Primary progressive MS

E Role in therapy Betaseron is useful for reducing symptomatic exacerbation in multiple sclerosis (MS) patients with relapsing-remitting disease. The drug should be considered in patients with ch-nically deflnite or laboratory-supported definite disease. It is not indicated in those patients with primary progressive MS. Interferon beta-la (Avonex) has also demonstrated activity in MS patients. 

Doskoch D (2005) Primary progressive MS The benefits of negative trials. MS Exchange 9(3) 1-3. 

Bramanti P, Sessa E, Rifici C, D Aleo G, Floridia D, Di Bella P, Lubhn F. Enhanced spasticity in primary progressive MS patients treated with interferon beta-lb. Neurology 1998 51(6) 1720-3. 

In contrast to T cells, in different immunopathologies, the brain provides a fostering envkonment to B cells. Primary central nervous system (CNS) lymphomas are usually of B cell origin. The cerebrospinal fluid (CSF) of patients with chronic infections and autoimmune diseases of the CNS typically contains remarkably stable oligoclonal Ig bands. In the CNS of multiple sclerosis patients, clonally expanded B cells and plasma cells persist. Ectopic B cell follicles develop in the meninges of patients with secondary progressive MS, and B cell differentiation may be recapitulated in the CNS of MS patients (Krumbholz et al., 2006) (see Chapters 18-24). 

NMR spectroscopy of CSF has been used in a number of studies of multiple sclerosis (MS). In one study a total of 19 patients with multiple sclerosis, 12 patients with degenerative dementia and 17 controls were examined. They showed increased lactate and fructose levels in multiple sclerosis patients but no correlations between NMR spectra and the differentiation of relapsing, remitting and primary, progressive multiple sclerosis. Another study examined 53 cases of multiple sclerosis plus others with a variety of neurological disorders and showed that the observed level of lactate correlated with the... 

The first enzyme titration, i.e., the recording of progress curves at a constant substrate concentration and different protease concentrations, should yield the increase of the initial rate with increasing protease concentration. The cleavage products should be analyzed (for example, by LC/MS) to identify the primary cleavage site and should be compared with the expected cleavage position. 

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