Serum endocan levels in multiple sclerosis relapse and remission

Endocan has been defined as an important marker of inflammatory diseases, vascular and endothelial injury, tumour progression, cell adhesion and angiogenesis. In our study, we compared the serum endocan, C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR) levels of relapsing-remitting multiple sclerosis (RRMS) patients in remission and in relapse.

This study included 53 RRMS remission patients, 30 RRMS relapse/post-relapse patients and 44 healthy volunteers. Blood samples were collected once from RRMS patients in remission and from the control group, and twice from RRMS relapse patients: once when relapsing and another 1 month after relapse. The endocan, CRP and NLR levels of the RRMS patients measured while in relapse, 1 month after relapse and while in remission were compared to those of the control group. The studied parameters were compared with the disease duration, relapse frequency, Expanded Disability Status Scale (EDSS) score, applied treatment and lesion burden assessed using magnetic resonance imaging (MRI).

The endocan, CRP and NLR levels were significantly higher in the RRMS group than in the control group (p < 0.05). The serum endocan levels were found to be significantly higher in the RRMS relapse group than in the post-relapse and control groups (p < 0.05). There were no significant correlations between the disease duration, EDSS score, relapse frequency and lesion burden on MRI and the endocan, CRP and NLR values (p > 0.05). According to the correlation analysis, there was a statistically strong positive relationship between the MRI lesion localisation and the EDSS score, disease duration and relapse frequency (p < 0.001).

Endocan increase is a marker of the endothelial injury that develops secondary to the inflammatory process in MS patients. It can thus be considered a moderately good indicator of relapse.