Clinical proteomics in neurodegenerative disordersZetterberg, H.; Rüetschi, U.; Portelius, E.; Brinkmalm, G.; Andreasson, U.; Blennow, K.; Brinkmalm, A.
doi: 10.1111/j.1600-0404.2007.00985.xpmid: 18279484
Neurodegenerative disorders are characterized by neuronal impairment that eventually leads to neuronal death. In spite of the brain’s known capacity for regeneration, lost neurons are difficult to replace. Therefore, drugs aimed at inhibiting neurodegenerative processes are likely to be most effective if the treatment is initiated as early as possible. However, clinical manifestations in early disease stages are often numerous, subtle and difficult to diagnose. This is where biomarkers that specifically reflect onset of pathology, directly or indirectly, may have a profound impact on diagnosis making in the future. A triplet of biomarkers for Alzheimer’s disease (AD), total and hyperphosphorylated tau and the 42 amino acid isoform of β‐amyloid, has already been established for early detection of AD before the onset of dementia. However, more biomarkers are needed both for AD and for other neurodegenerative disorders, such as Parkinson’s disease, frontotemporal dementia and amyotrophic lateral sclerosis. This review provides an update on recent advances in clinical neuroproteomics, a biomarker discovery field that has expanded immensely during the last decade, and gives an overview of the most commonly used techniques and the major clinically relevant findings these techniques have lead to.
Reproductive counselling, treatment and course of pregnancy in 73 German MS patientsHellwig, K.; Brune, N.; Haghikia, A.; Müller, T.; Schimrigk, S.; Schwödiauer, V.; Gold, R.
doi: 10.1111/j.1600-0404.2007.00978.xpmid: 18205883
Multiple sclerosis (MS) often affects women during the reproductive years of their life. During this period, issues such as choice of immunomodulatory treatment, seeking advice from specialists, relapse‐induced steroid application before, during or after pregnancy in combination with breastfeeding gain importance. The objective was to investigate these issues retrospectively using a questionnaire among 73 MS patients with a total of 88 pregnancies. Eighty per cent of the participants consulted their neurologists before and 60% during pregnancy. The annual relapse rate decreased during pregnancy and significantly increased during the first 3 months after delivery. Immunomodulatory treatment was stopped due to desired pregnancy for a mean of 4 years. Fourteen of the MS patients received intravenous immunoglobulin treatment post‐natal. Ninety per cent of the study subjects started breastfeeding. However, nearly 30% ablactated, as they received steroids due to a relapse. Weight and height of the full‐term children of singleton pregnancies from MS patients were significantly lower compared with the ones of age‐matched healthy controls. Our results confirm the known reduced relapse rate during pregnancy, which is followed by an increased relapse rate after delivery. They shed light on the epidemiology of childbirth in patients with MS.