Browsing by Author "Ciampi, Ethel"
Now showing 1 - 20 of 26
Results Per Page
Sort Options
- ItemAndrographis paniculata decreases fatigue in patients with relapsing-remitting multiple sclerosis: a 12-month double-blind placebo-controlled pilot study(2016) Bertoglio, J. C.; Baumgartner, M.; Palma Vásquez, Ramón Eduardo; Ciampi, Ethel; Cárcamo, Claudia; Cáceres, D. D.; Acosta-Jamett, G.; Hancke, J. L.; Burgos, R. A.Abstract Background Andrographis paniculata (A. paniculata), a medicinal plant, has shown anti-inflammatory, neuroprotective and antifibrotic effects in animal models as well as clinical efficacy in different studies, including an anti-fatigue effect in autoimmune diseases such as rheumatoid arthritis. In multiple sclerosis (MS), fatigue is rated as one of the most common and disabling symptoms. In the present trial, we investigated the effect of A. paniculata on relapse rate and fatigue in relapsing-remitting MS (RRMS) patients receiving interferon beta. Methods A randomised double-blind placebo-controlled trial assessed the effects of 170 mg of A. paniculata dried extract tablet b.i.d. p.o. on relapse rate and fatigue using the Fatigue Severity Scores (FSS) over 12 months in RRMS patients receiving interferon. The Expanded Disability Status Scale (EDSS) score, inflammatory parameters and radiological findings were also investigated. Twenty-five patients were enrolled, and twenty-two patients were ultimately analysed and randomised to the active or placebo group. Results Patients treated with A. paniculata showed a significant reduction in their FSS score as compared to the placebo, equivalent to a 44 % reduction at 12 months. No statistically significant differences were observed for relapse rate, EDSS or inflammatory parameters, with a trend in reducing new lesions among the A. paniculata group. One patient in the A. paniculata group presented with a mild and transient skin rash, which was alleviated with anti-histamine treatment for three weeks. Conclusion A. paniculata was well tolerated in patients and no changes in clinical parameters were observed. A. paniculata significantly reduces fatigue in patients with RRMS receiving interferon beta in comparison to placebo and only interferon beta treatment. Trial registration ClinicalTrials.gov Identifier: NCT02280876 ; Trial registration date: 20.10.2014.
- ItemCommentary on Pique et al.'s paper entitled : Peripheral late reactivation of a previously typical monofocal Balo's concentric sclerosis lesion(2015) Ciampi, Ethel; Tur, Carmen; Montalban, Xavier
- ItemCoronavirus disease 2019 in Latin American patients with multiple sclerosis(ELSEVIER SCI LTD, 2021) Fragoso, Yara D.; Schiavetti, Irene; Carmisciano, Luca; Ponzano, Marta; Steinberg, Judith; Trevino Frenk, Irene; Ciampi, Ethel; Vecino, Maria Cecilia A.; Correa, Edgar P.; Carcamo Rodriguez Claudia Andrea; Gomes, Sidney; Pimentel, Maria Lucia V.; Santos, Gutemberg A. C.; Vrech, Carlos; Winckler, Thereza C. A.; Sormani, Maria PiaPatients with multiple sclerosis (MS) who present coronavirus disease 2019 (COVID-19) are of particular interest to neurologists. These patients have a neuroimmune disease and receive immunomodulatory or immunosuppressive therapies in the long-term. We present here data from 73 patients with MS and a confirmed diagnosis of COVID-19 from five Latin American countries. Fifteen patients (20.5%) were hospitalized and two patients died. The use of anti-CD20 therapies was the only risk factor associated to hospitalization and death. Despite the small sample size, this study highlights the awareness regarding therapeutic options for MS during the pandemic.
