Current Pharmaceutical Design - Volume 18, Issue 29, 2012

Animal models have been used widely in neurology since many decades. They have led to an improved understanding of the pathophysiological processes underlying frequent diseases as multiple sclerosis or Parkinson's disease and enabled the development of highly effective therapeutical approaches. Current developments, drawbacks and limitations of animal models in neurology are discussed with a special focus on the Read More

Apoptosis is synonymous to programmed cell death, which occurs in response to a plethora of stimuli and employs a series of highly conserved mediators and pathways. Its ambivalent role in immunology is illustrated by the fact that this process not only serves homeostatic functions but also exerts harmful effects including tissue damage. This is particularly true for neuroinflammatory diseases such as multiple sclerosis (MS), t Read More

Cellular in vivo imaging can reveal the induction, progression and resolution of nervous system pathology in real-time. In this review, we summarize recent research in the field to illustrate how in vivo imaging has enhanced our understanding of a variety of neurological conditions caused by trauma, degeneration, ischemia or inflammation. Finally, we look ahead and discuss how novel biosensors might help us to follow not on Read More

The damage of axons and neurons in multiple sclerosis (MS) is well recognised and correlates with neurological disability. The reasons leading to axonal and neuronal injury are diverse and possibly change from an inflammatory mediated mechanism to a neurodegenerative mechanism over the course of the disease. Acute axonal injury is associated with inflammation in the CNS and thus immunomodulatory treatments may Read More

Multiple sclerosis (MS) is a chronic immune modulated disease of the central nervous system (CNS), characterized by inflammation, demyelination and axonal injury. Currently relapsing remitting type of MS patients are most commonly treated with immune- modulators like interferon β (IFN β) or glatiramer acetate (GA). However, while the majority of patients respond well to therapy others do not. Gene expression profiles in bl Read More

Psychoneuroimmunology is a relatively young field of research that investigates interactions between central nervous and immune system. The brain modulates the immune system by the endocrine and autonomic nervous system. Vice versa, the immune system modulates brain activity including sleep and body temperature. Based on a close functional and anatomical link, the immune and nervous systems act in a highly Read More

Baseline disease-modifying therapies (DMTs) for multiple sclerosis (MS) include three different preparations of interferonbeta (IFN-β) and glatiramer acetate (GA). These substances reduce relapse rates, side-effects are tolerated by most patients and - after more than 15 years of experience - the long-term safety profile for these drugs can be appraised as very good. In 2006, the therapeutic tool kit was augmented by the first mo Read More

Over the past 25 years, monoclonal antibodies (mAb) have become important elements in the therapeutic concepts for numerous clinical specialities, including oncology, gastroenterology, hemostaseology and endocrinology. One of the most dynamic fields of their use is the treatment of autoimmune diseases. Although the number of existing mAb interfering with the immune system has increased remarkably and man Read More

Autoimmunity is an overreaction of immune competent cells to self structures resulting in an unwanted clinical outcome. Traditional therapeutic strategies, still relevant in many cases, involve broad acting immunosuppressants such as cyclophosphamide with the predictable attendant toxicity. More recent concepts include blockade of specifically defined targets such as TNF-α, with resulting immunomodulation and less toxicity. Read More

Autoimmune diseases of the nervous system such as myasthenia gravis, inflammatory demyelinating polyneuropathies, multiple sclerosis and others are still not curable. Yet the introduction of modern immune therapies could significantly improve the prospects of many patients affected by these disorders. In addition to steroids and immunosuppression i.v. immunoglobulins are used for treatment of myasthenia gravis and c Read More

Paraneoplastic neurological syndromes (PNS) are rare nervous system dysfunctions in cancer patients, which are not due to a local effect of the tumour or its metastases. PNS in adults are mainly associated with lung cancer, especially small cell lung cancer, lymphoma and gynaecological tumours. In some cases an overlapping of different clinical syndromes can be observed. Since autoantibodies directed against tumour a Read More

The increasing understanding of autoimmune mechanisms continuously leads to new therapeutic targets and development of novel diagnostic tools in rheumatology. On the other hand, an improved comprehension of mechanisms of action of many drugs and the daily utilization in rheumatology leads to a better understanding of the underlying autoimmune processes. An example for the latter is Bcell depletion using anti-CD20 an Read More

Granulumatosis with polyangiitis (wegener's)/GPA microscopic polyangiitis (MPA) and Churg Strauss syndrome (CSS) are primary systemic vasculitides which predominantly affect small vessels, showing a high association with a positive C/PR3-ANCA in GPA and P/MPO-ANCA in MPA, so called ANCA-associated vasculitides (AAV). The diagnostic work-up relies on an interdisciplinary approach including imaging techniques a Read More

There are several different diseases in gastroenterology with an important role of immunological mechanisms in their pathogenesis. We know autoimmune diseases with immunological reactions against liver or pancreatic tissue. In addition there are diseases like chronic inflammatory bowel diseases representing inappropriate immunological reactions followed by inflammation and tissue destruction. The research of th Read More

Limb trauma can lead to the development of a complex regional pain syndrome (CRPS). CRPS is a descriptive term of a variety of different symptoms. According to the current IASP-approved criteria, human CRPS can be diagnosed if a combination of signs is present: continuing pain and hyperalgesia, disproportionate to the initial trauma, skin temperature and colour asymmetry, sweating asymmetry, edema, decreased r Read More

Immunosuppressive treatment still is an important element in the management of autoimmune mediated diseases. However, immunosuppressive therapy is often complicated by a narrow therapeutic index and high variability of treatment response. This review discusses the clinical management and monitoring strategies for the use of ciclosporin A, tacrolimus, azathioprine, mycophenolat mofetil, mitoxantrone and s Read More

Biochemical biomarkers are important candidates for the diagnosis and prognosis of neurological diseases of autoimmune etiology, since they may reflect the presence, nature and intensity of certain immune responses caused by both genetic and environmental processes. Different body fluids such as cerebrospinal fluid (CSF), serum, urine, and tears have been used to identify useful biomarkers. Autoimmune neurological disea Read More

Multiple sclerosis (MS) as a chronic disease presents a vast variability of neurological symptoms. Spasticity is one of the most common symptoms. The principle indication to treat spasticity is disability or handicap of capabilities. All pharmacological methods are attributed to a basic physical management. Different effective treatment schemes have been established. Nevertheless the value of intrathecal triamcinolone acetoni Read More

Intravenous immunoglobulins (IVIg) are used in treatment of a broad spectrum of diseases. Immunoglobulin replacement therapy is the standard treatment for immunodeficiencies with compromised humoural immunity. Use of this method as an immunomodulating therapy ranges from transplantation and treatment of autoimmune-haematological diseases to treatment of various neuroimmunological clinical entities. Lim Read More