Therapeutic effect of mitoxantrone combined with methylprednisolone in multiple sclerosis: a randomised multicentre study of active disease using MRI and clinical criteria.

Objective: To evaluate the efficiency of mitoxantrone in multiple sclerosis.

Methods: Forty two patients with confirmed multiple sclerosis, selected as having a very active disease on clinical and MRI criteria were randomised to receive either mitoxantrone (20 mg intravenously (IV) monthly) and methylprednisolone (1 g iv monthly) or methylprednisolone alone over six months. In the steroid alone group five patients dropped out due to severe exacerbation.

TAP2 gene polymorphism contributes to genetic susceptibility to multiple sclerosis.

MS is an autoimmune demyelinating disease that has been known to be associated with the HLA-DRB1*1501-DQA1*0102-DQB1*0602 haplotype. TAP1 and TAP2, two genes encoded within the MHC class II region between HLA-DP and -DQ loci, display genetic variability and are involved in the transport of antigenic peptides from the cytoplasm to the endoplasmic reticulum. Comparison of 116 MS patients with Caucasoid controls did not reveal any significant correlation between the previously described alleles of the TAP1 and TAP2 genes and MS.

[Benign forms of multiple sclerosis].

It is still difficult, in 1991, to evaluate precisely the position occupied by benign forms of multiple sclerosis (MS) in the natural history of the disease. The reality hidden behind the adjective "benign" varies from one author to another, and the estimated frequency of these forms is not the same when one refers to epidemiological studies on whole populations or to clinical studies in major hospitals. There is, however, no doubt that benign MS does exist, since about 10% of MS patients will suffer, throughout the whole duration of the disease (over 30 years), from no more than moderate disablement with few repercussions on their social and professional life.

[A focus of multiple sclerosis in Bretagne: HLA markers and evaluation of consanguinity].

In a previous study, we established the overall prevalence of multiple sclerosis at 25 per 100,000 inhabitants in the French province of Brittany and found that the geographical distribution was uneven with four circumscribed high prevalence areas with more than 45 per 100,000. We conducted the present study to try to ascertain whether the existence of such clusters of MS could be explained by genetic factors, using two ways: the major histocompatibility markers and the frequency of intermarriage. Among the four areas of high prevalence, we examined the one with the highest prevalence, exempt from migratory movements over the last 100 years.