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Serum inflammatory markers in patients with multiple sclerosis and their association with clinical manifestations and MRI findings

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Abstract

Inflammation in a myelinated portion of the nervous system is the mainstay of multiple sclerosis (MS). Elevation of inflammatory markers such as procalcitonin, ESR and hs-CRP is suspected to occur in MS patients. However, their prognostic role and their relationship with the severity of clinical symptoms of MS and MRI evidences has remained unnoticed in the literature. Hence, we aim to evaluate the serum level of inflammatory markers in the acute attack of MS patients and demonstrate the potential prognostic role of these inflammatory markers. This study was carried on case and control groups of definite MS patients. The cases were patients with active MS and were further allocated into four subgroups, while as control group included patients with non-active MS. Furthermore, all the participants underwent brain and cervical magnetic resonance imaging (MRI) using a contrast agent. A significant difference was detected in hs-CRP level (p = 0.009) across the subgroups of the cases. The highest level of hs-CRP was reported in patients with cerebellar and brain stem symptoms (mean = 6998.13 ± 3501.16), while the lowest in patients with pyramidal and urinary incontinence symptoms (mean = 1958.91 ± 2662.16). Moreover, correlation coefficient between values of MRI contrast-enhanced lesions and ESR level was statistically significant (Rs = 0.503 and p = 0.001). Elevation of ESR serum level positively correlates with disease activity evidenced by values of contrast-enhanced plaques of MRI in relapsing–remitting MS patients which may predict the disease activity. In addition, MS relapse with cerebellar and brain stem symptoms is associated with a high concentration of hs-CRP plasma level.

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References

  1. Absinta M, Vuolo L, Rao A, Nair G, Sati P, Cortese IC et al (2015) Gadolinium-based MRI characterization of leptomeningeal inflammation in multiple sclerosis. Neurology 85(1):18–28

    Article  CAS  Google Scholar 

  2. Bergamaschi R, Monti MC, Trivelli L, Introcaso VP, Mallucci G, Borrelli P et al (2019) Increased prevalence of multiple sclerosis and clusters of different disease risk in Northern Italy. Neurol Sci 41:1–7

    Google Scholar 

  3. Hashemi R, Hosseini-Asl SS, Arefhosseini SR, Morshedi M (2020) The impact of vitamin D3 intake on inflammatory markers in multiple sclerosis patients and their first-degree relatives. PLoS ONE 15(4):e0231145

    Article  CAS  Google Scholar 

  4. Debouverie M, Pittion-Vouyovitch S, Louis S, Guillemin F, Group L (2008) Natural history of multiple sclerosis in a population-based cohort. Eur J Neurol 15(9):916–921

    Article  Google Scholar 

  5. Aksungar FB, Topkaya AE, Yildiz Z, Sahin S, Turk U (2008) Coagulation status and biochemical and inflammatory markers in multiple sclerosis. J Clin Neurosci 15(4):393–397

    Article  CAS  Google Scholar 

  6. Nikseresht A, Salehi H, Foroughi AA, Nazeri M (2016) Association between urinary symptoms and urinary tract infection in patients with multiple sclerosis. Glob J Health Sci 8(4):253

    Article  Google Scholar 

  7. Holmøy T, Løken-Amsrud KI, Bakke SJ, Beiske AG, Bjerve KS, Hovdal H et al (2013) Inflammation markers in multiple sclerosis: CXCL16 reflects and may also predict disease activity. PLoS ONE 8(9):e54417

    Article  Google Scholar 

  8. McQualter JL, Bernard CC (2007) Multiple sclerosis: a battle between destruction and repair. J Neurochem 100(2):295–306

    Article  CAS  Google Scholar 

  9. Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G et al (2018) Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 17(2):162–173

    Article  Google Scholar 

  10. Doğan HO, Yildiz ÖK (2019) Serum NADPH oxidase concentrations and the associations with iron metabolism in relapsing remitting multiple sclerosis. J Trace Elem Med Biol 55:39–43

    Article  Google Scholar 

  11. Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ et al (2014) Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology 83(3):278–286

    Article  Google Scholar 

  12. Foroughi AA, Zare N, Saeedi-Moghadam M, Zeinali-Rafsanjani B, Nazeri M (2021) Correlation between contrast enhanced plaques and plaque diffusion restriction and their signal intensities in FLAIR images in patients who admitted with acute symptoms of multiple sclerosis. J Med Imag Radiat Sci

  13. Filippi M, Brück W, Chard D, Fazekas F, Geurts JJ, Enzinger C et al (2019) Association between pathological and MRI findings in multiple sclerosis. Lancet Neurol 18(2):198–210

