Comparison Study In Different Age Groups In Multiple Sclerosis And Effects Of Ancord On Acute Experimental Autoimmune Encephalolmyelitis

Objectives: To assess the natural history and prognostic features of early onset multiple sclerosis, adult onset multiple sclerosis and late onset multiple sclerosis in Chinese population.Methods: A retrospective analysis of 481 multiple sclerosis patients treated at the General Hospital of Chinese Public Liberation Army in China was performed. 87 patients were excluded due to lack of follow up details. Patients under (or equal to) the age of 16 years were considered as EOMS. Patients over (or equal to) the age of 50 years were considered as LOMS. Clinical features of the three groups were compared and statistically analyzed. Time to reach expanded disability status score (EDSS) 4 and time to reach secondary progression were used as end points for survival analysis. Log-rank tests were performed and Kaplan - Meier survival curves were presented.Results: About 51 (10.6%) patients had EOMS, and 69 (14.3%) patients had LOMS. The clinical characteristics of EOMS, AOMS and LOMS were significantly different. Most patients had relapsing remitting course. Mean time to reach EDSS 4 and mean time to reach secondary progression were significantly longer in EOMS. Kaplan - Meier survival analysis show difference among the three groups. Primary progressive and secondary progressive course were significantly unfavorable prognostic factors for all groups. Conclusions: The natural history of EOMS, AOMS and LOMS are significantly different in Chinese population. But the prognostic features of the three groups are significantly affected by course other than the age. The present study underlines the importance of ancord, a Malayan pit viper venom protein, drastically reduces plasma fibrinogen levels and fibrin deposition, in inhibiting the disease process of the experimental allergic encephalomyelitis (EAE), an animal model of acute multiple sclerosis. Clinical symptoms of EAE, infiltration of mononuclear cells and demyelination were significantly lower in C57BL/6 female mice receiving ancord than those without ancord. The histological and immunohistochemical analyses also demonstrate the inhibitory effect of ancord on the invasion of T cells into the spinal cord of EAE mice, and fibrin depositon would stimulate the reactive gliosis and oligodendrocyte loss. Furthermore, we demonstrate that the differential effect of ancord on the expression of MBPand MMP-9. Overall, these results indicate that fibrin regulates the inflammatory response in neuroinflammatory disease. Design of therapeutic strategies based on fibrin depletion could potentially benefit the clinical course of demyelinating disease such as multiple sclerosis.