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  • ISSN: 2333-6714
    Early Online
    Volume 5, Issue 1
    Research Article
    Laura Bucio-Lopez, Gabriela Pinon-Zarate, Katia Jarquin-Yanez, Beatriz Hernandez-Tellez, Miguel Angel Herrera-Enriquez, and Andres Eliu Castell-Rodriguez*
    Dendritic cells (DCs) may secrete nanometricparticules named exosomes that are implicated in antigen presentation to T lymphocytes, by mean of the expression of MHC II, costimulatory and coinhibitory molecules on its surface, which may determine the type of immune response developed. Also, it has recently proposed the use of exosomes as a new strategy for the generation of cell free anti-cancer immunotherapies, so it is important to know the phenotype differences between exosomes of DCs treated with different molecules such as IFNγ, TNFα and LPS, in order to avoid the induction of immunological tolerance in immunotherapy. Hence, the aim of this study was to analyze and compare the exosomes phenotype secreted by DCs treated with different stimuli. For this, DCs were treated with 500U or 10000U of IFNγ, TNFα, and LPS to generate different phenotypes. Exosomes were coupled to α-CD11c microbeads to detect the DCs exosomes by flow cytometry. To compare the phenotype of the DCs and the exosomes, costimulatory and coinhibitory molecules were analyzed by flow cytometry. As results, immature DCs and the DCs treated with 500U IFNγ, exhibited a tolerogenic phenotype, while the exosomes produced by this DCs exhibited low levels of costimulatory and coinhibitory molecules. In contrast, DCs treated with 10,000U IFNγ, TNF-α and LPS showed an activator phenotype, and their exosomes had high levels of costimulatory and coinhibitory molecules. In conclusion, this study becomes important since disclosed not only the phenotype of DCs cultured with different treatments but also the phenotype of the exosomes produced by DCs
    Special Issue on Multiple Sclerosis
    Review Article
    James Tracey, Yang Mao-Draayer, and John T. Stoffel*
    Abstract:
    Patients with multiple sclerosis are frequently bothered by urinary symptoms, including urinary urgency, incontinence and retention. Although referral to a urologic provider is frequently needed to treat these symptoms, the number visits can be reduced or even potentially avoided when treatment for urinary symptoms is initiated by the primary care team. First line therapy for urinary symptoms includes classifying urinary symptoms as a storage or emptying problem, measuring impact of the problem, reviewing behavioral therapy options, and discussing appropriate pharmacologic interventions.
    Case Report
    Sarah J. Clark, Qin Wang, and Yang Mao-Draayer*
    Abstract:
    For multiple sclerosis (MS) patients, discontinuing natalizumab and starting another disease modifying therapy (DMT) is complicated by two paradoxical considerations: 1) too short of a drug holiday might increase the risk of Progressive Multifocal Leukencephalopathy (PML) due to drug overlap; 2) too long of a drug holiday may increase the risk of disease activity while the patient is without drug modulation. In this case report, a 50 year-old male with relapsing remitting MS (RRMS) showed no signs of increased disease activity or PML during a nine month drug holiday after natalizumab treatment and for 24 months after beginning fingolimod therapy and remained relapse free. This suggests that a nine month break between natalizumab and fingolimod treatment may be an appropriate time length in patients with stable RRMS disease activity. While further analysis is required to determine the most appropriate drug holiday after natalizumab, this case report may help clinicians make such treatment decisions for patients with less aggressive disease.
    Cynthia Wang, America Ruiz, and Yang Mao-Draayer*
    Abstract:
    Relapses are the hallmark features of relapsing-remitting multiple sclerosis (RRMS). True relapses may be challenging to accurately diagnose. A clinician must rely on a combination of history, exam findings, laboratory studies, and neuroimaging to decide whether or not to treat for a presumed relapse. Although many consider MRI as the gold standard diagnostic test, it may not be rapidly accessible and still could miss lesions. In light of this diagnostic complexity, future directions including development and validation of a scale to assess MS relapse probability and severity would be useful to multiple sclerosis specialists and practicing neurologists. Given the complex pathophysiology of MS, more research is needed to ascertain the validity of promising biomarkers for predicting relapse.
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