Multiple sclerosis clinical presentation

Different people respond differently to any given drug, even if they present with essentially identical disease symptoms. Optimum dose requirements, for example, can vary significantly. Furthermore, not all patients respond positively to a specific drug (e.g. IFN-P is of clinical benefit to only one in three multiple sclerosis patients see Chapter 8). The range and severity of adverse effects induced by a drug can also vary significantly within a patient population base. 

This point of view overlooks the fact that every well and normal individual is potentially an ill individual, and the roots of disease may be present in his make-up years before there is any overt disease. A dozen young men used as normal controls may each have metabolic peculiarities that point toward a different metabolic derangement gout, multiple sclerosis, diabetes, anemia, atherosclerosis, hypertension, nephrosis, hypothyroidism, rheumatoid arthritis, rheumatic heart disease, liver cirrhosis, and myasthenia gravis, for example, and yet at the time of their use as controls these young men may show no symptoms of the disease which is to appear later in life. It seems far from safe to assume that because an individual on clinical examination seems well, all of his blood values, for example, are normal and meaningless so far as disease susceptibilities are concerned. 

AIDS, hepatitis, blood disorders, multiple sclerosis and others. At present, another 300 potential therapeutics are in various human clinical trials, although it is impossible to estimate how many of those will actually reach the marketplace. Combinatorial chemistry promises to revolutionize the rate of new-drug development by accelerating initial lead generation. Already, in its approximately 8-year corporate history, combinatorial chemistry has produced about 350 leads in various stages of preclinical development. 

Here again, we have a 44-year-old Caucasian male who presented himself to our clinic on May 16, 1988. At that time he required the assistance of his wife and our office staff just to get into the office for studies. Past history revealed that he was diagnosed with multiple sclerosis in 1975. At that time his presenting symptoms were ... 

The main clinical significance of cerebrospinal fluid (CSF) protein eleetrophoresis is for the detection of the oligoclonal bands, which are present in multiple sclerosis in the gamma region. Similar to urine, proteins in the CSF are present fluid in very low concentration (100 times less than serum). For the majority of the samples, a 10- to 20-fold concentration is preferred before analysis by CE (by the same membrane concentrators used for urine). CSF protein separation can be accomplished in less than 10 min with CE versus 2 h for AG with the ability to detect oligoclonal banding by this technique [36]. 

COX-2 is constitutively present in the brain, mainly in neurons, and has been shown to play a key role in brain-specific inflammatory episodes linked to the progression of Alzheimer s disease (AD). Epidemiological and clinical studies have observed the influence of NSAID on the evolution of AD, with recent studies showing an inverse correlation between the use of NSAID and the risk of developing AD (Bazan et al., 2002). In the central nervous system, prostanoid levels are normally very low, but they can substantially increase in a variety of pathological conditions such as trauma, ischemia, HIV infection and multiple sclerosis. COX-1 and COX-2 are expressed in the spinal cord. It has been suggested that the antihyperalgesic mechanism of COX-2 inhibitors lies with the modulation of constitutive COX-2 present at the spinal level (S vensson and Yaksh, 2002). 

---