Autonomic nervous system (ANS) disorders are common in multiple sclerosis (MS). Previous studies showed differences in insulin resistance (IR) and lipoprotein levels in MS subjects compared to controls. Lipolysis caused by increased sympathetic activity could be one of the possible linking mechanisms leading to dyslipidemia in MS. Our study aimed to evaluate ANS activity in the context of glucose and lipid metabolism in people with MS. We prospectively measured short-term heart rate variability (HRV), fasting lipoprotein concentrations, and calculated IR indices based on plasma glucose and insulin levels during oral glucose tolerance test (oGTT) in 32 patients with MS and 29 healthy controls matched for age, sex and body mass index in our study. There was no significant difference in HRV parameters and lipoprotein levels between MS and controls. A significant positive correlation was found between low/high-frequency power ratio (LF/HF) and triglycerides (r=0.413, p=0.021) in MS subjects but not in controls. A significantly lower whole-body insulin sensitivity index (ISIMat) was found in patients with MS compared to the control group (7.3±3.7 vs. 9.8±5.6, p=0.041). No significant correlations were found between LF/HF and IR parameters. In MS subjects, the positive correlation of LF/HF with triglycerides could reflect the effects of sympathetic activity on lipolysis. Positive correlations of sympathetic activity with increased lipoprotein levels could rather reflect processes associated with immune system activation/inflammation, than processes involved in glucose homeostasis maintenance.
The aim of the study was to compare the bone mineral density (BMD) and body composition between ambulatory male MS patients and control subjects and to evaluate the relationships among body composition, motor disability, glucocorticoids (GC) use, and bone health. Body composition and BMD were measured by dual-energy X-ray absorptiometry in 104 ambulatory men with MS (mean age: 45.2 years) chronically treated with low-dose GC and in 54 healthy age-matched men. Compared to age-matched controls, MS patients had a significantly lower total body bone mineral content (TBBMC) and BMD at all measured sites except for the radius. Sixty five male MS patients (62.5 %) met the criteria for osteopenia and twenty six of them (25 %) for osteoporosis. The multivariate analysis showed a consistent dependence of bone measures (except whole body BMD) on BMI. The total leg lean mass % was as an independent predictor of TBBMC. The Expanded Disability Status Scale (EDSS), cumulative GC dose and age were independent determinants for BMD of the proximal femur. We conclude that decreasing mobility in male MS patients is associated with an increasing degree of osteoporosis and muscle wasting in the lower extremities. The chronic low-dose GC treatment further contributes to bone loss., V. Zikán ... [et al.]., and Obsahuje seznam literatury
Over a century ago, hyperplasia and hypertrophy of astrocytes was noted as a histopathological hallmark of multiple sclerosis and was hypothesized to play an important role in the development and course of this disease. However until today, the factual contribution of astrocytes to multiple sclerosis is elusive. Astrocytes may play an active role during degeneration and demyelination by controlling local inflammation in the CNS, provoking damage of oligodendrocytes and axons, and glial scarring but might also be beneficial by creating a permissive environment for remyelination and oligodendrocyte precursor migration, proliferation, and differentiation. Recent findings from our lab suggest that brain lipid binding protein (FABP7) is implicated in the course of multiple sclerosis and the regulation of astrocyte function. The relevance of our findings and data from other groups are highlighted and discussed in this paper in the context of myelin repair., M. Kipp ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy
Coenzyme Q10 (CoQ10), a lipophilic substituted benzoquinone, is present in animal and plant cells. It is endogenously synthetized in every cell and involved in a variety of cellular processes. CoQ10 is an obligatory component of the respiratory chain in inner mitochondrial membrane. In addition, the presence of CoQ10 in all cellular membranes and in blood. It is the only endogenous lipid antioxidant. Moreover, it is an essential factor for uncoupling protein and controls the permeability transition pore in mitochondria. It also participates in extramitochondrial electron transport and controls membrane physicochemical properties. CoQ10 effects on gene expression might affect the overall metabolism. Primary changes in the energetic and antioxidant functions can explain its remedial effects. CoQ10 supplementation is safe and well-tolerated, even at high doses. CoQ10 does not cause any serious adverse effects in humans or experimental animals. New preparations of CoQ10 that are less hydrophobic and structural derivatives, like idebenone and MitoQ, are being developed to increase absorption and tissue distribution. The review aims to summarize clinical and experimental effects of CoQ10 supplementations in some neurological diseases such as migraine, Parkinson´s disease, Huntington´s disease, Alzheimer´s disease, amyotrophic lateral sclerosis, Friedreich´s ataxia or multiple sclerosis. Cardiovascular hypertension was included because of its central mechanisms controlling blood pressure in the brainstem rostral ventrolateral medulla and hypothalamic paraventricular nucleus. In conclusion, it seems reasonable to recommend CoQ10 as adjunct to conventional therapy in some cases. However, sometimes CoQ10 supplementations are more efficient in animal models of diseases than in human patients (e.g. Parkinson´s disease) or rather vague (e.g. Friedreich´s ataxia or amyotrophic lateral sclerosis).
