Multiple sclerosis is a demyelinating disease, characterized by inflammation in the brain and spinal cord, possibly due to autoimmunity. Large-scale sequencing of cDNA libraries, derived from plaques dissected from brains of patients with multiple sclerosis (MS), indicated an abundance of transcripts for osteopontin (OPN). Microarray analysis of spinal cords from rats paralyzed by experimental autoimmune encephalomyelitis (EAE), a model of MS, also revealed increased OPN transcripts. Osteopontin-deficient mice were resistant to progressive EAE and had frequent remissions, and myelin-reactive T cells in OPN-/- mice produced more interleukin 10 and less interferon-gamma than in OPN+/+ mice. Osteopontin thus appears to regulate T helper cell-1 (TH1)-mediated demyelinating disease, and it may offer a potential target in blocking development of progressive MS.

The influence of the proinflammatory cytokine, osteopontin, on autoimmune demyelinating disease

Patients with severe asthma are at increased risk for a decreased quality of life, fixed airway obstruction, hospitalization, and death. Biologics may be required to reduce the disease burden. This review discusses the mechanisms, efficacy, and safety of biologics for severe asthma. 

/pdf/biologic-therapies-for-severe-asthma-3gk22183.pdf

Biologic Therapies for Severe Asthma

Osteoporosis, a musculoskeletal disease characterized by decreased bone mineral density (BMD) and an increased risk of fragility fractures, is now recognized as an important public health problem in men. Osteoporotic fractures, particularly of the hip, result in significant morbidity and mortality in men and lead to considerable societal costs. Many national and international organizations now address screening and treatment for men in their osteoporosis clinical guidelines. However, male osteoporosis remains largely underdiagnosed and undertreated. The objective of this paper is to provide an overview of recent findings in male osteoporosis, including pathophysiology, epidemiology, and incidence and burden of fracture, and discuss current knowledge about the evaluation and treatment of osteoporosis in males. In particular, clinical practice guidelines, fracture risk assessment, and evidence of treatment effectiveness in men are addressed.

/pdf/the-clinical-epidemiology-of-male-osteoporosis-a-review-of-1w56zfclyj.pdf

The clinical epidemiology of male osteoporosis: a review of the recent literature

It is from the discovery of leptin and the central nervous system as a regulator of bone remodeling that the presence of autonomic nerves within the skeleton transitioned from a mere histological o...

Impact of the Autonomic Nervous System on the Skeleton.

Multiple sclerosis (MS) is a common neurological disease, and its etiology remains unknown. In recent years, increasing attention has been paid to the possible association between MS and vitamin D deficiency. Here, we review the current literature between MS and vitamin D, showing clear evidence that vitamin D deficiency is a risk factor for MS despite the lack of direct evidence for the effects of vitamin D in MS progression.

/pdf/update-in-vitamin-d-and-multiple-sclerosis-193wfy3dxe.pdf

Update in vitamin D and multiple sclerosis

Real-World Effectiveness of Benralizumab in Severe Eosinophilic Asthma.

Fractures resulting from osteoporosis are a major cause of morbidity and mortality in the developed world. People with multiple sclerosis experience reduced mobility and are susceptible to falls. Glucocorticoid use and reduced mobility are known risk factors for osteoporosis. This paper is a review of osteoporosis in people with multiple sclerosis, looking at its prevalence, risk factors and possible mechanisms. We also review management guidelines for osteoporosis in the general population and use these to propose guidelines for osteoporosis management amongst multiple sclerosis patients. A number of studies have examined the incidence of reduced bone mineral density amongst people with multiple sclerosis; the majority provide convincing evidence that bone mineral density is significantly reduced in multiple sclerosis patients. The most significant risk factors appear to arise from the chronic disease process of multiple sclerosis and not from glucocorticoid use. There are currently no guidelines or consensus as how best to treat osteoporosis amongst multiple sclerosis patients despite their being at an increased risk. We propose an algorithm for the screening and treatment of osteoporosis in people with multiple sclerosis.

Osteoporosis in multiple sclerosis

10. Ricciardolo FLM, Petecchia L, Sorbello V, et al. Bradykinin B2 receptor expression in the bronchial mucosa of allergic asthmatics: the role of NF-kB. Clin Exp Allergy. 2016;46:428-438. 11. Kang JY, Kim JW, Kim JS, et al. Inhibitory effects of anti-immunoglobulin E antibodies on airway remodeling in a murine model of chronic asthma. J Asthma. 2010;47:374-380. SUPPORTING INFORMATION Additional supporting information may be found online in the Supporting Information section.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/all.14693

Benralizumab after sub‐optimal response to mepolizumab in severe eosinophilic asthma

Benralizumab reduces oral corticosteroid requirements in patients with EGPA and leads to improved patient-reported outcome measures https://bit.ly/2GI0vhf.

https://openres.ersjournals.com/content/erjor/6/4/00451-2020.full.pdf

Andrew P. Hearn

Papers

Real-World Effectiveness of Benralizumab in Severe Eosinophilic Asthma.

Osteoporosis in multiple sclerosis

Benralizumab after sub‐optimal response to mepolizumab in severe eosinophilic asthma

Steroid-sparing effects of benralizumab in patients with eosinophilic granulomatosis with polyangiitis.

The relationship between FeNO and effectiveness of mepolizumab and benralizumab in severe eosinophilic asthma