- ItemCorpus callosum atrophy and post-surgical seizures in temporal lobe epilepsy associated with hippocampal sclerosis(2018) Uribe-San-Martin, Reinaldo; Ciampi, Ethel; Di Giacomo, Roberta; Vasquez, Macarena; Carcamo, Claudia; Godoy F., Jaime; Lo Russo, Giorgio; Tassi, Laura
- ItemCOVID-19 in MS and NMOSD: a multicentric online national survey in Chile(2020) Ciampi, Ethel; Uribe-San-Martín, Reinaldo; Soler, Bernardita; Fernández, Ramiro; García, Pía; Navarrete-Asenjo, Claudio; Tirapegui, José Miguel; Torres, Rubén; Polanco, Juan; Suárez, Felipe; Cuello, María José; Cárcamo, Claudia
- ItemCOVID-19 pandemic: the experience of a multiple sclerosis centre in Chile(2020) Ciampi, Ethel; Uribe-San-Martin, Reinaldo; Cárcamo, Claudia
- ItemEfficacy of andrographolide in not active progressive multiple sclerosis: a prospective exploratory double-blind, parallel-group, randomized, placebo-controlled trial(2020) Ciampi, Ethel; Uribe-San-Martin, Reinaldo.; Cárcamo Rodríguez, Claudia Andrea; Cruz, Juan Pablo; Reyes, Ana.; Reyes, Diego.; Pinto, Carmen.; Vásquez Torres, Macarena.; Burgos, Rafael A.; Hancke, Juan.Abstract Background Multiple sclerosis (MS) is a chronic immune mediated disease and the progressive phase appears to have significant neurodegenerative mechanisms. The classification of the course of progressive MS (PMS) has been re-organized into categories of active vs. not active inflammatory disease and the presence vs. absence of gradual disease progression. Clinical trial experience to date in PMS with anti-inflammatory medications has shown limited effect. Andrographolide is a new class of anti-inflammatory agent, that has been proposed as a potential drug for autoimmune disorders, including MS. In the present trial, we perform an exploratory pilot study on the efficacy and safety of andrographolide (AP) compared to placebo in not active PMS. Methods A pilot clinical trial using 140 mg oral AP or placebo twice daily for 24 months in patients with not active primary or secondary progressive MS was conducted. The primary efficacy endpoint was the mean percentage brain volume change (mPBVC). Secondary efficacy endpoints included 3-month confirmed disability progression (3-CDP) and mean EDSS change. Results Forty-four patients were randomized: 23 were assigned to the AP group, and 21 were assigned to the placebo group. The median baseline EDSS of both groups was 6.0. Annualized mPBVC was − 0.679% for the AP group and − 1.069% for the placebo group (mean difference: -0.39; 95% CI [− 0.836–0.055], p = 0.08, relative reduction: 36.5%). In the AP group, 30% had 3-CDP compared to 41% in the placebo group (HR: 0.596; 95% CI [0.200–1.777], p = 0.06). The mean EDSS change was − 0.025 in the AP group and + 0.352 in the placebo group (mean difference: 0.63, p = 0.042). Adverse events related to AP were mild rash and dysgeusia. Conclusions AP was well tolerated and showed a potential effect in reducing brain atrophy and disability progression, that need to be further evaluated in a larger clinical trial. Trial registration ClinicalTrials.gov NCT02273635 retrospectively registered on October 24th, 2014.
- ItemForecasting Seizure Freedom After Epilepsy Surgery Assessing Concordance Between Noninvasive and StereoEEG Findings(2021) Uribe San Martin, Reinaldo; Di Giacomo, Roberta; Mai, Roberto; Gozzo, Francesca; Pelliccia, Veronica; Mariani, Valeria; Cardinale, Francesco; Ciampi, Ethel; Onofrj, Marco; Tassi, LauraBACKGROUND: Accurate localization of the probable Epileptogenic Zone (EZ) from presurgical studies is crucial for achieving good prognosis in epilepsy surgery. OBJECTIVE: To evaluate the degree of concordance at a sublobar localization derived from noninvasive studies (video electroencephalography, EEG; magnetic resonance imaging, MRI; 18-fluorodeoxyglucose positron emission tomography FDG-PET, FDG-PET) and EZ estimated by stereoEEG, in forecasting seizure recurrence in a long-term cohort of patients with focal drug-resistant epilepsy. METHODS: We selected patients with a full presurgical evaluation and with postsurgical outcome at least 1 yr after surgery. Multivariate Cox regression analysis for seizure freedom (Engel Ia) was performed. RESULTS: A total of 74 patients were included, 62.2% were in Engel class Ia with a mean follow-up of 2.8 + 2.4 yr after surgery. In the multivariate analysis for Engel Ia vs >Ib, complete resection of the EZ found in stereoEEG (hazard ratio, HR: 0.24, 95%CI: 0.09-0.63, P = .004) and full concordance between FDG-PET and stereoEEG (HR: 0.11, 95%CI: 0.02-0.65, P = .015) portended a more favorable outcome. Most of our results were maintained when analyzing subgroups of patients. CONCLUSION: The degree of concordance between noninvasive studies and stereoEEG may help to forecast the likelihood of cure before performing resective surgery, particularly using a sublobar classification and comparing the affected areas in the FDG-PET with EZ identified with stereoEEG.