    Article  Google Scholar 

  14. Ömerhoca S, Akkaş SY, İçen NK (2018) Multiple sclerosis: diagnosis and differential diagnosis. Arch Neuropsych 55(Suppl 1):S1

    Google Scholar 

  15. Giovannoni G, Miller D, Losseff N, Sailer M, Lewellyn-Smith N, Thompson A et al (2001) Serum inflammatory markers and clinical/MRI markers of disease progression in multiple sclerosis. J Neurol 248(6):487–495

    Article  CAS  Google Scholar 

  16. Abolhasani Foroughi A, Salahi R, Nikseresht A, Heidari H, Nazeri M, Khorsand A (2017) Comparison of diffusion-weighted imaging and enhanced T1-weighted sequencing in patients with multiple sclerosis. Neuroradiol J 30(4):347–351

    Article  Google Scholar 

  17. Ropper AH, Samuels MA, Klein J, Prasad S (2019) Adams and Victor’s principles of neurology. McGraw-Hill Education, New York

    Google Scholar 

  18. Lublin FD, Reingold SC (1996) Defining the clinical course of multiple sclerosis: results of an international survey. Neurology 46(4):907–911

    Article  CAS  Google Scholar 

  19. Vågberg M, Axelsson M, Birgander R, Burman J, Cananau C, Forslin Y et al (2017) Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society. Acta Neurol Scand 135(1):17–24

    Article  Google Scholar 

  20. Hossain MJ, Morandi E, Tanasescu R, Frakich N, Caldano M, Onion D et al (2018) The Soluble form of toll-like receptor 2 is elevated in serum of multiple sclerosis patients: a novel potential disease biomarker. Front Immunol 9:457

    Article  Google Scholar 

  21. Farrokhi M, Jahanbani-Ardakani H, Eskandari N, Shaygannejad V, Ghafari S (2017) Cerebrospinal fluid and serum markers of inflammation in patients with multiple sclerosis. Adv Neuroimmune Biol 6(3–4):149–152

    Article  CAS  Google Scholar 

  22. Polachini C, Spanevello R, Casali E, Zanini D, Pereira L, Martins C et al (2014) Alterations in the cholinesterase and adenosine deaminase activities and inflammation biomarker levels in patients with multiple sclerosis. Neuroscience 266:266–274

    Article  CAS  Google Scholar 

  23. Oliveira SR, Kallaur AP, Reiche EM, Kaimen-Maciel DR, Panis C, Lozovoy MAB et al (2017) Albumin and protein oxidation are predictors that differentiate relapsing-remitting from progressive clinical forms of multiple sclerosis. Mol Neurobiol 54(4):2961–2968

    Article  CAS  Google Scholar 

  24. Abolhasani Foroughi A, Saeedi-Moghadam M, Zeinali-Rafsanjani B, Nazeri M (2018) Comparison between T2, STIR and PSIR sequences, for detection of cervical cord MS plaques. Iran J Radiol 16(3):e82134

    Google Scholar 

  25. Sahraian MA, Radue E-W (2007) Gadolinium enhancing lesions in multiple sclerosis. Springer, MRI Atlas of MS Lesions, pp 45–74

    Google Scholar 

  26. Campbell Z, Sahm D, Donohue K, Jamison J, Davis M, Pellicano C et al (2012) Characterizing contrast-enhancing and re-enhancing lesions in multiple sclerosis. Neurology 78(19):1493–1499

    Article  CAS  Google Scholar 

  27. Cheng C, Jiang Y, Chen X, Dai Y, Kang Z, Lu Z et al (2013) Clinical, radiographic characteristics and immunomodulating changes in neuromyelitis optica with extensive brain lesions. BMC Neurol 13(1):72

    Article  Google Scholar 

  28. Louis ED, Mayer SA, Rowland LP (2016) Merritt's neurology. p 607

Download references

Acknowledgements

The present article was extracted from the MD dissertation of Hanie Bazrafshan (Thesis No. 97-01-94-18346). The authors wish to thank Mr. H. Argasi at the Research Consultation Center (RCC) of Shiraz University of Medical Sciences for his invaluable assistance in editing this manuscript.

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Correspondence to Amin Abolhasani Foroughi.

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Nazeri, M., Bazrafshan, H. & Abolhasani Foroughi, A. Serum inflammatory markers in patients with multiple sclerosis and their association with clinical manifestations and MRI findings. Acta Neurol Belg 122, 1187–1193 (2022). https://doi.org/10.1007/s13760-021-01647-9

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