Multiple sclerosis (MS) is one of the most common neurological diseases. This neurodegenerative autoimmune disease manifests as inflammatory and demyelinating impairment of the central nervous system (CNS). Although some studies demonstrated associations between altered steroidogenesis and pathophysiology of MS as well as the importance of steroids in the pathophysiology of MS, the knowledge concerning the steroid metabolome in female patients is limited. Hence, 51 steroids and steroid polar conjugates were measured in the serum of 12 women with MS, untreated with steroids and 6 agecorresponding female controls with the use of gas chromatography - mass spectrometry (GC-MS). The data were processed using age adjusted ANCOVA, receiver operating characteristics (ROC) analysis and orthogonal projections to latent structures (OPLS). Our data show higher levels of circulating C21 steroids including steroid modulators of ionotropic type A γ-aminobutyric acid (GABA A) receptors and glutamate receptors. Furthermore, the levels of GABAergic androsterone and 5-androsten-3β,7α,17β-triol were also higher in the female MS patients. In conclusion, the data demonstrate higher levels of circulating C21 steroids and their polar conjugates and some bioactive C19 steroids in women with MS, which may influence neuronal activity and affect the balance between neuroprotection and excitotoxicity., R. Kanceva, L. Stárka, L. Kancheva, M. Hill, M. Veliková, E. Havrdová., and Obsahuje bibliografii
Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of the central nervous system. In addition to the genetic, epigenetic and immunological components, various other factors, e.g. unhealthy dietary habits, play a role in the MS pathogenesis. Dietary intervention is a highly appealing approach, as it presents a simple and relatively low risk method to potentially improve outcomes in patients with brain disorders in order to achieve remission and improvement of clinical status, well-being and life expectancy of patients with MS. The importance of saturated fat intake restriction for the clinical status improvement of MS patients was pointed for the first time in 1950s. Recently, decreased risk of first clinical diagnosis of CNS demyelination associated with higher intake of omega-3 polyunsaturated fatty acids particularly originating from fish was reported. Only few clinical trials have been performed to address the question of the role of dietary intervention, such is e.g. low saturated fat diet in MS treatment. This review summarizes current knowledge about the effect of different dietary approaches (diets low in saturated fat and dietary supplements such as fish oil, lipoic acid, omega-3 polyunsaturated fatty acids, seeds oils, high fiber diet, vitamin D, etc.) on neurological signs, patient’s well-being, physical and inflammatory status. So far the results are not conclusive, therefore much more research is needed to confirm and to understand the effectiveness of these dietary interventions in the long term and well defined studies., A. Penesová, Z. Dean, B. Kollár, A. Havranová, R. Imrich, M. Vlček, Ž. Rádiková., and Obsahuje bibliografii
