Hasil untuk "Therapeutics. Pharmacology"

Katherine D Alex, E. Pehek

Petra Tozser, Szabina Kádár, Edina Szabó et al.

Background and purpose: The effective transport of an active pharmaceutical ingredient across various membrane systems is critical for enhancing its bioavailability, especially in formulations involving solubilizing agents. This study aims to investigate the permeability differences of carvedilol (CAR) between lipophilic and size-exclusion membranes in the presence of hydroxypropyl-beta-cyclodextrin (HP-β-CD) using in vitro side-by-side diffusion cell assays. Experimental approach: Solubility and permeability assays confirmed that HP-β-CD significantly enhanced the solubility of CAR, while simultaneously decreasing its permeability, indicating an interplay between the two parameters. Key results: A mathematical model based on Fick’s first law of diffusion was developed to describe drug transport across the UWL, and generally through the UWL-membrane system, with a particular focus on the role of solubilizing agents. Conclusion: Results from both the UWL and membrane limited transport conditions demonstrated that the supersaturation ratio (SSR, defined as the ratio of the drug concentration present in solution to its thermodynamic solubility measured in exactly the same media) between donor and acceptor compartments is the real driving force of the transport, when the complexing agent and the drug- HP-β-CD complex does not penetrate the membrane or the permeation of the solubilizing additive through the membrane is relatively slow, so it does not affect the transport of the API substantially.

Robert Ancuceanu, Adriana Iuliana Anghel, Marilena Viorica Hovaneț et al.

With a widespread distribution throughout the Northern Hemisphere and 11 genera, Pinaceae is the largest family of <i>Gymnosperms</i> in the world. Essential oils are an important chemotaxonomic marker for the species of this family, although the degree of chemical and biological investigation has not been the same for all genera. Essential oils from <i>Abies</i> and <i>Cedrus</i> (from the abietoid clade) or <i>Pinus</i> and <i>Picea</i> (from the pinoid clade) have been more extensively investigated with respect to their chemical composition and biological or pharmacological properties, including their antioxidant effects. Instead, essential oils from the other genera of the family have been less explored in this respect or even have not been investigated at all. This is a narrative review looking into the knowledge acquired up to date, the variability and limitations of the current methods used to estimate antioxidant effects, and multiple comparisons between EOs obtained from different genera, species, and plant parts, as well as potential applications and future directions of research and utilization of essential oils derived from Pinaceae species.

Carlos Risco-Risco, César Henriquez-Camacho, Marta Herrera-Rueda et al.

Background: This study aims to assess the effectiveness and safety of cefiderocol in treating severe infections caused by multidrug-resistant Gram-negative bacteria (MDR-GNB) in critically ill patients, particularly those in intensive care units (ICUs). Methods: A meta-analysis of studies, including randomized clinical trials and observational studies in adult patients, was performed. Studies with at least 50% of critically ill patients were included. Studies with small sample size or without comparison groups were excluded. Sources included PubMed, Scopus, or Google Scholar, up to 14 August 2024. Risk of bias was assessed according to the Cochrane tool. The main outcome examined was 30-day mortality, while secondary outcomes assessed included clinical cure rates and adverse effects. Results were expressed with odds ratios. No funding was received for this study. It was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with reference CRD42024563041. Results: eight studies, with 1339 patients were included in the meta-analysis. Cefiderocol treatment was associated with a lower 30-day mortality rate than other available therapies (pooled OR 0.47; 95% CI: 0.23–0.97, <i>p</i> = 0.04), particularly in cases of carbapenem-resistant <i>A. baumannii</i> infections (pooled OR 0.29; 95% CI: 0.14–0.60, <i>p</i> < 0.001). Although there was a non-significant trend toward higher clinical cure rates in the cefiderocol group (OR 1.59; 95% CI: 0.96–2.62, <i>p</i> = 0.07), the drug demonstrated at least non-inferiority when compared to other treatment options. Study limitations included moderate heterogeneity between studies, and a high risk of bias in non-RCT studies. (Five cohort studies were included). Another limitation is that five of the eight studies compared cefiderocol versus colistine, an antibiotic with known toxicity. Conclusions: The findings suggest that cefiderocol is a promising therapeutic option for managing severe MDR-GNB infections in critically ill patients, offering a potential global benefit on mortality and at least non-inferiority in the cure rate when compared with other therapies.

B. Patwardhan, A. Vaidya, M. Chorghade

P. Sandner, D. Zimmer, G. Todd Milne et al.

When Furchgott, Murad, and Ignarro were honored with the Nobel prize for the identification of nitric oxide (NO) in 1998, the therapeutic implications of this discovery could not be fully anticipated. This was due to the fact that available therapeutics like NO donors did not allow a constant and long-lasting cyclic guanylyl monophosphate (cGMP) stimulation and had a narrow therapeutic window. Now, 20 years later, the stimulator of soluble guanylate cyclase (sGC), riociguat, is on the market and is the only drug approved for the treatment of two forms of pulmonary hypertension (PAH/CTEPH), and a variety of other sGC stimulators and sGC activators are in preclinical and clinical development for additional indications. The discovery of sGC stimulators and sGC activators is a milestone in the field of NO/sGC/cGMP pharmacology. The sGC stimulators and sGC activators bind directly to reduced, heme-containing and oxidized, heme-free sGC, respectively, which results in an increase in cGMP production. The action of sGC stimulators at the heme-containing enzyme is independent of NO but is enhanced in the presence of NO whereas the sGC activators interact with the heme-free form of sGC. These highly innovative pharmacological principles of sGC stimulation and activation seem to have a very broad therapeutic potential. Therefore, in both academia and industry, intensive research and development efforts have been undertaken to fully exploit the therapeutic benefit of these new compound classes. Here we summarize the discovery of sGC stimulators and sGC activators and the current developments in both compound classes, including the mode of action, the chemical structures, and the genesis of the terminology and nomenclature. In addition, preclinical studies exploring multiple aspects of their in vitro, ex vivo, and in vivo pharmacology are reviewed, providing an overview of multiple potential applications. Finally, the clinical developments, investigating the treatment potential of these compounds in various diseases like heart failure, diabetic kidney disease, fibrotic diseases, and hypertension, are reported. In summary, sGC stimulators and sGC activators have a unique mode of action with a broad treatment potential in cardiovascular diseases and beyond.

Georgia Watt, T. Karl

Alzheimer's disease (AD) is a debilitating neurodegenerative disease that is affecting an increasing number of people. It is characterized by the accumulation of amyloid-β and tau hyperphosphorylation as well as neuroinflammation and oxidative stress. Current AD treatments do not stop or reverse the disease progression, highlighting the need for new, more effective therapeutics. Cannabidiol (CBD) is a non-psychoactive phytocannabinoid that has demonstrated neuroprotective, anti-inflammatory and antioxidant properties in vitro. Thus, it is investigated as a potential multifunctional treatment option for AD. Here, we summarize the current status quo of in vivo effects of CBD in established pharmacological and transgenic animal models for AD. The studies demonstrate the ability of CBD to reduce reactive gliosis and the neuroinflammatory response as well as to promote neurogenesis. Importantly, CBD also reverses and prevents the development of cognitive deficits in AD rodent models. Interestingly, combination therapies of CBD and Δ9-tetrahydrocannabinol (THC), the main active ingredient of cannabis sativa, show that CBD can antagonize the psychoactive effects associated with THC and possibly mediate greater therapeutic benefits than either phytocannabinoid alone. The studies provide “proof of principle” that CBD and possibly CBD-THC combinations are valid candidates for novel AD therapies. Further investigations should address the long-term potential of CBD and evaluate mechanisms involved in the therapeutic effects described.

Musadiq A. Bhat, Abolghasem Esmaeili, Elena Neumann et al.

GABAB receptors control neuronal excitability via slow and prolonged inhibition in the central nervous system. One important function of GABAB receptors under physiological condition is to prevent neurons from shifting into an overexcitation state which can lead to excitotoxic death. However, under ischemic conditions, GABAB receptors are downregulated, fostering over-excitation and excitotoxicity. One mechanism downregulating GABAB receptors is mediated via the interaction with the endoplasmic reticulum (ER) stress-induced transcription factor CHOP. In this study, we investigated the hypothesis that preventing the interaction of CHOP with GABAB receptors after an ischemic insult restores normal expression of GABAB receptors and reduces neuronal death. For this, we designed an interfering peptide (R2-Pep) that restored the CHOP-induced downregulation of cell surface GABAB receptors in cultured cortical neurons subjected to oxygen and glucose deprivation (OGD). Administration of R2-Pep after OGD restored normal cell surface expression of GABAB receptors as well as GABAB receptor-mediated inhibition. As a result, R2-Pep reduced enhanced neuronal activity and inhibited progressive neuronal death in OGD stressed cultures. Thus, targeting diseases relevant protein-protein interactions might be a promising strategy for developing highly specific novel therapeutics.

Stephanie Pepin, Jean-François Nicolas, Henryk Szymanski et al.

A quadrivalent high-dose inactivated influenza vaccine (IIV4-HD) is licensed for adults ≥65 y of age based on immunogenicity and efficacy studies. However, IIV4-HD has not been evaluated in adults aged 60–64 y. This study compared immunogenicity and safety of IIV4-HD with a standard-dose quadrivalent influenza vaccine (IIV4-SD) in adults aged ≥60 y. This Phase III, randomized, modified double-blind, active-controlled study enrolled 1,528 participants aged ≥60 y, randomized 1:1 to a single injection of IIV4-HD or IIV4-SD. Hemagglutination inhibition (HAI) geometric mean titers (GMTs) were measured at baseline and D 28 and seroconversion assessed. Safety was described for 180 d after vaccination. The primary immunogenicity objective was superiority of IIV4-HD versus IIV4-SD, for all four influenza strains 28 d post vaccination in participants aged 60–64 and ≥65 y. IIV4-HD induced a superior immune response versus IIV4-SD in terms of GMTs in participants aged 60–64 y and those aged ≥65 y for all four influenza strains. IIV4-HD induced higher GMTs in those aged 60–64 y than those aged ≥65 y. Seroconversion rates were higher for IIV4-HD versus IIV4-SD in each age-group for all influenza strains. Both vaccines were well tolerated in participants ≥60 y of age, with no safety concerns identified. More solicited reactions were reported with IIV4-HD than with IIV4-SD. IIV4-HD provided superior immunogenicity versus IIV4-SD and was well tolerated in adults aged ≥60 y. IIV4-HD is assumed to offer improved protection against influenza compared with IIV4-SD in adults aged ≥60 y, as was previously assessed for adults aged ≥65 y.

Li Q, Liang Y, Liu Z et al.

Qinghuan Li,1,&ast; Yi Liang,1,&ast; Zeng Liu,2 Chuanyun Yu1 1Oncology Radiotherapy Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, 441021, People’s Republic of China; 2Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, 441021, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chuanyun Yu Tel/Fax +86-710-2813559Email yuchuanyunxy@163.comZeng Liu Email liu8901@126.comBackground: Head and neck squamous cell carcinoma (HNSCC) ranks the sixth most common cancer worldwide. This study aims to evaluate the associations of GWAS-identified HNSCC risk loci with progression, efficacy and toxicity of radiotherapy of HNSCC treated with radiotherapy.Methods: Six GWAS-identified risk loci were genotyped and evaluated. Multivariate logistic regression was used to determine the associations of these SNPs with progression, efficacy and toxicity of radiotherapy of HNSCC treated with radiotherapy.Results: We found that rs259919 was significantly associated with higher TNM stage (allele A vs G: OR=1.49; 95% CI: 1.09– 2.03; P=0.012), while rs3135001 was significantly associated with better efficacy of radiotherapy (allele T vs C: OR=1.80, 95% CIs=1.19– 2.73, P=0.005). Both SNP rs1265081 (allele A vs C: OR=1.41, 95% CIs=1.08– 1.86, P=0.012) and rs3135001 (allele T vs allele C: OR=0.53, 95% CIs=0.35– 0.79, P=0.002) were significantly associated with the occurrence of grade 3– 4 oral mucositis.Conclusion: We identified that three GWAS-identified HNSCC risk loci were significantly associated with progression, efficacy and toxicity of radiotherapy of HNSCC. Our findings strengthen the understanding of the essential role of genetic background in the progression and therapeutic effects of HNSCC.Keywords: progression, genetic, radiotherapy, HNSCC, efficacy, toxicity

Alizadeh M, Jalal M, Hamed K et al.

Mohammad Alizadeh,1,* Moludi Jalal,2 Khodaei Hamed,3 Amir Saber,2,* Sorayya Kheirouri,1 Fatemeh Pourteymour Fard Tabrizi,3 Negin Kamari2 1Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 2Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran; 3Department of Biochemistry and Diet Therapy, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran*These authors contributed equally to this workCorrespondence: Moludi JalalDepartment of Nutrition, School of Nutritional Sciences and Food Technologies, Kermanshah University of Medical Sciences, Isar Sq., Across from Farabi Hospital, Kermanshah, IranTel +98-83 37102009Fax +98-83 37102002Email jalal.moludi68@gmail.comKhodaei HamedDepartment of Biochemistry and Diet Therapy, Faculty of Nutrition, Tabriz University of Medical Sciences, Daneshgah Street, Tabriz, IranEmail hamedkhodaei@yahoo.comAbstract: The furan nucleus is found in a large number of biologically active materials. In recent years, many natural furan derivatives were isolated and their biological effects were investigated. In this review, we focused on the anti-inflammatory and antimicrobial effects of some natural furans and discussed their effects on the immune system. Our investigation revealed that furan natural derivatives have effective antioxidant activities and exert regulatory effects on various cellular activities by modifying some signaling pathways such as MAPK (mitogen-activated Protein Kinase) and PPAR-ɣ (peroxisome proliferator-activated receptor gamma). The antimicrobial activity of these natural compounds was performed through selective inhibition of microbial growth and modification of enzymes. Further studies are needed for isolation and detection of different furan derivatives from natural compounds and investigation of their precise mechanisms for revealing health beneficial effects of these compounds.Keywords: anti-inflammatory, antimicrobial, furans, benzofurans, furan natural derivatives

Cristina Proserpio, Giovanna Fia, Ginevra Bucalossi et al.

One of the food industry’s priorities is to recover byproducts and move towards more sustainable systems. Among wine-chain byproducts, unripe grapes represent a promising source of antioxidants. However, the development of new foods enriched using phenol-rich ingredients is challenging due to their sensory attributes. The aims of the present study were to (1) use phenol-rich extract from unripe grapes to enrich a model plant-based food (beetroot puree—BP); (2) evaluate consumers’ acceptance and expectations for the beetroot purée samples. The effect of information about the sustainability and pro-health activity of value-added ingredients on consumers’ responses was also investigated. Four beetroot purees with increasing concentrations of phenol extract (0–1.93 g/kg) added were evaluated by 101 participants in three tasting conditions (blind: only samples; expected: only information without tasting; real: both samples and information).Liking slightly decreased with increasing concentrations of phenol extract, even if all the samples were considered acceptable. The health and sustainability information increased the hedonic expectations, although it was not assimilated by all consumers involved. The development of new phenol-enriched foods using functional ingredients from unripe grapes is challenging. However, it is also promising, since all the samples were generally accepted by the consumers and they presented phenol levels that were stable over time and that could have positive health effects when consumed.

Pamela Nair Silva-Holguín, Simón Yobanny Reyes-López

Innovative and improved antimicrobial agents by nanotechnology are developed to control and mitigation of resistant microorganisms. Nanoparticles of metals or oxide metals be able to be toxic to bacteria, demonstrating biocidal behaviors at low concentrations. The integration of silver nanoparticles in ceramic matrices has enhanced the antimicrobial performance, resulting in the search for new composites with improved bactericidal properties. The aim of this study was to prepare and characterize hydroxyapatite-silver nanocomposite and evaluate its antimicrobial properties against various Gram-positive and negative bacteria related to drug-resistance infections. Hydroxyapatite nanopowders were produced by sol-gel and silver nanoparticles were synthesized by reduction of Ag + ions with the simple addition of gallic acid. Hydroxyapatite-silver composite (HAp-AgNPs) was prepared by adsorption of AgNPs at several concentrations. The results of UV–visible spectroscopy, dynamic light scattering, and transmission scanning electron microscopy revealed the existence of AgNPs with diameters around 6 nm. Scanning electron microscopy and energy dispersive X-ray spectroscopy corroborated the presence of silver disseminated over the surface of hydroxyapatite nanopowders. All HAp-AgNPs composites demonstrated excellent antibacterial effect even at lower silver concentration. HAp-AgNPs composites have a higher possibility for medical applications focused no the control of microorganisms with drug-resistance.

Nina V. Fedorova, Natalia V. Zhurkova, Nato D. Vashakmadze et al.

Background. Type II mucolipidosis (I-cell disease, ICD) is one of the lysosomal storage diseases. It is very rare disease; the literature describes only few cases with confirmed diagnosis of mucolipidosis. Cardiovascular changes in children with such pathology are even less often. Clinical case description. The article describes the clinical case of type II mucolipidosis alongside with cardiovascular pathology — valvular heart apparatus defect with abdominal aortic hypoplasia and reversible myocardial dysfunction on the therapy of chronic heart failure (CHF). The patient has coarse face, gingival hyperplasia, macroglossia, dysostosis multiplex, diffuse muscular hypotonia, and mass of subcutaneous tissue. Arterial hypertension, heart cavities dilatation, left ventricular (LV) walls hypertrophy, and data of CT aortography let us to diagnosis abdominal aortic hypoplasia. Conclusion. Cardiovascular malformation in patients with mucolipidosis leads to severe, life-threatening conditions development. Untimely diagnosis can worsen the course of disease. Multidisciplinary approach is needed for the patient management.

Okukwe C. Obode, Abiodun H. Adebayo, Chunyang Li

Context: Phoenix dactylifera (PD) is a medicinal plant reportedly used in folklore for hypertension management. Scientific validation for its use as an antihypertensive agent is scanty. Aims: To investigate the bioactive compounds present in extract and differential solvent fractions, and the in vitro inhibitory effect of PD on the activities of key enzymes associated with hypertension. Methods: Ethanol and differential solvent (ethyl acetate, butanol and water) fractions of PD were prepared using established methods and were thereafter used for the enzyme inhibition assays, which includes: angiotensin-converting enzyme (ACE), acetylcholinesterase (AChE), phosphodiesterase-5 (PDE-5), adenosine deaminase (ADA) and arginase. Gas chromatography-mass spectrometry was used to evaluate bioactive compounds present in the extracts and fractions. Results: Preliminary phytochemical evaluations revealed the presence of tannins, flavonoids, betacyanins and phenols in all solvent fractions. Some of the compounds detected in P. dactylifera that have been implicated in hypertension management include squalene, lauric acid, palmitic acid, caprate, stearate, vitamin E, β-sitosterol, phytol, linolenic acid, isosorbide, coumarins and taurine. Furthermore, all except the aqueous fraction exerted significantly (p<0.05) higher ACE inhibition than the control drug (lisinopril). Also, the ethanol, butanol, and aqueous fractions exerted significantly (p<0.05) higher inhibition of PDE-5 than the control drug (sildenafil). However, the aqueous fraction exhibited the highest PDE-5 and AChE inhibition at 86.99 ± 0.10 and 91.81 ± 1.20%, respectively. Also, the aqueous fraction had the highest inhibitory effect on ADA (82.87 ± 4.32%). Conclusions: These findings, therefore, justify the use of P. dactylifera as an antihypertensive agent in the folklore medicine.

Chiara B. M. Platania, Annamaria Fidilio, Francesca Lazzara et al.

Diabetic retinopathy (DR), a secondary complication of diabetes, is a leading cause of irreversible blindness accounting for 5% of world blindness cases in working age. Oxidative stress and inflammation are considered causes of DR. Curcumin, a product with anti-oxidant and anti-inflammatory properties, is currently proposed as oral supplementation therapy for retinal degenerative diseases, including DR. In this study we predicted the pharmacodynamic profile of curcumin through an in silico approach. Furthermore, we tested the anti-oxidant and anti-inflammatory activity of curcumin on human retinal pigmented epithelial cells exposed to oxidative stress, human retinal endothelial and human retinal pericytes (HRPCs) cultured with high glucose. Because currently marketed curcumin nutraceutical products have not been so far evaluated for their ocular bioavailability; we assessed retinal distribution of curcumin, following oral administration, in rabbit eye. Curcumin (10 μM) decreased significantly (p &lt; 0.01) ROS concentration and TNF-α release in retinal pigmented epithelial cells and retinal endothelial cells, respectively. The same curcumin concentration significantly (p &lt; 0.01) protected retinal pericytes from high glucose damage as assessed by cell viability and LDH release. Among the tested formulations, only that containing a hydrophilic carrier provided therapeutic levels of curcumin in rabbit retina. In conclusion, our data suggest that curcumin, when properly formulated, may be of value in clinical practice to manage retinal diseases.

Xinyue Liang, Junlian Gu, Dehai Yu et al.

Hormesis and adaptive responses are 2 important biological effects of low-dose ionizing radiation (LDR). In normal tissue, LDR induces hormesis as evinced by increased cell proliferation; however, whether LDR also increases tumor cell proliferation needs to be investigated. In this study, cell proliferation was assayed by total cell numbers and the Cell Counting Kit 8 assay. Mitogen-activated protein kinases (MAPK)/extracellular signal-regulated kinase (ERK) and phosphatidylinositol 3′ -kinase( PI3K )- Akt (PI3K/AKT) phosphorylation were determined by Western blot analysis. Human embryonic lung fibroblast 2BS and lung cancer NCI-H446 cell lines were irradiated with LDR at different doses (20-100 mGy). In response to 20 to 75 mGy X-rays, cell proliferation was significantly increased in 2BS but not in NCI-H446 cells. In 2BS cells, LDR at 20 to 75 mGy also stimulated phosphorylation of MAPK/ERK pathway proteins including ERK, MEK, and Raf and of the PI3K/AKT pathway protein AKT. To test whether ERK1/2 and AKT pathway activation was involved in the stimulation of cell proliferation in 2BS cells, the MAPK/ERK and PI3K/AKT pathways were inhibited using their specific inhibitors, U0126 and LY294002. U0126 decreased the phosphorylation of ERK1/2, and LY294002 decreased the phosphorylation of AKT; each could significantly inhibit LDR-induced 2BS cell proliferation. However, LDR did not stimulate these kinases, and kinase inhibitors also did not affect cell proliferation in the NCI-H446 cells. These results suggest that LDR stimulates cell proliferation via the activation of both MAPK/ERK and PI3K/AKT signaling pathways in 2BS but not in NCI-H446 cells. This finding implies the potential for applying LDR to protect normal tissues from radiotherapy without diminishing the efficacy of tumor therapy.

Louis S. Goodman, Alfred Gilman, G. Koelle

Yao-Wen Zhang, Qing Li, Chun-Xiao Lv et al.

A rapid, simple and practical high-performance liquid chromatography method coupled with diode array detector (HPLC–DAD) was developed to evaluate the quality of Alisma orientale (Sam.) Juz. through a simultaneous determination of four major active triterpenes using a single standard to determine the multi-components (SSDMCs). Alisol B 23-acetate was selected as the reference compound for calculating the relative response factors. All calibration curves showed good linearity (R2>0.9998) within test ranges. RSDs for intra- and inter-day of four analytes were less than 3.6% and 2.3%; the overall recovery was 92.1–110.2% (SSDMC). The proposed method was successfully applied to quantify the four components in 20 samples from different localities in China. Moreover, significant variations were demonstrated in the content of these compounds. In addition, hierarchical clustering analysis (HCA) and principal components analysis (PCA) were performed to differentiate and classify the samples based on the contents of Alisol C 23-acetate, Alisol A, Alisol A 24-acetate and Alisol B 23-acetate. This simple, rapid, low-cost and reliable HPLC–DAD method using SSDMC is suitable for routine quantitative analysis and quality control of A. orientale (Sam.) Juz. Keywords: SSDMC, Alisma orientale (Sam.) Juz, Quality control, HCA, PCA

Maryam Faraeen, Bahman Alizadeh, Mirhojat Mousavinejad

چکیده مقدمه:   بیماری مالتیپل اسکلروسیس (MS)یکی از شایع ترین بیماری های سیستم اعصاب مرکزی است که در اثر تخریب غلاف میلین ایجاد می شود. ام اس باعث تخریب میلین اعصاب مرکزی می شود که می تواند موجب ایجاد اشکال در انتقال پتانسیل عمل در زمانی شود که سیستم عصبی مرکزی قصد دارد با بدن ارتباط برقرار کند و بر عکس.  هدف این تحقیق تاثیر شش هفته تمرین منتخب تعادلی بر سرعت راه رفتن و تعادل بیماران مبتلا به ام اس بود.  مواد و روشها: در این تحقیق  30 بیمار مبتلاء به ام اس با ناتوانی کم تا متوسط ، بر اساس مقیاس ناتوانی کورتزکی، انتخاب  و پس از انجام آزمون تعادلی برگ به دو گروه تجربی (15نفر) و کنترل (15نفر) تقسیم  شدند .سپس از هر دو گروه آزمون سرعت راه رفتن به عمل آمد. گروه تجربی سه روز در هفته به انجام تمرینات تعادلی منتخب می پرداخت و گروه کنترل به فعالیت های روزانه خود  ادامه می داد. در پایان از هر دو گروه آزمون سرعت راه رفتن و تعادل به عمل آمد. از آزمون  tمستقل جهت تجزیه وتحلیل داده ها استفاده شد .سطح معناداری 05/0 در نظر گرفته شد . يافته ها: نتیجه این تحقیق نشان داد که تمرینات تعادلی در بهبود تعادل و سرعت راه رفتن بیماران ام اس تأثیر دارد . بين دو گروه تجربي و کنترل تفاوت معني داري در آزمون تعادل (23/3t=،05/0P<)و آزمون سرعت راه رفتن (44/4-t=  ،  05/0P<)  مشاهده شد.   نتيجه گيري :نتایج این تحقیق نشان داد که تمرینات تعادلی در بهبود تعادل و سرعت راه رفتن بیماران ام اس موثر بوده است. کلید واژه ها : مالتیپل اسکلروسیس، تمرینات تعادلی،تعادل، سرعت راه  رفتن.   عنوان پیشنهادی: تاثیر تمرینات تعادلی بر تعادل و سرعت راه رفتن بیماران ام اس