Publications by authors named "John Tzartos"

Radiotherapy (RT) remains crucial in treating both primary and metastatic central nervous system cancer. Despite advancements in modern techniques that mitigate some toxic adverse effects, magnetic resonance imaging (MRI) scans still reveal a wide range of radiation-induced changes. Radiation can adversely affect neuroglial cells and their precursors, potentially triggering a demyelinating pattern similar to multiple sclerosis (MS).

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Background And Objectives: Biologics that target pathogenic antibodies (Abs) and their effector functions such as the complement inhibitor ravulizumab and the neonatal Fc receptor agonist efgartigimod have recently been approved for the treatment of acetylcholine receptor (AChR)-Ab-positive myasthenia gravis (MG), but comparative studies are lacking.

Methods: In a prospective, exploratory real-world study, we assessed clinical efficacy, safety, and biological effects of ravulizumab and efgartigimod treatment initiation. Myasthenia Gravis-Activities of Daily Living and Quantitative Myasthenia Gravis scores were used as clinical endpoints.

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Article Synopsis
  • * A case study of a 66-year-old woman illustrates how subacute motor weakness and numbness followed a respiratory infection, highlighting the importance of her medical history, including diabetes and Sezary syndrome.
  • * The text stresses the need for thorough evaluations and awareness of clinical signs and tests in neuropathy cases, particularly for those with a history of blood-related cancers, as early treatment can significantly impact outcomes.
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Arthritis, particularly osteoarthritis (OA), is a common synovial condition observed in individuals with multiple sclerosis (MS). Despite its high prevalence and significant impact on the quality of life of MS individuals, there is a gap in the current literature regarding the prevalence of OA in this population and its relation to MS pathology. This systematic review and meta-analysis aimed to estimate the prevalence of OA in the MS population and explore potential associations with demographic and MS-specific characteristics.

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: Myelin oligodendrocyte glycoprotein (MOG) is exclusively expressed in the central nervous system (CNS) and is found on the outer surface of oligodendrocytes. Antibodies to MOG are associated with CNS demyelination, whereas peripheral nervous system (PNS) demyelination is seldom reported to be related to MOG-IgG. : The database of patients seen in our neurological academic center was searched for MOG-IgG seropositivity and concomitant demyelinating polyneuropathy.

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Background: Neuronal nicotinic acetylcholine receptors (nAChRs) are abundant in the central nervous system (CNS), playing critical roles in brain function. Antigenicity of nAChRs has been well demonstrated with antibodies to ganglionic AChR subtypes (i.e.

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Background: Epidemiological data are sparse regarding the risk of stroke in patients with multiple sclerosis (MS).

Objective: To estimate the following: (1) the pooled prevalence of all-cause stroke, acute ischaemic stroke (AIS) and intracerebral haemorrhage (ICH) in MS patients; (2) the relative risk for all-cause stroke, AIS and ICH in MS patients compared to the general population; (3) associations between patient characteristics and the risk for AIS and ICH in MS patients.

Methods: Systematic review and meta-analysis of registry-based and cohort studies.

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While obesity has been shown to elevate the risk of developing multiple sclerosis (MS), there is a lack of strong evidence regarding its role in the disability progression and status of MS patients. This systematic review and meta-analysis aimed to provide comparative estimates of WC and BMI in patients with MS (PwMS) and to investigate potential associations between the waist circumference (WC) and body mass index (BMI) and demographic and specific MS characteristics. Adhering to PRISMA guidelines, a detailed search of the MEDLINE PubMed, Cochrane Library, and Scopus databases was conducted.

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Background/aim: The presence of a monoclonal gammopathy of undetermined significance (MGUS) even in small amounts may trigger tissue damage through immunological or other mechanisms, irrespective of the potential for malignant transformation. The aim of the study was to present a case of monoclonal gammopathy of clinical significance with ocular manifestations and discuss relevant literature.

Case Report: In our case, a patient presented with vision disturbances that was eventually attributed to the underlying IgM MGUS after extensive workup to exclude other potential etiologies.

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Background: Paraneoplastic Neurological Syndromes (PNS) comprise a diverse group of disorders propagated by immune-mediated effects of malignant tumors on neural tissue.

Methods: A single-center longitudinal study was performed including consecutive adult patients treated at a tertiary academic hospital between 2015 and 2023 and diagnosed with PNS. PNS were ascertained using the 2004 and the revised 2021 PNS-Care diagnostic criteria.

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Background/aim: Kelch-like protein 11 (KLHL11)-antibody may be found in paraneoplastic neurological disorders presenting with epileptic seizures. The aim of this study was to investigate the prevalence and clinical significance of KLHL11-antibody in epilepsy.

