Posters II

Abstract

Objective: This study describes the frequency of lumbar punction in patients with newly diagnosed MS in clinical practice in 4 hospitals in the Netherlands from 2000 til 2010. Methods: NEDbase is a part of MSBase. NEDBase is a multiinstitutional database from the Netherlands, currently receiving data of 5 contributing centers using the iMed MS documentation software. Patients with onset of MS between 2000 and 2010 were identified retrospectively from NEDBase.Percentage of lumbar punction performed after the first symptoms in MS patients per centre per year were listed. Results: At the time of analysis NEDBase contained 2608 patients. One of the 5 contributing centers could not upload all data containing information about the lumbar punction, these patients (n = 402) were excluded. Of 884 patients with MS onset between 2000 and 2010, 441 (49,9 %) patients underwent a lumbar punction. There was a wide variation between the 4 centers (27,1%, 49,2 %, 67,2 % and 82,9%) The center with lowest percentage was a tertiary center, the other centers were community hospitals. Time of the lumbar punction after first symptoms was in 65% within 1 year, 11% between 1 -2 years and 24 % after 2 years. The percentage of lumbar punction performed per year per center was fairly constant during the last decade. Conclusion: There is a wide varation in the percentage of lumbar punction performed in the diagnosis of MS between different centers. There is no decline in performing lumbar punction in the diagnosis of MS the last decade per center.Verheul,F van Hooff,B Zwanniken,C and van Munster,E have northing to disclose. Hupperts,R gets consulting fees from Biogen-Idec,Merck-SERONO,Bayer-Scheering and TEVA -Aventis Background: Anti-Ro/SSA, the antibody to Sjogren's-syndromerelated antigen A (SSA), shows a close association with recurrent transverse myelitis or neuromyelitis optica (NMO) as well as systemic autoimmune diseases such as Sjogren's syndrome (SS). In addition, patients with a specific serological marker for NMO, NMO-IgG show higher frequency of anti-SSA-positivity than NMO-IgG-negative patients. However, it remains to be elucidated that the titer of anti-SSA is associated with NMO/NMO-IgG or SS. Objectives: The aim of this study is to elucidate the association of high-titer anti-SSA and NMO/NMO-IgG in CNS demyelinating diseases. Method: We retrospectively reviewed medical records of consecutive 232 patients with CNS demyelinating disorders, who visited our tertiary hospital from 2006 to 2010. A total of 207 patients tested for anti-SSA and anti-AQP4 were included. Anti-SSA was positive in 23 patients, of whom 7 met the revised diagnostic criteria for NMO, 12 had NMO spectrum disorders. The remaining 4 patients had only brain involvement without anti-AQP4 and did not satisfy the diagnostic criteria of NMO/ NMO spectrum disorders. Patients with positive anti-SSA (N=23) were divided into two groups; (1) with high titer ≥;200 (N=12) and (2) with low titer <200 (N=5). Anti-SSA was measured by quantitative enzyme immunoassay (EIA) a...

Teriflunomide Attenuates Immunopathological Changes in the Dark Agouti Rat Model of Experimental Autoimmune Encephalomyelitis

“…As mentioned, through its inhibition of DHO-DH, teriflunomide exerts a cytostatic effect on stimulated lymphocytes (7). In a study of human PBMCs stimulated in vitro , Li et al showed that teriflunomide principally affected proliferation of lymphocytes, with little effect on function (41), and teriflunomide-treated patients have been shown to mount effective responses to seasonal influenza vaccination (42). In an adoptive transfer model of EAE, in vitro teriflunomide treatment of MBP-specific T cells prior to transfer reduced maximal disease scores in recipient naïve animals.…”

“…Teriflunomide’s effects on the proliferation of activated lymphocytes are expected to lead to decreased CNS inflammation (50). T-cell expansion within the CNS has been documented in the EAE model (51), so it will be important for future studies to establish whether teriflunomide affects the proliferation of T cells within the CNS in addition to its effects on T-cell proliferation in the periphery (41). Other immunomodulatory effects independent of pyrimidine synthesis that have been described for teriflunomide may also account for the reduction in DA rat spinal cord immunocytes observed in this study, including reduced T-cell chemotaxis (43), inhibition of protein aggregation (52), and weakening of T-cell interactions with antigen-presenting cells (53).…”