Corona Teresa, Guerrero-Camacho Jorge L, Alonso-Vilatela M Elisa, Flores-Rivera José de Jesús
Laboratorio Clínico de Enfermedades Neurodegenerativas, Instituto Nacional de Neurología y Neurocirugía. México DF, México.
Rev Neurol. 2010;50(1):19-22.
The clinical course of multiple sclerosis (MS) varies widely. The natural history of the disease has shown that approximately 50% of patients that begin with a relapsing-remitting clinical course will have a progressive course about 10 years after disease onset and will need some kind of aid to walk. The expression of apolipoprotein E (ApoE) increases in nerve tissue undergoing regeneration and the ApoE epsilon-4 allele is associated with abnormal neural repair. Several different reports indicate that the ApoE epsilon-4 allele is associated with a greater progression of disability in patients with MS, although this is still a matter of debate.
We analyse the clinical characteristics of 99 patients diagnosed with MS, we describe the correlation between the presence or absence of the ApoE epsilon-4 allele and the age of onset, clinical subtype, progression of the disease, score on the Expanded Disability Status Scale and the relapse rate. We explore the impact of the presence of the epsilon-2 allele on the progress of the disease.
In patients under 21 years of age, we observed a higher frequency of the presence of the epsilon-4 allele (p = 0.057). Nevertheless, no association was found between any of the ApoE alleles and the indices of disease progression.
Our results do not suggest any association between the presence of the ApoE epsilon-4 allele and the progression of disability in patients with MS in our sample.
多发性硬化症(MS)的临床病程差异很大。该疾病的自然史表明,约50%以复发缓解型临床病程起病的患者在疾病发作约10年后会进入进展期,且需要某种辅助才能行走。载脂蛋白E(ApoE)在正在再生的神经组织中表达增加,且ApoEε4等位基因与异常神经修复有关。几份不同的报告表明,ApoEε4等位基因与MS患者更大程度的残疾进展有关,尽管这仍存在争议。
我们分析了99例诊断为MS的患者的临床特征,描述了ApoEε4等位基因的有无与发病年龄、临床亚型、疾病进展、扩展残疾状态量表评分及复发率之间的相关性。我们探讨了ε2等位基因的存在对疾病进展的影响。
在21岁以下的患者中,我们观察到ε4等位基因存在的频率较高(p = 0.057)。然而,未发现任何ApoE等位基因与疾病进展指标之间存在关联。
我们的结果并未表明在我们的样本中,ApoEε4等位基因的存在与MS患者的残疾进展之间存在任何关联。