a1_Ciele. Štúdia poukazuje na negatívne zmeny v prežívaní jednotlivcov so sclerosis multiplex (SM). Zisťuje mieru a charakter distresu; objasňuje vplyv fyzického postihnutia a potenciálnych psychosociálnych prediktorov – neistoty, sebaúčinnosti, sociálnej opory a zmyslu života. Cieľom je vytvorenie modelu, ktorý poskytne komplexnejší obraz o vzťahoch medzi skúmanými premennými. Súbor a metóda. Výskumný výber tvorí 356 pacientov z USA, Slovenska a Českej republiky, ktorí boli oslovení prostredníctvom internetu. Respondentom bola administrovaná séria dotazníkov v troch jazykových verziách – Hospital Anxiety and Depression Scale, sebahodnotiaca verzia Kurtzkeho škály EDSS, Škála spokojnosti so životom, Škála neistoty v chorobe, Škála sebaúčinnosti pre SM pacientov, Škála životnej zmysluplnosti a Multidimenzionálna škála vnímanej sociálnej opory. Štatistická analýza. V súlade s cieľom bola zvolená postupnosť od komparačnej a korelačnej analýzy, cez hľadanie potenciálnych mediátorov až po navrhnutie a testovanie modelov metódou štrukturálneho modelovania. Záver. Výsledky potvrdzujú, že ochorenie sclerosis multiplex je spojené so zvýšeným rizikom vzniku psychického distresu. Pri tom bol poukázaný signifikantný vzťah so závažnosťou postihnutia, ako aj so zvolenými psychosociálnymi premennými. Konečným výsledkom je model, v ktorom sebaúčinnosť predstavuje mediátor vplyvu neistoty a zmyslu života na distres, zatiaľ čo sociálna opora vystupuje ako nezávislý prediktor. Poznatky o ochrannej funkcii psychosociálnych premenných vytvárajú základ pre plánovanie terapeutických intervencií s dôrazom na kognitívno – behaviorálne postupy a využitie podporných skupín. Obmedzenia. Internetový výskum je spojený s určitými rizikami v dôsledku absencie priameho kontaktu s respondentom., a2_Nedostatkom je tiež použitie sebaposudzujúcej škály pri hodnotení zdravotného stavu. Zapojenie ďalších prediktorov, najmä osobnostných čŕt a vlastností prostredia, môže prispieť k spresneniu vytvoreného modelu., b1_Objectives. Study provides a view of negative emotional changes experienced by individuals with multiple sclerosis (MS). After exploring degree and character of distress it clarifies the influence of physical impairment and potential psychosocial predictors – uncertainty, self–efficacy, social support and life meaning. The aim is to identify a model offering more complex view of relationships between the variables. Subjects and setting. Sample consists of 356 MS patients from USA, Slovakia and Czech Republic, recruited via internet suffering from various forms of MS. The set of questionnaires in three language versions were administrated – Hospital Anxiety and Depression Scale, self– assessment version of Kurtzke Scale, Satisfaction with Life Scale, Uncertainty in Illness Scale, Self–efficacy scale for MS patients, Life Meaningfulness Scale and Multidimensional Scale of Perceived Social Support. Statistical analysis. Following the aim of study multi–step analysis was proposed starting with comparative and correlation analysis and continues through potential mediators search up to construction and testing of certain models using structural equation modeling. Results. The results confirm that MS patients are at higher risk of psychological distress. Statistically significant relationships with the degree of impairment as well as the psychosocial variables were observed. In the best–fitting model self–efficacy mediates the influence of uncertainty and meaning of life, while social support is an independent predictor of distress. The knowledge of protective function of psychosocial variables creates theoretical basis for therapeutic interventions planning, underlining the CBT approaches and utilization of support groups. Study limitation. Certain disadvantages of internet research are connected with absence of direct contact with respondent., b2_Limitations of self–assessment of health status are also considered. Further specification of model may be obtained by adding more predictors, especially personality and environmental variables., Jana Vindišová., and Obsahuje seznam literatury