Markoglou Nikolaos, Simeakis George, Alevizaki Maria, Velonakis Georgios, Chatzistamatiou Theofanis, Spyropoulou-Vlachou Maria, Stavropoulos-Giokas Catherine, Stefanis Leonidas, Anagnostouli Maria
Research Immunogenetics Laboratory, 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Aeginition University Hospital,11528 Athens, Greece.
Multiple Sclerosis and Demyelinating Diseases Unit, 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Aeginition University Hospital,11528 Athens, Greece.
Biomedicines. 2022 Nov 8;10(11):2850. doi: 10.3390/biomedicines10112850.
Multiple sclerosis (MS) and its various comorbidities that may be observed are of great interest due to the complexity of MS pathophysiology and all of the immunological changes that follow. The incidence of cancer in MS has been investigated for several years, as not only does it affect ongoing therapeutical decisions, but also, certain disease-modifying treatments (DMTs) may increase the risk of tumorigenesis. For the first time, we present a case of a female patient with pediatric-onset MS (POMS) and multiple endocrine neoplasia 2B (MEN2B) and analyze the immunological impact of these diseases on the therapeutical choice, under the umbrella of her COVID-19 infection and the SARS-CoV-2 pandemic as a whole. We also review the existing literature regarding the immunogenetic and immunological correlations between these two extremely rare diseases and discuss the most suitable treatment for our case, which seems to be an anti-CD20 agent due to a better outcome in putative MS worsening and tumor progression, when killer immunoglobulin-like receptors' (KIR) expression is reduced in natural killer (NK) cells. We also broaden our concerns on this comorbidity issue, at the same time focusing on the future research needed in this unexplored field of the comorbidity of MS and cancers.
由于多发性硬化症（MS）病理生理学的复杂性以及随之而来的所有免疫变化，MS及其可能出现的各种合并症备受关注。MS患者患癌症的发生率已被研究多年，因为这不仅会影响正在进行的治疗决策，而且某些疾病修正治疗（DMTs）可能会增加肿瘤发生的风险。我们首次报告了一例患有儿童期起病的MS（POMS）和多发性内分泌肿瘤2B型（MEN2B）的女性患者，并在她感染COVID-19以及整个SARS-CoV-2大流行的背景下，分析了这些疾病对治疗选择的免疫影响。我们还回顾了关于这两种极其罕见疾病之间免疫遗传和免疫相关性的现有文献，并讨论了针对我们病例的最合适治疗方法，由于在自然杀伤（NK）细胞中杀伤免疫球蛋白样受体（KIR）表达降低时，推测MS病情恶化和肿瘤进展有更好的结果，似乎抗CD20药物是最合适的。我们还拓宽了对这种合并症问题的关注，同时关注MS与癌症合并症这一未被探索领域未来所需的研究。
