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Background: The aim of this study was to evaluate the status of anti-myelin oligodendrocyte glycoprotein (MOG) antibodies in patients with transverse myelitis (TM) and compare the clinical and imaging characteristics of MOG immunoglobulin G (IgG)-positive with negative cases. Methods: This cohort study enrolled 71 patients diagnosed with new-onset of TM who were being followed at a referral university clinic in Isfahan, Iran, from November 2016 to January 2019. Magnetic resonance imaging (MRI) images and blood samples for anti-MOG, anti-aquaporin 4 (anti-AQP4) (using the cell-based technique), and vasculitis-related antibodies were collected from patients. Outcomes were assessed by the evolution of the Expanded Disability Status Scale(EDSS) score and brain and spinal cord imaging findings within three months. All patients underwent imaging and clinical assessment during a mean period of one year as a follow-up. We compared the characteristics of clinical and radiological outcomes in MOG-IgG-positive and negative cases. Results: Of the total population studied, there were 26.8% men and 73.2% women, with a mean age of 33 ± 10 years. 12 (16.9%) patients were seropositive for MOG antibody and 17 (89.5%) were positive for anti-AQP4 antibodies. There was no significant association between anti-MOG antibody seropositivity and age, gender distribution, the presence of other autoimmune diseases, and number and interval of relapses. However, the involvement site of the spine at first imaging was significantly different between seronegative and seropositive patients. Conclusion: In patients with MOG antibody disease (MOG-AD) TM, the MRI findings suggest a preferential involvement of the cervical-thoracic section in seropositive cases which may help differentiate from non-MOG demyelination TM.

Cerebral venous sinus thrombosis is an important pathology with various clinical symptoms. Early detection of thrombosis is very important for the improvement of the prognosis. The aim of this study was to calculate the diagnostic value of T2-weighted sequences of magnetic resonance imaging (MRI) in detecting subacute thrombosis. All patients that were suspected of having subacute cerebral venous sinus thrombosis and were referred to the emergency center of Kashani hospital (between September 2018 and September 2019) were entered into the study. Magnetic resonance venography (MRV) and T2-weighted MRI were accomplished for each patient. The sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of MRI using MRV as the reference method were calculated. A total of 630 patients were entered into the study. A positive subacute venous sinus thrombosis was detected in the MRV of 53 patients; consequently, the sensitivity of 60%, the specificity of 80%, the PPV of 21%, and the NPV of 96% were calculated. MRI was highly specific for detecting the subacute thrombosis of superior sagittal sinus, transverse sinuses, sigmoid sinuses, and straight sinus (specificity>94%). A substantial agreement was detected between MRI and MRV in distinguishing thrombosis of superior sagittal sinus, transverse sinuses, sigmoid sinuses, and straight sinus (kappa>0.6). T2-weighted MRI is a specific method in detecting cerebral venous sinus thrombosis. In a patient with signs of thrombosis in the T2-weighted sequence, additional workups are highly suggested to rule out the pathology.

Background Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder of unknown etiology; although infection and inflammation have recently been considered as important etiologic agents. A recent meta-analysis showed correlations between cytokine [interleukin-10 (IL-10) and tumor necrosis factor (TNF)] gene polymorphisms and IBS; however, it is still unknown whether patients with IBS have different cytokine profiles compared to healthy population. Methods To determine the relationships between serum/plasma levels or mucosal expression of IL-10/TNF-α and IBS, we conducted a systematic review and meta-analysis based on case–control studies retrieved from PubMed and EMBASE search through August 2013. Standardized mean difference (SMD) was generated by using the inverse variance method. Heterogeneity was assessed based on I2 values. Key Results Serum/plasma levels of TNF-α tended to be higher in IBS vs controls (p = 0.09); this reached significance in IBS subtypes vs controls and in female patients with IBS. However, serum/plasma levels of IL-10 were not significantly different in IBS patients vs controls. Further analysis of serum/plasma IL-10 levels in IBS subtypes did not show any difference; however, analysis based on gender showed a significantly lower serum/plasma IL-10 levels in male patients with IBS vs male controls (p = 0.02). Colonic IL-10 mRNA had a significantly lower expression in IBS vs control (p = 0.001). Conclusions & Inferences There is an imbalance of proinflammatory TNF-α, and anti-inflammatory IL-10, cytokines in IBS. Stratifying IBS patients based on cytokine profile may represent an opportunity for personalized treatment of this condition.

