Multiple sclerosis, precipitation

In the past there was reason to think that glucocorticoids might precipitate multiple sclerosis. However, this has not been confirmed, and there is evidence that a special glucocorticoid regimen can actually be capable of retarding deterioration in multiple sclerosis (SEDA-18, 387). 

Immunogenicity may be affected by the route of administration. Extravascular injection has been shown to stimulate antibody formation more than IV application, but this is most likely due to the increased immunogenicity of protein aggregates and precipitates formed at the injection site [44]. A recent study investigated the effect of the route of administration of INF-P preparations on inducing anti-INF-P antibodies in multiple sclerosis patients. The results indicate that IM injections appear less immunogenic compared to SC injections, resulting in both a lower serum level of anti-INF-P antibodies as well as a delay in their appearance [45]. 

Nervous system Mandibular nerve block with articaine has been associated with possible precipitation of multiple sclerosis [44 ]. 

An LC-MS-MS method measures directly the concentration of amantadine (1-adamantylamine, used for treatment of influenza, hepatitis C, parkinsonism, and multiple sclerosis) without protein precipitation, centrifugation, extraction, and derivatization steps. Only 50 p,l sample is needed. Internal standard is l-(l-adamantyl)pyridinium bromide. The serum sample is diluted by water in a 96-well plate. The chromatographic separation is performed using an eluent of isocratic water/acetonitrile (60/40, v/v) with 5 g/1 formic acid on a C8 column. Run time is 3 min. Electrospray atmospheric pressure ionization, positive ion, and selective reaction monitoring mode were used. Detection hmit 20 mg/1, linearity 20-5000 mg/1, intraassay/interassay coefficient of variation <6%/<8% recovery 99-101%. 

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