- ItemGalectin-8 as an immunosuppressor in experimental autoimmune encephalomyelitis and a target of human early prognostic antibodies in multiple sclerosis(2017) Pardo, Evelyn; Cárcamo, Claudia; Uribe-San Martín, Reinaldo; Ciampi, Ethel; Segovia-Miranda, Fabián; Curkovic-Peña, Cristobal; Montecino, Fabián; Holmes, Christopher; Tichauer, Juan Enrique; Acuña, Eric; Osorio-Barrios, Francisco; Castro, Marjorie; Cortes, Priscilla; Oyanadel, Claudia; Valenzuela, David M.; Pacheco, Rodrigo; Naves, Rodrigo; Soza, Andrea; González, AlfonsoGalectin-8 (Gal-8) is a member of a glycan-binding protein family that regulates the immune system, among other functions, and is a target of antibodies in autoimmune disorders. However, its role in multiple sclerosis (MS), an autoimmune inflammatory disease of the central nervous system (CNS), remains unknown. We study the consequences of Gal-8 silencing on lymphocyte subpopulations and the development of experimental autoimmune encephalitis (EAE), to then assess the presence and clinical meaning of anti-Gal-8 antibodies in MS patients. Lgals8/Lac-Z knock-in mice lacking Gal-8 expression have higher polarization toward Th17 cells accompanied with decreased CCR6+ and higher CXCR3+ regulatory T cells (Tregs) frequency. These conditions result in exacerbated MOG35-55 peptide-induced EAE. Gal-8 eliminates activated Th17 but not Th1 cells by apoptosis and ameliorates EAE in C57BL/6 wild-type mice. β-gal histochemistry reflecting the activity of the Gal-8 promoter revealed Gal-8 expression in a wide range of CNS regions, including high expression in the choroid-plexus. Accordingly, we detected Gal-8 in human cerebrospinal fluid, suggesting a role in the CNS immune-surveillance circuit. In addition, we show that MS patients generate function-blocking anti-Gal-8 antibodies with pathogenic potential. Such antibodies block cell adhesion and Gal-8-induced Th17 apoptosis. Furthermore, circulating anti-Gal-8 antibodies associate with relapsing-remitting MS (RRMS), and not with progressive MS phenotypes, predicting clinical disability at diagnosis within the first year of follow-up. Our results reveal that Gal-8 has an immunosuppressive protective role against autoimmune CNS inflammation, modulating the balance of Th17 and Th1 polarization and their respective Tregs. Such a role can be counteracted during RRMS by anti-Gal-8 antibodies, worsening disease prognosis. Even though anti-Gal-8 antibodies are not specific for MS, our results suggest that they could be a potential early severity biomarker in RRMS.
- ItemIn Reply: Forecasting Seizure Freedom After Epilepsy Surgery Assessing Concordance Between Noninvasive and StereoEEG Findings(2021) Uribe San Martin, Reinaldo; Di Giacomo, Roberta; Mai, Roberto; Gozzo, Francesca; Pelliccia, Veronica; Mariani, Valeria; Cardinale, Francesco; Ciampi, Ethel; Onofrj, Marco; Tassi, Laura
- ItemOftalmoparesia dolorosa episódica asociada a rinosinusitis aguda recurrente: Un caso de síndrome de Tolosa Hunt(2015) Perelli S, J.; Vergara V, M.; Ciampi, Ethel; Cabezón A, R.; Uribe S, R.Tolosa Hunt Syndrome is the idiopathic inflammation of cavernous sinus, characterized by one or more episodes of unilateral orbital pain followed by ophtalmoparesis (III, IV o VI nerve palsy) and sometimes the affection of maxillary branch of the trigeminal nerve. We describe the case of a 27 years old man with episodes of painful right ophtalmoparesis associated with acute rhinosinusitis. On high resolution MRI there was inflammation of the III, IV, V2 and VI right nerves with gadolinium enhancement. We propose the THS diagnosis exacerbated by rhinosinusitis and started on chronic steroid therapy.
- ItemOptic neuritis revealing Kikuchi-Fujimoto's disease: clinical commentary(2014) Ciampi, Ethel
- ItemPractical issues concerning the use of Magnetic Resonance Imaging in Multiple Sclerosis in Latin America: discussion from 16 centres on behalf of the Foro Latam EM Study Group(Elsevier B.V., 2022) Ciampi, Ethel; Guerra-Posada, Carolina; Treviño-Frenk, Irene; Cortes-Enriquez, Fernando; Correa-Díaz, Edgar Patricio; Steinberg, Judith; Fragoso, Yara; Garcia Bonitto, Juan; Macias, Miguel Angel; Novarro, Nelson; Carra, Adriana; Vizcarra, Darwin; Vrech, Carlos; Cárcamo Rodríguez, Claudia AndreaMAGNIMS-CMSC-NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis have been recently published, and they have been fundamental for improving patient care. Implementation of these and previous MAGNIMS recommendations have not been established in many countries. Addressing the local limitations behind these difficulties is needed. A panel of 14 MS neurologists from 16 different reference centres from Chile, Argentina, Mexico, Colombia, Ecuador, Panamá, Perú and Brazil met to discuss the current situation regarding the use of MRI in MS including a) Access and availability, b) Standardized acquisition protocols and reports, and c) Multicentric research potential.