Background Low-grade inflammation has been increasingly implicated in the pathophysiology of irritable bowel syndrome (IBS). Imbalances of pro- and anti-inflammatory cytokines and polymorphisms in cytokine genes have been reported in IBS; however, these findings have not been consistently observed. This may be due to small sample sizes and differences in ethnicities. Therefore, we performed a meta-analysis on the studies that investigated cytokine gene polymorphisms in IBS patients compared to healthy controls. Methods A PubMed and EMBASE search was performed, and cytokine gene polymorphisms, which had been investigated in at least two case-control studies, were evaluated. Pooled odds ratios (OR) for the genotypes were calculated using random- or fixed-effects models. Key Results Five studies that investigated interleukin-10 (IL-10; −1082 G/A), transforming growth factor-β1 (TGF-β1; +869 T/C and +915 G/C) and tumor necrosis factor (TNF; −308 G/A) polymorphisms in IBS patients and controls were included. High producer IL-10 (−1082 G/G; OR: 0.64 [95% CI: 0.48–0.87]) was significantly associated with a decreased risk of IBS. The intermediate producer TGF-β1 (+915 G/C) genotype showed a tendency toward decreasing the risk of IBS. No associations were found between TNF (−308 G/A) genotypes and IBS in the whole meta-analysis although an analysis of Asian studies revealed an association between TNF (−308 G/A and G/G) genotypes and IBS (OR: 0.50 [95% CI: 0.29–0.85]), and 1.82 [95% CI: 1.08–3.07], respectively). Conclusions & Inferences This meta-analysis indicates a role for IL-10 polymorphisms in IBS in general and TNF in Asian populations. Whether or not gene polymorphisms are associated with alterations in cytokine levels leading to functional effects at the level of the gut needs further investigation.

Background: Irritable bowel syndrome (IBS) is a highly prevalent functional gastrointestinal (GI) disorder. Although the mucosal histology of the GI tract is normal, low grade inflammation is considered as an underlyingmechanism in IBS. Imbalances in proand anti-inflammatory cytokines and polymorphisms of cytokines genes have been observed in some studies. However, studies on cytokine gene polymorphisms have not revealed consistent genetic features in these patients, possibily due to lack of statistical power, small sample sizes and differences in ethnicities. To overcome this problem, we performed a systematic review and meta-analysis on the case-control studies which investigated cytokine gene polymorphisms in IBS patients vs. healthy controls. Methods: A MEDLINE and EMBASE search of the literature was performed. Cytokine gene polymorphisms which had been investigated in at least 2 published studies were included. Pooled odds ratios (OR) with 95% confidence interval (95%CI) for the genotypes and allelic distributions were calculated using randomor fixed-effects models. Results: Five case-control studies were identified. IL-10 (−1082 G/ A), TGF-β1 (+869T/C and +915G/C) and TNF-α (−308G/A) were investigated in 5, 3 and 4 studies, respectively. A total of 529 IBS patients and 860 controls were included. High producer IL-10 (−1082 G/G) (OR: 0.68 [95%CI: 0.50-0.91]), intermediate producer TGFβ1 (+869T/C) (OR: 0.64 [95%CI: 0.45-0.91]) and intermediate producer TGF-β1 (+915G/ C) (OR: 0.55 [95%CI: 0.32-0.97]) genotypes were associated with a decreased risk of IBS. No associations were found between IBS and TNF-α (-308G/A) genotypes. Moreover, there was no significant association between the frequency of alleles of each polymorphism and IBS. Conclusion: Results from this meta-analysis suggest a role for IL-10 and TGF-β1 polymorphisms in IBS. Whether the changes in IL-10 and TGF-β1 producer genes translate to alterations in the levels of these cytokines in the gut wall and the nature of their protective role need further investigations.