THE STUDY OF DYNAMICS OF CLINICAL AND MOLECULAR PHENOTYPES IN THE GENERALIZED FORM OF MYASTHENIA WITH OPTIMIZED AND COMBINED TREATMENT

Cover Page
  • Authors: Drozd O.A.1, Efremov V.V.1, Romantsov M.G.2, Sarvilina I.V.3
  • Affiliations:
    1. Rostov state medical university, Rostov-on-Don, Russian Federation
    2. I.I. Mechnikov North-Western State Medical University, Saint-Petersburg, Russian Federation
    3. LLC «Medical centre «Novomeditsina», Rostov-on-Don, Russian Federation
  • Issue: Vol 68, No 5 (2013)
  • Pages: 60-64
  • Section: SHORT MESSAGES
  • URL: https://vestnikramn.spr-journal.ru/jour/article/view/187
  • DOI: https://doi.org/10.15690/vramn.v68i5.664

Abstract


The aim of the study was the research of clinical and molecular phenotypes in the generalized form of myasthenia with optimized treatment, which includes the application of basic mode of the treatment and meglumine sodium succinate, and also the combined mode of the treatment, which includes above the mentioned drugs and ozonotherapy. The most expressed improvement of indicators of the clinical and neurologic status (the elimination of motoring breakdown, eye movement disorders, the weaknesses of mimic, respiratory and chewing muscles, bulbar syndrome, the doubling in eyes and ptosis, pharyngeal violations and increase in volume of movement of eyes) was observed in the group of patients receiving the combined therapy. The reduction of the expressiveness of the defeat of the neuromotor device and the decrement of the amplitude of the various degree of M-answer in patients with myasthenia is revealed in the application of the combined therapy in the comparison with the application of the basic and optimized therapy. For the first time we have investigated the dynamics of the intensity of the expression of specific peptides and proteins in blood serum in patients with the application of basic therapy, reamberin and ozonotherapy, which have allowed to open the new mechanisms of the efficiency of the combined therapy of the disease.

 


O. A. Drozd

Rostov state medical university, Rostov-on-Don, Russian Federation

Author for correspondence.
Email: drozd.oksy@gmail.com

Russian Federation PhD student, Department of Nervous Diseases and Neurosurgery, Rostov State Medical University, Resident, Municipal Budgetary Health-Care Institution City Hospital № 8 in Rostov-on-Don Address: 344029, Rostov-on-Don, Nakhichevan Lane, 29; tel.: (863) 250-41-33

V. V. Efremov

Rostov state medical university, Rostov-on-Don, Russian Federation

Email: drozd.oksy@gmail.com

Russian Federation MD, Neurologist, PhD, Associate Professor, Associate Professor, Department of Nervous Diseases and Neurosurgery, Rostov State Medical University. Address: 344029, Rostov-on-Don, Nakhichevan Lane, 29; tel.: (863) 250-41-33

M. G. Romantsov

I.I. Mechnikov North-Western State Medical University, Saint-Petersburg, Russian Federation

Email: mr@polysan.ru

Russian Federation Doctor of Medical Science, PhD in Pedagogics, Full Member of the Russian Academy of Natural Sciences. Address: 105037, Moscow, PO Box 47

I. V. Sarvilina

LLC «Medical centre «Novomeditsina», Rostov-on-Don, Russian Federation

Email: isarvilina@mail.ru

Russian Federation PhD, Clinical Pharmacologist, General Director of Ltd. “Medical Center “Novomeditsina” Address: 344002, Rostov-on-Don, Sotsialisticheskaya St., 74