Patients And Methods: Sera of 42 pediatric and 59 adult patients with seizures of undetermined cause were screened using a cell-based assay.

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This review attempted to explore all recent clinical studies that have investigated the clinical and autoimmune impact of gut microbiota interventions in multiple sclerosis (MS), including dietary protocols, probiotics, fecal microbiota transplantation (FMT), and intermittent fasting (IF). Thirteen studies were held between 2011 and 2023 this demonstrated interventions in gut microbiome among patients with MS and their impact the clinical parameters of the disease. These included specialized dietary interventions, the supply of probiotic mixtures, FMT, and IF.

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Article Synopsis
  • Autoimmune disorders (ADs) are a group of around 80 conditions caused by the body's immune system mistakenly targeting itself due to genetic factors and issues with self-tolerance.
  • This study used polygenic risk scores and examined data from the UK Biobank to explore genetic links among 11 different ADs and 3,254 health-related traits.
  • The findings revealed significant associations with 508 phenotypes related to ADs, uncovering four genetic factors shared among them, highlighting the need for further investigation into these novel insights.
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  • Sporadic cerebral amyloid angiopathy (CAA) is linked to amyloid-β buildup in small brain arteries, and a study in Greece assessed its prevalence and outcomes in 68 patients over 12 months.
  • Common clinical symptoms included focal neurological deficits (75%), cognitive decline (57%), and transient episodes (21%), while neuroimaging showed high rates of lobar cerebral microbleeds (93%) and cortical superficial siderosis (48%).
  • Key findings indicated that cortical superficial siderosis predicted transient episodes and recurrent intracerebral hemorrhage, while a large number of lobar microbleeds was associated with cognitive decline, emphasizing the importance of neuroimaging in clinical decision-making.
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Article Synopsis
  • * Dysfunctions or autoimmune responses to AQPs, especially AQP4, are linked to diseases such as neuromyelitis optica spectrum disorder (NMOSD), which affects CNS health.
  • * The review discusses the detection methods for AQP1-antibodies in the CNS and examines evidence suggesting their potential role in the pathophysiology of NMOSD.
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: The interactions between Diabetes Mellitus type II (DMII) and Multiple Sclerosis (MS) lead to higher levels of fatigue, higher risk of physical disability, faster cognitive decline, and in general a lower quality of life and a higher frequency of depression compared to the general population. All of the above accelerate the disability progression of patients with MS, reduce the patients' functional capacity, and further increase their psychological and economic burden. : This systematic review and meta-analysis aims to calculate the prevalence of DMII in the MS population.

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Muscle-specific kinase (MuSK) Myasthenia Gravis (MG) represents a prototypical antibody-mediated disease characterized by predominantly focal muscle weakness (neck, facial, and bulbar muscles) and fatigability. The pathogenic antibodies mostly belong to the immunoglobulin subclass (Ig)G4, a feature which attributes them their specific properties and pathogenic profile. On the other hand, acetylcholine receptor (AChR) MG, the most prevalent form of MG, is characterized by immunoglobulin (Ig)G1 and IgG3 antibodies to the AChR.

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Neurofilament light chain (NfL), is a neuron-specific cytoskeletal protein detected in extracellular fluid following axonal damage. Extensive research has focused on NfL quantification in CSF, establishing it as a prognostic biomarker of disability progression in Multiple Sclerosis (MS). Our study used a new commercially available Enzyme-Linked Immunosorbent Assay (ELISA) kit and Single Molecular Array (Simoa) advanced technology to assess serum NfL levels in MS patients and Healthy Controls (HC).

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Anti-NMDAR encephalitis has been associated with multiple antigenic triggers (i.e., ovarian teratomas, prodromal viral infections) but whether geographic, climatic, and environmental factors might influence disease risk has not been explored yet.

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Since the outbreak of coronavirus (COVID-19) in 2019, various rare movement disorders and cognitive changes have been recognized as potential neurological complications. The early treatment of some of these allows rapid recovery; therefore, we must diagnose these manifestations in a timely way. We describe the case of a 76-year-old man infected with severe acute respiratory syndrome coronavirus-2 who presented with confusion and hallucinations and was admitted to our hospital 14 days after the onset of symptoms.

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Cancer-associated retinopathy (CAR) is a rare paraneoplastic disorder mediated by auto-antibodies that cross-react with retinal antigens leading to gradual visual defects. Early diagnosis and initiation of treatment is crucial to avoid permanent visual loss. Although most patients with CAR respond to intravenous steroids and intravenous immunoglobulin (IVIG), there are some cases refractory to the aforementioned treatment strategies.

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