title: Decreased levels of repulsive guidance molecule A in association with beneficial effects of repeated intrathecal triamcinolone acetonide application in progressive multiple sclerosis patients.
abstract: Repeated intrathecal application of the sustained release steroid triamcinolone acetonide is beneficial in progressive multiple sclerosis patients. Its putative regenerative effect may involve regulation of the repulsive guidance molecule A synthesis. This protein inhibits axonal regeneration and functional recovery. Objectives were to demonstrate the efficacy of four triamcinolone applications every other day in association with repulsive guidance molecule A levels in cerebrospinal fluid. Clinical evaluation was performed at baseline and on each day after a triamcinolone administration in 25 progressive multiple sclerosis patients. Repulsive guidance molecule A concentrations were determined before each triamcinolone application by western blot analysis with quantification. Clinical scores for multiple sclerosis improved, and the maximum walking distance and speed ameliorated in 17 patients. Repulsive guidance molecule A levels declined in these responders. The remaining patients showed no prompt clinical benefit and no decrease of repulsive guidance molecule A concentrations. Decline of repulsive guidance molecule A may reflect regeneration and functional recovery by triamcinolone in progressive multiple sclerosis patients.
authors.affiliation: Department of Neurology, St. Joseph Hospital Berlin-Weissensee, Gartenstr. 1, 13088, Berlin, Germany, th.mueller@alexius.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Müller
authors.forename: Stefan
authors.initials: S
authors.lastname: Barghorn
authors.forename: Sven
authors.initials: S
authors.lastname: Lütge
authors.forename: Thomas
authors.initials: T
authors.lastname: Haas
authors.forename: Reinhold
authors.initials: R
authors.lastname: Mueller
authors.forename: Bjoern
authors.initials: B
authors.lastname: Gerlach
authors.forename: Gabi
authors.initials: G
authors.lastname: Öhm
authors.forename: Katrin
authors.initials: K
authors.lastname: Eilert
authors.forename: Isabel
authors.initials: I
authors.lastname: Trommer
authors.forename: Bernhard K
authors.initials: BK
authors.lastname: Mueller
mesh_terms: D015153:Blotting, Western; D005080:Exercise Test; D005260:Female; D058851:GPI-Linked Proteins / Q000134:cerebrospinal fluid; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000134:cerebrospinal fluid* / Q000188:drug therapy*; D009419:Nerve Tissue Proteins / Q000134:cerebrospinal fluid*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*; D016138:Walking
chemical_list: D058851:GPI-Linked Proteins; D007166:Immunosuppressive Agents; D009419:Nerve Tissue Proteins; C522183:RGMA protein, human; D014222:Triamcinolone Acetonide