Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Multiple sclerosis (MS) is the most frequent demyelinating disease of the central nervous system (CNS). Lymphocytes seem to play a crucial role in the pathogenesis of the disorder. They are rich in, among others, beta-2Microglobulin (beta 2M)--a low molecular weight protein located extracellularly and associated with class 1 antigens of the major histocompatibility complex. beta-2M is considered as a marker for disease activity in immune disorders. Its precise role in pathology remains still unknown, but there is evidence that it may be involved in lymphocyte activation. Cladribine (2-chloro-2-deoxyadenosine, 2-CDA) is a potent lymphocytotoxic agent under investigation in the treatment in MS patients, earlier used in hairy-cell-leukemia therapy. Previous studies in MS populations showed beta 2-microglobulin to be moderately increased. Suspecting that beta 2M levels might indicate inflammatory events in CNS we determined CSF-beta 2M and serum beta 2M concentration in patients with relapsing-remitting MS (n = 15) before and after cladribine treatment as well as in a control group diagnosed as tension type headache (n = 10). There was a significant decrease in the CSF and sera beta 2M level in MS patients after cladribine treatment, associated with a slight but significant clinical improvement measured by Kurtzke's Expanded Disability Status Scale. We conclude that beta 2M is a sensitive marker of the CDA influence on the immune system in MS patients; however, increase in CSF and sera beta 2M is not specific as there was no statistically significant difference between MS and control patients.
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PMID:[The effect of cladribine treatment on beta-2 microglobin in the cerebrospinal fluid and serum of patients with multiple sclerosis]. 1096 21

The presence of IgM paraproteinemia in low-grade lymphomas is usually considered a clinical syndrome known as Waldenstrom's macroglobulinemia (WM). In the WHO classification, WM is associated to lymphoplasmacytic lymphoma (LPL); it is a clinicopathologic entity characterized by a monoclonal expansion of predominantly small B-lymphocytes with variable plasmacytoid differentiation. LPL constitutes less than 5% of all NHL and it is associated with hepatitis C virus infection in 26% of cases. Cells of LPL/WM are B cells positive for monocytic Ig light chains, IgM, pan-B-cell markers, and negative for CD3 and CD103. The t(9;14)(p13;q32) is present in 50% of LPL, and determines PAX-5 over-expression. 6q21 deletion is observed in 42% of cases. LPL occurs in older adults. Clinical presentation usually consists of disseminated disease, but extranodal involvement and leukemic phase are rare. Most WM patients have symptoms attributable to tumour infiltration and/or monoclonal protein. In fact, a monoclonal serum paraprotein of IgM type and hyperviscosity symptoms may occur in more than 20% of cases (WM). Hyperviscosity syndrome is usually manifested by bleeding, blurring or loss of vision, dizziness, headache, and neurologic symptoms. Malignant infiltration of the CNS (Bing-Neel syndrome) is uncommon. LPL/WM is an indolent malignancy that is not usually curable with conventional treatments. The median survival of patients with LPL or WM is 50-60 months, transformation to large cell lymphoma may occur. Stage definition is irrelevant in WM considering that initiation of therapy is decided on the bases of prognostic factors and the development of disease-related symptoms and signs. The main adverse prognostic factors are older age, B symptoms, anemia, low albumin serum levels, raised SGOT, and high beta 2-microglobulin values. Several therapeutic alternatives for newly diagnosed or relapsed LPL/WM are available; however, the best location for every strategy is a matter of investigation. Several new drugs are being assessed in prospective trials. As a significant progress in this field, response criteria and therapeutic recommendations were updated during the Third International Workshop on WM (7-10 October 2004, Paris, France).
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PMID:Lymphoplasmacytic lymphoma-Waldenstrom's macroglobulinemia. 1849 69


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