon-gamma (IFNγ) by peri... more The aim of the study was to evaluate the stimulated production of interferon-gamma (IFNγ) by peripheral CD3+CD4+ T lymphocytes in patients with multiple sclerosis (MS) with regard to the degree of fatigue, and to investigate relationships between immunological parameters, level of depression and clinical variables. Forty MS patients (30 women, 10 men, aged 22-60 years): 20 fatigued and 20 non-fatigued were involved in the study. Fatigue was evaluated using the Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS), depression level - using Beck Depression Inventory (BDI). Production of IFNγ by stimulated peripheral blood CD3+CD4+ T lymphocytes, assessed using flow cytometry, was compared between MS patients with different levels of fatigue and controls. Correlations were searched out between immunological findings and BDI, age, duration and course of MS, relapse rate, disability (assessed in Expanded Disability Status Scale - EDSS) and its progression. Stimulated production of IFNγ by CD3+CD4+ T lymphocytes was higher in severely fatigued patients in comparison with non-fatigued ones and controls, tended to correlate with FSS and MFIS, and correlated with BDI. No relationships were found between immunological findings and disease-related variables. Stimulated production of IFNγ by peripheral CD3+CD4+ T lymphocytes is related to fatigue and depression in MS patients.
Migdałki podniebienne oraz migdałek gardłowy wchodzą w skład pierścienia chłonnego Waldeyera, sta... more Migdałki podniebienne oraz migdałek gardłowy wchodzą w skład pierścienia chłonnego Waldeyera, stanowiącego skupisko tkanki limfatycznej, położonej na granicy między ektodermalną a endodermalną częścią drogi oddechowej i pokarmowej. Na pierścień Waldeyera, który ...
Sarcoidosis, systemic inflammatory disease, may involve the nervous system and muscles.Typical sy... more Sarcoidosis, systemic inflammatory disease, may involve the nervous system and muscles.Typical symptoms and signs of neurological deficit suggest considering sarcoidosis in differential diagnostics of their background. The authors describe two cases, in which involvement of the nervous system or muscles contributed to the direction of further diagnostics and approaching the diagnosis of sarcoidosis.
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego, 2006
Multiple sclerosis (MS) is believed to be a T cell-mediated autoimmune disease. One of the partic... more Multiple sclerosis (MS) is believed to be a T cell-mediated autoimmune disease. One of the particularly important signals is mediated by CD40L, a costimulatory molecule which appears on activated T cell. The aim of this study was examination of the CD40L expression on freshly obtained lymphocytes T CD4+ which were ex vivo stimulated with monoclonal antibody anti CD3+rIL-2 in patients with relapsing-remitting and secondary progressive multiple sclerosis. 12 relapsing-remitting (RR) and 16 secondary progressive (SP) MS patients with long-lasting clinical remission and 24 healthy subjects were included in the study. The proportion of unstimulated and ex vivo stimulated with anti CD3+rIL-2 TCD4+ cells from peripheral blood co-expressing CD40L was studied by dual immunofluorescence method. The proportion of unstimulated and stimulated T CD4+CD40L+ cells did not differ significantly between RRMS and controls. The percentage of unstimulated TCD4+CD40L+ cells from SP patients exhibited sign...
ALCAM and CD6 may play an important role in the pathogenesis of multiple sclerosis (MS), since th... more ALCAM and CD6 may play an important role in the pathogenesis of multiple sclerosis (MS), since they are involved in the transmigration of leukocytes across the blood-brain barrier. In this study, we confirmed our previous findings about the association of the ALCAM gene with risk, development and progression of MS. Additionally, we showed that in the case of the CD6 gene (encoding receptor of ALCAM) not only polymorphisms but also mRNA expression level are associated with MS. Our analysis revealed that the risk of the disease for AA individuals in rs12360861 was almost 3.0-fold lower in comparison to GG individuals (OR=0.34; CI95%=0.12; 0.81). Moreover, we observed lower expression of CD6 mRNA in patients than in healthy individuals (T(2)2,74=6.678; p=0.002).
CD40-CD40L interaction is necessary for the activation of both humoral and cellular immune respon... more CD40-CD40L interaction is necessary for the activation of both humoral and cellular immune response and has been suggested to play a role in the pathogenesis of multiple sclerosis (MS). Therefore, we analyzed the combined influence of the CD40 and CD40L variants on MS susceptibility and progression on well-defined Polish population. Our investigation revealed that CT individuals in rs1883832 locus of CD40 possessed almost 1.5-fold higher risk for MS than CC individuals (OR = 1.44; 95%CI = 1.03-2.1; p = 0.032), while this risk for TT individuals was almost 2.5-fold higher (OR = 2.36; 95%CI = 1.19-4.78; p = 0.014). Moreover, for the first time, we observed the association of CD40 gene with MS development and progression. We observed that for the rs1883832CC individuals the age at diagnosis was on average 2 years lower than for the rs1883832CT and rs1883832TT individuals (CI95% = -3.69-(-0.29); p = 0.023). Additionally, we detected that individuals with TT and CT genotypes showed lower risk of developing secondary progressive course in comparison to those with CC genotype. For rs1883832TT individuals this risk was 4-fold lower (HR = 0.24; CI95% = 0.10-0.53; p = 0.00062). Despite the fact that CD40-CD40L pathway plays a key role in development of autoimmune diseases, we were not able to detect gene-gene interactions between CD40 and CD40L polymorphisms associated with multiple sclerosis.