  1. Conti-Fine B., Milani M., Kaminski H. Myasthenia gravis: past, present, and future. J. Clin. Invest. 2006; 1, 116 (11): 2843–2854.
  2. McGrogan A., Sneddon S., de Vries C. The incidence of myasthenia gravis: a systematic literature review. Neuroepidemiology. 2010; 34: 171–183.
  3. Gekht B.M., Sanadze A.G. Myasthenia gravis: diagnosis and treatment. Nevrologicheskii zhurnal – Journal of neurology. 2003; 8 (Appendix 1): 8–11.
  4. Romanov T.V. Ways to optimize the diagnostic and therapeutic care to patients with myasthenia gravis (analysis of regional experience myasthenic center). Prakticheskaya meditsina = The practice of medicine. 2012; 2 (57): 153–157.
  5. Likhachev S.A., Astapenko A.V., Kulikova S.L. Modern approach to the treatment of myasthenia gravis. Neurology and Neurosurgery. Vostochnaya Evropa = Eastern Europe. 2012; 1 (13):.4–11.
  6. Giraud M., Vandiedonck C., Garchon H. Genetic factors in autoimmune myasthenia gravis. Ann. N.Y. Acad. Sci. 2008; 1132: 180–192.
  7. Sanadze A.G., Gekht B.M., Sidnev D.V., Khlebnikova N.N., Chugunova N.A., Shcherbakova N.I. Antibodies to acetylcholine receptor in the diagnosis of myasthenia gravis and other forms associated with the pathology of neuromuscular transmission. . Nevrologicheskii zhurnal = Journal of neurology. 2003; 8 (Prilozhenie 1): 19–21.
  8. van den Broeck J., Vrolix K., Janssen S., Lemmens M., Van Der Esch E., Duimel H., Frederik P., Molenaar P., Martínez-Martínez P., De Baets M., Losen M. Antibody effector mechanisms in myasthenia gravis-pathogenesis at the neuromuscular junction. Autoimmunity. 2010; 43: 353–370.
  9. Cavalcante P., Barberis M., Cannone M., Baggi F., Antozzi C., Maggi L., Cornelio F., Barbi M., Didò P., Berrih-Aknin S., Mantegazza R., Bernasconi P. Detection of poliovirus-infected macrophages in thymus of patients with myasthenia gravis. Neurology. 2010; 74: 1118–1126.
  10. Stefansson K., Dieperink M., Richman D., Marton L. Sharing of epitopes by bacteria and the nicotinic acetylcholine receptor: a possible role in the pathogenesis of myasthenia gravis. Ann. N.Y. Acad. Sci. 1987; 505: 451–460.
  11. Chien P., Yeh J., Chiu H., Hsueh Y. Inhibition of peripheral blood natural killer cell cytotoxicity in patients with myasthenia gravis treated with plasmapheresis. Eur. J. Neurol. 2011; 18: 1350–1357.
  12. Gideline for the treatment of autoimmune neuromuscular transmission disorders. Eur. J. Neurol. 2006; 13: 691–699.
  13. Mantegazza R. Bonanno S., Camera G., Antozzi C. Current and emerging therapies for the treatment of myasthenia gravis. Neuropsych. Dis. Treat. 2011; 7: 151–160.
  14. García-Carrasco M., Escarcega R., Fuentes-Alexandro S., Riebeling C., Cervera R. Therapeutic options in autoimmune myasthenia gravis. Autoimmun. Rev. 2007; 6: 373–378.
  15. Jordi D. Treatment strategies for myasthenia gravis. Exp. Opin. Pharmacotherap. 2009; 10 (8): 1329–1342.
  16. Gold R., Hohlfeld R., Klaus V. Toyka progress in the treatment of myasthenia gravis. Ther. Adv. Neurol. Disord. 2008;1 (2): 36–51.
  17. Huang C., Lin S., Liao P., Young S., Yang C. The immunopharmaceutical effects and mechanisms of herb medicine. Cell Mol. Immunol. 2008; 5: 23–31.
  18. Myasthenia Gravis: Recommendations of clinical research standards. Neurology. 2000; 55 (1): 16–23.
  19. Tüzün E., Huda R., Christadoss P. Complement and cytokine based therapeutic strategies in myasthenia gravis. J. Autoimmun. 2011; 37: 136–143.
  20. Yeh J., Wang S., Chien P., Shih C., Chiu H. Changes in serum cytokine levels during plasmapheresis in patients with myasthenia gravis. Eur. J. Neurol. 2009; 16: 1318–1322.
  21. Hortin G. The MALDI-TOF mass spectrometric view of the plasma proteome and peptidome. Clin. Chem. 2006; 52: 1223–1237.

Views

Abstract - 11

PDF (Russian) - 6

Cited-By


PlumX



Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.