Frederik Barkhof.

Jeffrey A ed pills . Cohen, M.D., Frederik Barkhof, M.D., Giancarlo Comi, M.D., Hans-Peter Hartung, M.D., Bhupendra O. Khatri, M.D., Xavier Montalban, M.D., Jean Pelletier, M.D., Ruggero Capra, M.D., Paolo Gallo, M.D., Guillermo Izquierdo, M.D., Klaus Tiel-Wilck, M.D., Ana de Vera, M.D., James Jin, Ph.D., Tracy Stites, Ph.D., Stacy Wu, M.D., Shreeram Aradhye, M.D., and Ludwig Kappos, M.D. After phosphorylation, fingolimod acts as an operating antagonist of the sphingosine-1-phosphate type 1 receptor, inducing receptor internalization and rendering T and B cells insensitive to a signal necessary for egress from secondary lymphoid tissues.1,2 The resulting redistribution to lymph nodes reduces recirculation of autoaggressive lymphocytes to the central nervous system.6 Through conversation with sphingosine-1-phosphate receptors on neural cells, fingolimod might have neuroprotective or reparative results.6-9 Fingolimod treats experimental autoimmune encephalomyelitis effectively, an animal model of multiple sclerosis.1,10,11 In a 6-month, stage 2 study involving sufferers with relapsing multiple sclerosis,12 daily oral fingolimod at a dosage of 5.0 or 1.25 mg significantly reduced the number of gadolinium-enhancing lesions seen on magnetic resonance imaging and the relapse rate, in comparison with placebo.

Supachai Rerks-Ngarm, M.D., Punnee Pitisuttithum, M.D., D.T.M.H., Sorachai Nitayaphan, M.D., Ph.D., Jaranit Kaewkungwal, Ph.D., Joseph Chiu, M.D., Robert Paris, M.D., Nakorn Premsri, M.D., Chawetsan Namwat, M.D., Tag de Souza, Ph.D., Elizabeth Adams, M.D., Michael Benenson, M.D., Sanjay Gurunathan, M.D., Jim Tartaglia, Ph.D., John G. McNeil, M.D., Donald P. Francis, M.D., D.Sc., Donald Stablein, Ph.D., Deborah L. Birx, M.D., Supamit Chunsuttiwat, M.D., Chirasak Khamboonruang, M.D., Prasert Thongcharoen, M.D., Ph.D., Merlin L. Robb, M.D., Nelson L. Michael, M.D., Ph.D., Prayura Kunasol, M.D., and Jerome H. Kim, M.D.1-3 Initially, these combined groups consisted of injection-drug users and industrial sex workers; they were expanded to add persons in the general population subsequently.