Secondary progressive MS

Sorensen TL, Sellebjerg F (2001) Distinct chemokine receptor and cytokine expression profile in secondary progressive MS. Neurology 57 1371-1376 Sorensen TL, Tani M, Jensen J, Pierce V, Lucchinetti C, Folcik VA, Qin S, Rottman J, Sellebjerg F, Strieter RM, Frederiksen JL, Ransohoff RM (1999) Expression of specific chemokines and chemokine receptors in the central nervous system of multiple sclerosis patients. J Clin Invest 103 807-815... 

European Study Group on Interferon Beta-lb in Secondary Progressive MS. Placebo-controlled multicentre... 

Patten SB, Metz LMSPECTRIMS Study Group. Interferon betala and depression in secondary progressive MS data from the SPECTRIMS Trial. Neurology 2002 59(5) 744-6. 

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). 

Cytokines themselves may also be used for MS therapy. IFN-p has been in clinical use as an immunomodulatory drug for the d eatment of MS for more than 10 years. Adminisda-don of IFN-p decreases the relapse rates and new MRI lesions in padents with relapsing/remitdng MS (The IFN-p Muldple Sclerosis Study Group, 1993) or delay cUsease progression in padents with secondary progressive MS (lacobs et al., 1996 ... 

European Study Group on Interferon Beta-lb in Secondary Progressive MS. Placebo-controlled multicentre randomised trial of interferon beta-lb in treatment of secondary progressive multiple sclerosis. Lancet 1998 352(9139) 1491-7. 

Kappos L, Weinshenker B, Pozzilli C, Thompson AJ, Dahike F, Beckmann K, Polman C, McFarland H, and for the European and North American Interferon beta-lb in Secondary Progressive Multiple Sclerosis Trial Steering Committees and Independent Advisory Boards. Interferon beta-1 b in secondary progressive MS A combined analysis of the two trials. Neurology 63 1779-1787, 2004. 

The only treatments approved for secondary progressive MS are mitoxantrone and interferon-/ - b. 

Kappos L, Rolman C, Pozzilh C, et al. Final analysis of the Emopean multicenter trial on IFN/ -lbin secondary-progressive MS. Nemology 2001 57 1969-1975. 

Secondary Rrogressing Efficacy Chnical Trial of Recombinant Interferon-/ -la in MS (SPECTRIMS) Study Group. Randomized controlled trial of interferon-/ -la in secondary progressive MS Chnical results. Neurology 2001 56 1496—1504. 

Cohen J, Cutter G, Eischer J, et al. Benefit of interferon-/ -la on MSEC progression in secondary progressive MS. Nemology 2002 59 679-687. 

Paolillo A, Coles AJ, Molyneux PD, et al. Quantitative MRl in patients with secondary progressive MS treated with monoclonal antibody Cam-path IH. Neurology 1999 53 751-757. 

For relapsing-remitting attacks and for secondary progressive MS, the alkylating agent cyclophosphamide and the anthracenedionene-derivative mitoxantrone (Nova-trone) are currently used in patients refractory to other immunomodulators. These agents, used primarily for... 

IFN, interferon IM, intramuscularly RRMS, relapsing-remitting MS SC, subcutaneously SPMS, secondary progressive MS IV, intravenously. Gd, gadolinium, used in Gd-enhanced MRI to assess number and size of inflammatory brain lesions EDSS, Expanded Disability Status Scale, a neurologic assessment scale for MS pathology MMP, matrix... 

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