- ItemPregnancy outcomes in women with Multiple Sclerosis(2021) Soler León, Bernardita María; Ciampi, Ethel; Uribe San Martín, Reinaldo; Keller K.; Astudillo M.; Charaf V.; Reyes A.; Vergara E.; Cárcamo Rodríguez, Claudia Andrea
- ItemPrevalence of comorbidities in Multiple Sclerosis and impact on physical disability according to disease phenotypes(2020) Ciampi, Ethel; Uribe San Martín, Reinaldo; Soler León, Bernardita María; Molnar, Karolyn; Reyes Placencia, Diego Armando; Keller Matamala, Karina Pascale; Cárcamo Rodríguez, Claudia AndreaBackground: Comorbidities are prevalent among Multiple Sclerosis (MS) patients. Few studies have characterized their prevalence and impact in Latin American populations.Objective: We aim to assess the prevalence of comorbidities and their impact on the risk of physical disability across different MS phenotypes.Methods: Cross-sectional multicenter study of patients under regular clinical care at the Programa de Esclerosis Múltiple UC and Hospital Dr. Sótero del Río in Chile. Prevalence of comorbidities was estimated from the retrospective assessment of electronic medical charts. Disease phenotypes were categorized into two groups: clinically isolated syndrome/relapsing-remitting (inflammatory group) and primary/secondary progressive MS patients (progressive group). A multivariable analysis using binary logistic regression for assessing the risk of EDSS ≥ 6.0 in each group was performed.Results: A total of 453 patients was included, 71% female, mean age at onset 31 years, mean disease duration 10 years, and median EDSS 2.0 (range 0–10). In the whole sample, most prevalent comorbidities were ever-smoking (42.2%), depression/anxiety (34.9%), thyroid disease (15.7%), hypertension (11.3%) and insulin resistance/type 2 diabetes mellitus (11.0%). When assessing the risk of EDSS ≥ 6, in the inflammatory group (N = 366), age at onset (OR 1.06, 95%CI(1.02–1.11), p = 0.008), disease duration (OR 1.06, 95%CI(1.00–1.12), p = 0.039) and epilepsy comorbidity (OR 5.36, 95%CI(1.33–21.5), p = 0.018) were associated with a higher risk of disability. In the progressive group (N = 87), disease duration was a risk factor (OR 1.08 95%CI(1.02–1.16), p = 0.014), while shorter diagnostic delay (OR 0.91 95%CI(0.85–0.99), p = 0.025) and insulin resistance/type 2 diabetes mellitus comorbidity were protective factors (OR 0.18 95%CI(0.04–0.83), p = 0.028), 72% of these patients were receiving metformin.Conclusions: Comorbidities are common across different MS disease phenotypes. Epilepsy seems particularly related with a higher risk of physical disability in relapsing-remitting patients, while the role of insulin resistance/type 2 diabetes mellitus or the impact of metformin use as a protective factor should be further studied. Prospective and larger studies are still needed in order to assess the real impact of comorbidities and their management in MS outcomes.
- ItemPrevalence of epilepsy in a cohort of patients with multiple sclerosis(2014) Uribe San Martín, Reinaldo; Ciampi, Ethel; Suárez Hernández, F.; Vasquez Torres, M.; Godoy F., Jaime; Cárcamo Rodríguez, Claudia Andrea
- ItemRefractory epilepsy associated with anti-ribosomal P antibodies successfully treated with topiramate(2020) Uribe San Martín, Reinaldo; Ciampi, Ethel; Cruz, Juan Pablo; Vásquez, M.; Cárcamo Rodríguez, Claudia Andrea
- ItemRelationship between Social Cognition and traditional cognitive impairment in Progressive Multiple Sclerosis and possible implicated neuroanatomical regions(2018) Ciampi, Ethel; Uribe San Martín, Reinaldo; Vásquez, M.; Ruiz-Tagle, A.; Labbé Atenas, Tomás; Cruz, J. P.; Lillo, P.; Slachevsky, A.; Reyesk, D.; Reyes, A.; Cárcamo Rodríguez, Claudia Andrea
- ItemResonancia magnética funcional : principios básicos y aplicaciones en neurociencias(2018) Labbé Atenas, Tomás; Ciampi, Ethel; Cruz, Juan Pablo; Uribe Arancibia, Sergio A.; Cárcamo Rodríguez, Claudia Andrea
- ItemRisk factors of early adverse drug reactions with phenytoin: A prospective inpatient cohort(2017) Uribe San Martín, Reinaldo; Ciampi, Ethel; Uslar, Wilhelm; Villagra, Silvana; Plaza Plaza, José Cristián; Godoy F., Jaime; Mellado T., Patricio