The influence of cerebral atrophy and leukoaraiosis (LA) on the degree and profile of cognitive i... more The influence of cerebral atrophy and leukoaraiosis (LA) on the degree and profile of cognitive impairment remains unclear. The aim of the study was to assess neuropsychological features of cognitive performance and parameters of event-related potentials (ERP) in subjects with generalised cerebral atrophy and LA. Department of Neurology, University of Medicine. Forty-two patients with LA and/or cerebral atrophy and twenty controls. Neuropsychological testing (NT) included Mini Mental State Examination (MMSE), Auditory Verbal Learning Test (AVLT) and Trail Making Test (TMT). Auditory ERPs were performed and parameters of the N2 and P3 components were compared in the patients and controls. Relationships were analysed between radiological indices of atrophy and LA, and NT and ERP results. Results of NT suggested generalised mild cognitive impairment in all the patients. P3 and N2 latencies were longer in the patients than in controls, especially in the LA subgroup. Correlations were found for indices of atrophy, AVLT and ERP parameters. There was a predominant influence of age upon ERP parameters and radiological indices. Cerebral atrophy and LA result in deficits in memory and attention. NT and ERP may be used as complementary methods in the assessment of cognitive impairment in patients with cerebral atrophy and LA.
The prevalence of autoantibodies in multiple sclerosis (MS) patients and their clinical associati... more The prevalence of autoantibodies in multiple sclerosis (MS) patients and their clinical associations differ between various studies. This study investigated antiphospholipid and antinuclear antibodies in 85 patients with multiple sclerosis (MS) and clinically isolated syndrome (CIS) with regard to their association with demographic features, MS specific clinical features and symptoms of connective tissue diseases. Autoantibodies tested included antinuclear antibodies (ANA) with their specificities and anticardiolipin (aCL) and anti-beta-2-glycoprotein I (anti-β2GPI) antibodies. Antinuclear antibodies were more prevalent in MS patients than in controls (63.5% vs. 3.3%; p < 0.01) and in 19% of patients specific antinuclear antibodies were detected. Anti-β2GPI IgM antibodies were more frequent in MS patients than in the control group (20% vs. 3.3%; p < 0.05). The frequency of anticardiolipin antibodies did not differ between MS patients and controls. MS patients seropositive for ANA and extractable nuclear antigens (ENA) had significantly shorter disease duration than seronegative patients (p < 0.05) and a lower disability score (Expanded Disability Status Score; EDSS) (p < 0.05). Anti-β2GPI antibodies were more frequent in patients with secondary progressive MS (SP-MS) and specific ANA antibodies were more frequent in patients with clinically isolated syndrome (CIS) (p < 0.05). The presence of autoantibodies was not associated with the predominant site of neurological involvement or the clinical features of connective tissue diseases.
Twenty-two neuropsychiatric (NPSLE) and 13 systemic lupus erythematosus (SLE) patients with a nor... more Twenty-two neuropsychiatric (NPSLE) and 13 systemic lupus erythematosus (SLE) patients with a normal appearing brain on plain magnetic resonance (MR) as well as 20 age-matched healthy controls underwent MR spectroscopy (MRS), perfusion-weighted (PWI) and diffusion-tensor imaging (DTI). In MRS NAA/Cr, Cho/Cr and mI/Cr ratios were calculated from the posterior cingulate cortex and left parietal white matter. In PWI, values of cerebral blood volume (CBV) were assessed from 14 regions, including gray and white matter. In DTI fractional anisotropy (FA) values were obtained from 14 white matter tracts including projection, commissural and association fibers. All MR measurements were correlated with clinical data. SLE and NPSLE patients showed significantly (p < 0.05) lower NAA/Cr ratios within both evaluated regions and FA values within the cingulum, as well as a tendency to cortical hypoperfusion. Compared to SLE, NPSLE subjects revealed lower FA values within a wide range of association fibers and corpus callosum. Advanced MR techniques are capable of in vivo detection of complex microstructural brain damage in SLE and NPSLE subjects regarding neuronal loss, mild hypoperfusion and white matter disintegrity. MRS and DTI seem to show the highest usefulness in depicting early changes in normal appearing gray and white matter in SLE patients.
The aim of the study was to evaluate the stimulated production of interferon-gamma (IFNγ) by peri... more The aim of the study was to evaluate the stimulated production of interferon-gamma (IFNγ) by peripheral CD3+CD4+ T lymphocytes in patients with multiple sclerosis (MS) with regard to the degree of fatigue, and to investigate relationships between immunological parameters, level of depression and clinical variables. Forty MS patients (30 women, 10 men, aged 22-60 years): 20 fatigued and 20 non-fatigued were involved in the study. Fatigue was evaluated using the Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS), depression level - using Beck Depression Inventory (BDI). Production of IFNγ by stimulated peripheral blood CD3+CD4+ T lymphocytes, assessed using flow cytometry, was compared between MS patients with different levels of fatigue and controls. Correlations were searched out between immunological findings and BDI, age, duration and course of MS, relapse rate, disability (assessed in Expanded Disability Status Scale - EDSS) and its progression. Stimulated production of IFNγ by CD3+CD4+ T lymphocytes was higher in severely fatigued patients in comparison with non-fatigued ones and controls, tended to correlate with FSS and MFIS, and correlated with BDI. No relationships were found between immunological findings and disease-related variables. Stimulated production of IFNγ by peripheral CD3+CD4+ T lymphocytes is related to fatigue and depression in MS patients.
Migdałki podniebienne oraz migdałek gardłowy wchodzą w skład pierścienia chłonnego Waldeyera, sta... more Migdałki podniebienne oraz migdałek gardłowy wchodzą w skład pierścienia chłonnego Waldeyera, stanowiącego skupisko tkanki limfatycznej, położonej na granicy między ektodermalną a endodermalną częścią drogi oddechowej i pokarmowej. Na pierścień Waldeyera, który ...
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