2. Multiple Sclerosis patients treated with Apitherapy: Immunological pattern Ahmad G. Hegazi, Khaled Al-Menabbawy, Mona Ganem, Samira Shawky, Eman H. Abdel-Rahman and Suzette I. Helal, National Research Center, Dokki, Giza, Egypt ahmed@ahmedhegazi com and ahmedhegazi128@gmail.com www.ahmedhegazi.c om

3. Special thanks to Scientific Committee of the THE 2nd INTERNATIONAL CONFERENCE ON QUALITY MEDICATION IN PROPHETIC MEDICINE King Abdulaziz University April 5-7, 2016 Jeddah, KSA Novel treatment of localized plaque psoriasis by some bee products Multiple Sclerosis patients treated with Apitherapy: Immunological pattern

6. Definition: Multiple Sclerosis ( MS ): Is a chronic disease characterized by Multiple Sclerosis ( MS ): Is a chronic disease characterized by multiple areas of central nervous system ( CNS ) multiple areas of central nervous system ( CNS ) white matter inflammation white matter inflammation demyelination, demyelination, sclerosis sclerosis it usually begins in young adults. it usually begins in young adults.

7. Multiple Sclerosis ( MS ): Multiple Sclerosis ( MS ): Also known as disseminated sclerosis or encephalomyelitis disseminata). myelin axons It is a disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, demyelination leading to demyelination and scarring as well as a broad spectrum of signs and symptoms

8. onset usually occurs in young adults, it is more common in females. It has a prevalence that ranges between 2 and 150 per 100,000. Multiple Sclerosis Society four subtype definitions: Multiple Sclerosis Society standardized four subtype definitions:

9. relapsing remitting, secondary progressive, primary progressive, progressive relapsing.

10. Signs & Symptoms : The person with MS can suffer almost any neurological symptom or sign, including: changes in sensation, muscle weakness, difficulty in moving; difficulties with coordination and balance spasm,

11. problems in speech or swallowing, visual problems, fatigue, pain bladder and bowel difficulties. Cognitive impairment of varying degrees emotional symptoms of depression or unstable mood are also common. Signs & Symptoms :

12. Causes Of MS : Most likely MS occurs as a result Genetics: Environmental factors Infections

13. Radiological Findings

18. Ninety patients with MS, ages ranged between 26-71 years, subjected to complete clinical and neurological history and examination to confirm the diagnosis.

19. All cases were under their regular treatment either by corticosteroids, or interferon. These cases were divided into two main groups, each group consists of 45 cases (15 males and 30 females)

20. Group I received honey, pollen, royal jelly and propolis treated with bee acupuncture 3 times weekly, for 12 months,

21. started gradually by one sting then gradually increase up to 25 stings per session, in addition to their medical treatment

22. Apiacupuncture was done by bee stings for regulating the immune system.

23. Bee acupuncture points

24. Du 14

25. Du 13

26. LI11

27. SP6

28. SP 9

29. ST 36

30. points for MS Pat Wagner Buttocks Jiagi points for cervical area and lumber area vision points

31. GB2 Auditory Convergence GB2

32. LIV3

33. Group II remains on their ordinary medical treatment only.

34. All cases were subjected to complete clinical neurological history examination to confirm the diagnosis.

35. All patients were instructed to receive 2000-3000 mg Vitamin C, 15 mg Vit. B1, 3 mg Vit. B2, 2mg Vit. B6, 5 mg Vit. B12,

36. 25 mg Folic acid, 3 mg Calcium pantothenate, 15mg Nicotinamide, 20 mg L- Arginine, 20 mg L- Lysine and 3 mcg Biotin / day.

37. Serum samples were obtained from patients with clinically definite MS for estimation of serum levels of immunoglobulin E (Hirano et al., 1989)Hirano using commercially available ELISA kits according to the manufacturers' directions.

38. . IFN-γ, interleukin (IL) 1β, IL-4, IL-6, IL-10, tumor necrosis factor alpha (TNFα) were detected. Serum cytokine levels

39. were assessed using enzyme inked ‑ immunosorbent assays (Abrams, 1995) using commercially available ELISA kits according to the manufacturers' directions (kits produced by Bender Med System, Vienna, Austria). Serum cytokine levels

40. All these investigations were done at the beginning of the study and by the end of one year of supplementation and bee sting sessions

42. We found that 8 patients out of 12 (paraparesis cases), showed some improvement regarding their defects in gait, bowel control, constipation and urination,

43. while 12 cases out of 16 cases ( quadriparesis cases), showed some mild improvement in their movement in bed, and better improvement in bed sores, sensation, and better motor power, only two cases of them ( 12.5% ) were able to stand for few minutes with support.

44. Symptoms Score Improvement Recorded Every Two Months (1-12):

64. Immunological Pattern

65. Mean levels of IgE of both groups at the start and end of the study

66. Mean levels of (TNF) α of both groups at the start and end of the study

67. Mean levels of (IL) 1β of both groups at the start and end of the study

68. Mean levels of IL-6 of both groups at the start and end of the study

69. Mean levels of (IL 4) of both groups at the start and end of the study

70. Mean levels of IL-10 of both groups at the start and end of the study

72. Although Apitherapy is not a curable therapy in MS, but it can be used to minimize some of the clinical symptoms of MS, and can be included among programs of MS therapy.

74. ” سَنُرِيهِمْ آيَاتِنَا فِي الاَفَاقِ وَفِيَ أَنفُسِهِمْ ” سَنُرِيهِمْ آيَاتِنَا فِي الاَفَاقِ وَفِيَ أَنفُسِهِمْ حَتّىَ يَتَبَيّنَ لَهُمْ أَنّهُ الْحَقّ أَوَلَمْ يَكْفِ بِرَبّكَ أَنّهُ عَلَىَ كُلّ شَيْءٍ شَهِيدٌ “ فصلت 53. حَتّىَ يَتَبَيّنَ لَهُمْ أَنّهُ الْحَقّ أَوَلَمْ يَكْفِ بِرَبّكَ أَنّهُ عَلَىَ كُلّ شَيْءٍ شَهِيدٌ “ فصلت 53.

76. Multiple Sclerosis patients treated with Apitherapy: Immunological pattern

77. Thank you Multiple Sclerosis patients treated with Apitherapy: Immunological pattern

78. Prof. Dr. Ahmed Hegazi Professor of Microbiology and Immunology National Research Center, Dokki, Giza, Egypt President of Egyptian Environmental Society for uses and production of bee products Secretary of Egyptian Society of Apitherapy Secretary General of African Federation of Apiculture Associations Member of Apitherapy Commission, APIMONDIA E mail: ahmed@ahmedhegazi.com andahmed@ahmedhegazi.com ahmedhegazi128@gmail.com www.ahmedhegazi.com Tel: + 2023 7749222 and + 20238860682 Fax: + 202 37749222 and + 202 33370931 GMS: + 201001440063