cauda equina syndrome (CES) 36

C

able calcimimetic drug used mainly in the treatment of secondary hyperparathyroidism in patients with chronic renal disease. The calcilytics are CaSR antagonists inhibiting CaSR thereby stimulating the secretion of PTH. At present, NPS 2143 is the only repre-sentative of calcilytics. The calcilytics are re-garded as a possible future alternative for the treatment of postmenopausal osteoporosis, because of a presumed osteoformation effect due to a regular, repeated and mild increase of PTH secretion. Ca SR modulators are re-garded as prospective preparations for the treatment of disturbances of phosphate-calci-um metabolism.

Cauda Equina syndrome (CES) A poten-tially serious neurological disease causing saddle anaesthesia, bilateral weakness of the calf muscles, Achilles tendon areflexia, dys-function of the ano-vesico-genital area with impairment of sphincters and impotence, as well as polyradicular pain of lumbar and sacral nerve roots. The syndrome is most fre-quently caused by herniation of an interver-tebral disc into sacral roots of the spine, rare-ly by malignancies or by a late form of anky-losing spondylitis. Chronic compression of the cauda has an indistinct course, which can be manifested only by ano-vesicular sphinc-ters impairment and radicular pain in the lower extremities. The diagnosis of CES in patients suffering from lumbar pain requires urgent surgical intervention.

Causalgia A burning pain sensation after a painful stimulus. It is elicited by damage to the sympathetic nervous system. The sensa-tion is localised to the area of innervation of the injured nerve or its surrounding environ-ment. It is linked to autonomic changes (trophic, vascular).

CD (cluster of differentiation) The CD system is a group of surface attributes (anti-gens) on cells according to which it is possible to establish the type, the differentiation and developmental stage of the cell, or certain other characteristics

CD2 (LFA-2) This transmembrane glyco-protein is localised especially on thymocytes and adult T-lymphocytes. It is a receptor ad-sorbing sheep erythrocytes, and so creates the basis for various rosette tests for deter-mining T-cell counts. The adhesive molecule LFA-3 is a natural ligand for CD2.

CD3 This is a complex molecule composed of five polypeptide chains – members of the immunoglobulin superfamily – linked with antigen receptors of T-cells (TCR). It is a typ-ical marker for all adult T-lymphocytes. CD3 transmits the signal from TCR into the cell.

CD4 A glycoprotein belonging to the immu-noglobulin superfamily is a typical surface marker for T-helper (TH) lymphocytes. In much lower counts, it also appears on the surface of macrophages, monocytes, dendrit-ic cells, cells of Langerhans and several oth-ers. It participates in the presentation of ex-ogenous antigens by antigen-presenting cells in the form of a complex with MHC class II of HLA antigens. It serves as a receptor for HIV infection, leading to AIDS.

CD5 A single-chain glycoprotein localised on B-lymphocytes, as well as on T-lympho-cytes. B-cells can be divided into the two sub-sets CD5+ and CD5– depending on the pres-ence or absence of CD5. The CD5+-cells pro-duce natural antibodies, primarily of IgM isotype, enforcing the elimination of ill-con-ditioned or unnecessary inherent antigens and cell structures. An increased CD5+-cell count has been found in certain autoimmune disorders (juvenile diabetes mellitus, Hashim-oto’s thyroiditis, and systemic lupus erythe-matosus). The cause for the increased au-toantibody formation can be due to the fact that CD5+-cells produce IL-10, which inhib-its the activity of TH1-cells, shifting the TH1/TH2 balance towards increased activity of TH2-cells and thus increased autoantibody formation. The CD72 is the ligand for CD5.

CD8 A transmembrane glycoprotein which is a member of the immunoglobulin super-family and a typical surface sign of cytotoxic