Pilot study to examine the effect of antibiotic therapy on MRI outcomes in RRMS

Subramaniam, Sriram; Yao, Song‐Yi; Stratton, Charles W.; Moses, Harold; Narayana, Ponnada A.; Wolinsky, Jerry S.

doi:10.1016/j.jns.2005.03.042

Cited by 18 publications

(11 citation statements)

References 22 publications

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“…In the first study, anti-chlamydial treatment reduced brain atrophy, but did not show any beneficial influence on the number of MRI Gd enhancing lesions in four newly diagnosed RR MS patients (Sriram et al, 2005a). In a subsequent report, no substantial changes on relapse rate and severity of the disease were found in 9 RR, 5 SP and 1 PP patients after Chlamydia-specific antibiotic therapy (Woessner et al, 2006).…”

Section: Clinical Trialsmentioning

confidence: 93%

Under the Microscope: Focus on Chlamydia pneumoniae Infection and Multiple Sclerosis

Fainardi¹,

Castellazzi²,

Seraceni³

et al. 2008

CNR

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Multiple Sclerosis (MS) is a chronic inflammatory demyelinating disease of the Central Nervous System (CNS) of supposed autoimmune origin whose etiology still remains unknown. Epidemiological studies suggest that MS pathogenesis could be related to an infection superimposed on a predisposing genetic background. However, at present, no direct evidence for an infectious implication in MS autoimmunity exists. Recently, the potential role of Chlamydia pneumoniae as a causative agent of MS has received increasing attention. After the initial high rates reported for molecular and culture demonstration of C. pneumoniae in cerebrospinal fluid (CSF) of MS patients, the association between C. pneumoniae and MS was intensively investigated with controversial results. Seroepidemiological reports did not show any strong association between C. pneumoniae infection and the risk of MS. Isolation techniques failed to detect C. pneumoniae in CSF and brain tissue of MS patients. Polymerase chain reaction (PCR) evidence of C. pneumoniae in CSF and intrathecal synthesis of anti-C. pneumoniae IgG have been undetectable in MS patients or, if present, were not selectively associated with MS, but were shared by several inflammatory neurological conditions. Nevertheless, in a subgroup of MS patients, an association between PCR positivity for C. pneumoniae in CSF and disease activity was found. Intrathecal production of anti-C. pneumoniae high-affinity IgG predominated in MS progressive forms and metabolically active C. pneumoniae was identified in CSF. C. pneumoniae was recognized in CSF and brain tissue at immunohistochemical, molecular and ultrastructural levels. C. pneumoniae was also able to induce the animal model of MS. This growing body of data does not support a central role for C. pneumoniae as a candidate in MS pathogenesis, but suggests that, in a subset of MS patients, C. pneumoniae could induce a chronic persistent brain infection acting as a cofactor in the development of the disease. Thus, the actual involvement of C. pneumoniae in MS still remains to be elucidated.

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Section: Clinical Trialsmentioning

confidence: 93%

Under the Microscope: Focus on Chlamydia pneumoniae Infection and Multiple Sclerosis

Fainardi¹,

Castellazzi²,

Seraceni³

et al. 2008

CNR

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“…The z4 composite6,8,9 combines T2LV, T1 hypointense lesion volume, BPF, and gadolinium-enhancing lesions. In a follow-up study of patients with RR or SP MS, the z4 at 3 months predicted the change in physical disability (p <0.02) 6.…”

Section: Commentmentioning

confidence: 99%

“…Composite MRI measurements offer a new approach to link MRI with clinical or therapeutic outcomes 6–9. Our goal was to describe the severity of brain MRI involvement by a novel combination of three measures:…”

Section: Introductionmentioning

confidence: 99%

Predicting Clinical Progression in Multiple Sclerosis With the Magnetic Resonance Disease Severity Scale

Bakshi¹,

Neema²,

Healy³

et al. 2008

Arch Neurol

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“…In one trial the antibiotic minocycline resulted in a reduction in the number of gadolinium-enhancing MRI-detected lesions [133]. Another study showed that anti-chlamydial treatment reduced brain atrophy, but did not show any beneficial influence on the number of MRI Gd enhancing lesions [134]. The Vanderblit University group is currently treating patients with MS with a combination of bacterial protein synthesis inhibitors (doxycycline and azithromycin or roxithromycin or rifampicin) and then adding metronidazole to this.…”

Section: C Pneumoniae Neurodegenerative and Demyelinating Disomentioning

confidence: 99%

Chlamydophila pneumoniaeInfection and Its Role in Neurological Disorders

Contini

Seraceni

Cultrera

et al. 2010

Interdisciplinary Perspectives on Infectious Diseases

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Chlamydophila pneumoniae is an intracellular pathogen responsible for a number of different acute and chronic infections. The recent deepening of knowledge on the biology and the use of increasingly more sensitive and specific molecular techniques has allowed demonstration of C. pneumoniae in a large number of persons suffering from different diseases including cardiovascular (atherosclerosis and stroke) and central nervous system (CNS) disorders. Despite this, many important issues remain unanswered with regard to the role that C. pneumoniae may play in initiating atheroma or in the progression of the disease. A growing body of evidence concerns the involvement of this pathogen in chronic neurological disorders and particularly in Alzheimer's disease (AD) and Multiple Sclerosis (MS). Monocytes may traffic C. pneumoniae across the blood-brain-barrier, shed the organism in the CNS and induce neuroinflammation. The demonstration of C. pneumoniae by histopathological, molecular and culture techniques in the late-onset AD dementia has suggested a relationship between CNS infection with C. pneumoniae and the AD neuropathogenesis. In particular subsets of MS patients, C. pneumoniae could induce a chronic persistent brain infection acting as a cofactor in the development of the disease. The role of Chlamydia in the pathogenesis of mental or neurobehavioral disorders including schizophrenia and autism is uncertain and fragmentary and will require further confirmation.

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Pilot study to examine the effect of antibiotic therapy on MRI outcomes in RRMS

Cited by 18 publications

References 22 publications

Under the Microscope: Focus on Chlamydia pneumoniae Infection and Multiple Sclerosis

Under the Microscope: Focus on Chlamydia pneumoniae Infection and Multiple Sclerosis

Predicting Clinical Progression in Multiple Sclerosis With the Magnetic Resonance Disease Severity Scale

Chlamydophila pneumoniaeInfection and Its Role in Neurological Disorders

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