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Published on: December 9, 2015
Evaluation of oxidative stress and coagulation factors in MS patients throughout both relapse and remission stages
Nima Naseri1, Mohammad Hossein Harirchian2, Iraj Khodadadi1
1Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
Background:
Relapsing-remitting Multiple Sclerosis (RRMS) is characterized by inflammatory attacks on myelin. Previous studies have shown the vital role of coagulation factors, inflammation, and oxidative stress in multiple sclerosis (MS). Hence, changes in these factors in relapse occurrence could propose novel therapeutic and diagnostic targets.The blood samples were collected during relapse status. Then, patients were followed up for three months with no difference in disease modifying treatments (DMTs)-naive status, and the second blood samples were collected in the remission phase.
Methods:
The coagulation factors were measured in 24 RRMS (13F/11M) patients and 24 healthy controls (12F/12 M). Oxidative stress markers such as total oxidant status (TOS), malondialdehyde (MDA), total antioxidant capacity (TAC) and inflammatory biomarkers such as IL-6, ferritin, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured in both relapse and remission phases.
Results:
The expanded disability status scale (EDSS) was considerably higher in relapse versus remission status (p = 0.001). The results indicate that d-dimer, as a coagulation marker, ferritin, CRP, ESR, MDA, and TOS are higher in relapse vs remission (p < 0.05). Besides, further analysis showed that fibrinogen, ferritin, IL-6, and TOS were significantly different in RRMS vs the control (p < 0.05). These parameters showed no significant correlation between EDSS with coagulation, inflammatory, and oxidative markers (p > 0.05).
Conclusion:
Our results showed that the levels of fibrinogen, TOS, ferritin, and IL-6 may have diagnostic efficacy in MS vs control. This study has some limitations. The first was the follow-up of RRMS candidates in relapse and remission. The second is that we did not measure the coagulation, inflammatory, and oxidative markers in the CSF sample.
Insights
Relapsing-remitting Multiple Sclerosis (RRMS) patients show elevated coagulation, inflammation, and oxidative stress markers during relapse compared to remission. These markers, including fibrinogen and ferritin, may aid in diagnosing MS.
Area of Science:
- