[Results of a phase 1 clinical study of anti-CD20 monoclonal antibody (BCD-132): pharmacokinetics, pharmacodynamics and safety].

Aim: To study the pharmacokinetics, pharmacodynamics, and immunogenicity of two intravenous dosing regimens of the new anti-B-cells drug BCD-132 (JSC BIOCAD, Russia) at ascending doses in patients with remitting multiple sclerosis.

Material And Methods: Twenty-four patients with multiple sclerosis were sequentially randomized in the multicenter open-label uncontrolled multicohort phase I study (3+3 design) and assigned to 4 cohorts (8 groups). Patients in each cohort received an intravenous infusion of BCD-132 at a predefined dose ranging from 100 to 1000 mg based on the planned algorithm of dose escalation if no dose-limiting toxicities occurred.

[Cortical atrophy in multiple sclerosis].

Objective. To identify clear patterns of the cerebral cortex atrophy in multiple sclerosis that may provide valuable information for the development of additional paraclinical methods of stages and variants of MS objectification and verification and used for assessing treatment efficacy. Material and methods.

[Treatment of relapses of multiple sclerosis (a review)].

The most common clinical type of multiple sclerosis (MS), affecting up to 85% of patients living with this disease, is relapsing remitting(RRMS). Relapses are associated with significant functional impairment and decreased quality of life. Residual symptoms after MS relapses may persist and lead to sustained disability.

[Diagnosis of isolated angiitis of the central nervous system].

We have analyzed clinical presentations, neuroimaging data, blood and cerebrospinal fluid diagnostic tests in isolated angiitis of the central nervous system on the basis of data of recent publications and 22 our own cases. Due to the insufficient diagnostic value of invasive methods including biopsy of leptomeningeal and intracerebral vessels, we considered practical approaches to the diagnosis of cerebral vasculitis and ways of its optimization. We suggested the stratification of clinical, neuroimaging and laboratory criteria for the evaluation of their sensitivity and specificity and for the development of diagnostic algorithms.

[Current possibilities of the comprehensive diagnostic assessment in the differential diagnosis of inflammation and tumors of the spine cord].

The article discusses the differential diagnosis of transverse myelitis. An algorithm for the assessment of patients was given. The authors present two clinical examples demonstrating the role of the integrated neuroradiological approach in the differential diagnosis of difficult cases.

[Intrathecal immunoglobulin production in the diagnosis and differential diagnosis of multiple sclerosis].

The evaluation of diagnostic significance of different immunological tests for intrathecal immunoglobulin production is summarized on the historical basis of investigation of patients with inflammatory, demyelinating and other neurological disorders. The assessment of cerebrospinal fluid lost its previous significance in the 2010 revision of diagnostic criteria for multiple sclerosis. Nowadays, it is used only for the diagnosis of primary progressive multiple sclerosis.

[Symptomatic epilepsy in inflammatory demyelinating diseases].

Based on the own observations, we have summarized the features of symptomatic epilepsy in multiple sclerosis and conducted a clinical analysis of the most diagnostically difficult cases of inflammatory and demyelinating diseases in which epilepsy was the major clinical syndrome. The cases of post-infectious acute disseminated encephalomyelitis, idiopathic cerebral angiitis, Rasmussen's encephalitis are reviewed. Peculiarities of MRI structural brain lesions in these patients are discussed.

[Neuromyelitis optica: problems of heterogeneity and systematization].

Prospective-retrospective data on 10 cases of neuromyelitis optica (NO) have been analyzed. Demographic and clinical features of patients with primary NO as well as NO comorbid with other organospecific disorders are discussed. Magnetic-resonance imaging data of the brain and spinal cord are summarized and discussed in the context of its heterogeneity.

[Brain atrophy and neurological impairment in patients with multiple sclerosis].

An aim of the study was to investigate a relationship between global and local brain atrophy with neurological impairment (motor dysfunction) in multiple sclerosis (MS) patients with different levels of disease severity. Fifty five patients with definite MS (Mc Donald's criteria), aged 18-60 years, disease duration 1-30 years, and 25 healthy age-matched controls have been studied. Neurological assessment (Kurtzke and EDSS scales) was performed in the all patients.

[Clinical and radiological (PET, MRI) correlations depending on disease progression in patients with multiple sclerosis].

The aim of the study was to investigate the structural-functional changes in the cerebral gray matter (cortical and subcortical areas) of patients with multiple sclerosis (MS) depending on the disease severity. One hundred and seven patients (107) with definite diagnosis of MS (Mc Donald's criteria), aged 16-60 years, illness duration 1-30 years, and 21 healthy age-matched controls have been studied. Neurological assessment including Kurtzke and EDSS scales (range 0-8) was performed in all the patients.

[Magnetic-resonance tomography in differential diagnosis of brain lesions in demyelinating and systemic autoimmune diseases].

An aim of the study was to establish MRT signs that may be useful for differential diagnosis of multiple sclerosis (MS). Three groups of patients have been examined: 300 patients with MS, 35 with demyelinating diseases (acute disseminated encephalomyelitis, neuromyelitis optica--Devic's syndrome); 90 patients with systemic autoimmune diseases (systemic lupus erythematosus, primary antiphospholipid syndrome, sclerodermatitis, Sjugren's syndrome, autoimmune thyroiditis, vasculitis and vasculopathy). Classification of MRT syndromes in MS and their frequency are presented: syndrome of chronic inflammatory demyelination (79%), syndrome of acute inflammatory demyelination (9%), syndrome of multifocal degenerative leucoencephalopathy (8%), syndrome of combined multifocal diffusive leucoencephalopathy (4%).

[Interferon-beta treatment in patients with childhood-onset and juvenile multiple sclerosis].

Prospectively observed natural history in 10 cases of pediatric multiple sclerosis (MS), with respect to prognosis comparing to that of adult-onset MS (n=100) is presented. Poor-prognosis with severe disability was found in juvenile MS (age at onset 10-16 years old) with high annual rate of relapses in 2 years after the disease onset. The results of the long-term (2.

[Multiple sclerosis in children and adolescents: history and current experience of immunomodulating treatment].

An agreement accepted worldwide for treatment of multiple sclerosis (MS) in adult patients has not been achieved so far for children and adolescents, mostly due to the insufficient information on the features of MS with early age-at-onset. New methods of immunomodifying treatment and the conception of early MS treatment have changed the attitude to prognosis of MS with early onset. In such cases, a course of the disease is less aggressive and characterized by more intensive remyelination as well as brain plasticity and less neurological deficit that may predict highest efficacy of the disease modifying treatment timely started in these patients.

[Results of a multicenter study of Rebif-22 mcg administration in Russia].

The results of multicenter study of Rebif 22 micrograms in Russia have been reported. 167 multiple sclerosis patients have received Rebif 22 micrograms three times a week for 1 year. This study provides evidence for reduction of the relapse rate in patients with relapsing/remitting and secondary progressive multiple sclerosis.

[Possibilities of magnetic resonance visualization in the diagnosis of multiple sclerosis].

Magnetic-resonance imaging (MRI) is considered to be the most informative non-invasive method in diagnosis, differential diagnosis and estimation of activity of multiple sclerosis (MS). MRI data of 270 patients with clinically and laboratory definite MS were analyzed to assess diagnostic MRI-criteria for MS, MRI presentations at the time of first clinical manifestation of the disease, neuroimaging patterns in children and elderly persons with MS. The MRI variants of MS are substantiated.

[Multiple sclerosis with childhood onset].

The clinical manifestations, magnetic resonance imaging (MRI) data, blood and cerebrospinal fluid (CSF) tests were analyzed in 19 patients with early-onset (before the age of 17 years) multiple sclerosis (MS) and in 100 patients with the definite diagnosis of MS with adult onset. Between group differences in sex ratio and initial neurological symptoms, with the prevalence of acute brainstem dysfunction (37%) and optic neuritis (37%) in the patients with early onset MS, were revealed. In childhood, the disease course was poorer with early disablement on the background of attendant unfavorable conditions.

[Free light-chain immunoglobulins in the biological fluids of patients with multiple sclerosis].

15 patients with clinically significant multiple sclerosis (MS) were examined in terms of content of free light chains of immunoglobulins of kappa- and lambda-types in blood serum, cerebrospinal liquor, lacrimal fluid, saliva, urine, indices were compared with corresponding data of 12 patients with other neurological diseases and of 10 healthy individuals (control group). Significantly increased content of kappa-chains in cerebrospinal, lacrimal fluids and urine was revealed in patients with MS as compared with other two groups and in saliva of patients as compared with controls. The frequency of alterations was high in all biological fluids of the patients with MS.

[Antibodies to brain galactocerebrosides in the serum and cerebrospinal fluid of patients with disseminated sclerosis].

The titers of antibodies (AB) to myelin's glycolipids galactocerebrosides (GC) as well as some other immunological indices were measured in 63 patients with multiple sclerosis (MS), in 14 patients with other similar neurological diseases and in 9 individuals with cerebellospinal ataxias. The correlation between the frequency of revelation of high serum AB titers and MS stage was observed. Thus the highest frequency was observed at primary progredient current of MS and at decline of its aggravation while the latter was found in steady remission.

[The content of free light-chain immunoglobulins in the cerebrospinal fluid and the importance of its determination for the differential diagnosis of multiple sclerosis].

The serum and liquor of 70 patients with multiple sclerosis (MS), 54 patients with other neurological diseases and 20 controls were examined for free light chains (FLC) of immunoglobulins type chi and lambda. The findings were compared to blood-brain barrier competence, liquor pleocytosis, IgG intrathecal synthesis 86% MS patients exhibited high levels of liquor chi-type FLC which appeared early in the disease course irrespectively of MS phase and pattern. Simultaneous high content of lambda-type FLC was reported in 52% of the cases.

[UV irradiation of the cerebrospinal fluid in the treatment of patients with disseminated sclerosis].

Cerebrospinal fluid (SF) in the quantity 5-7 ml from 26 multiple sclerosis patients was exposed to UV radiation with subsequent reinfusion. The assessment of clinical symptoms and immunological indices 7 days later showed that positive results (6 scores by Sipe scale) were achieved in 14 patients with cell abundance in the SF. The improvement was indicated by positive trends in pelvic functions, sensory and coordination disorders, normalization of the blood immunological picture.

[Enterosorption in the combined treatment of patients with multiple sclerosis].

Fifty-nine patients exhibiting an exacerbation of multiple sclerosis were examined for efficacy of enterosorption with the fibrous coal sorbent vaulen. The solvent powder was administered 3 times a day in a dose of 50-60 mg/kg for 20 days between meals. The relief of neurological symptoms started on treatment days 3-4 with subsequent attenuation within the course of treatment.

[Efferent methods of the treatment of cerebrospinal fluid hypertension in exacerbation of multiple sclerosis].

Analysis is made of the efficacy of the treatment of CSF hypertension in 40 patients in the phase of exacerbation of multiple sclerosis. Use was made of sorption detoxication methods: hemoperfusion (the author's certificate No.1466754) and enterosorption (the priority certificate No.

[Status of local and general immunity in patients with multiple sclerosis].

A study was made of the general (blood) and local (CSF) immunity in 18 patients with clinically active multiple sclerosis running different course and in 14 controls. The relative and absolute count of T and B lymphocytes, phagocytizing cells, the content of IgA, IgM and IgG, circulating immune complexes, some fractions of complement, functional activity of blood granulocytes and mononuclears were measured. The patients with multiple sclerosis manifested appreciable alterations in cellular and humoral immunity of the blood and CSF.

[Methodologic characteristics of determining immunologic indices in cerebrospinal fluid].

The authors have tried to adapt the micro-methods for assessment of the peripheral blood immunologic parameters to measurements of these characteristics in the cerebrospinal fluid (CSF) and examined a group of patients to define the diagnostic value of these parameters. Eighteen patients with disseminated sclerosis and 14 normal controls were examined. Relative and absolute counts of T and B lymphocytes, phagocytes, IgA, IgG, and IgM were measured.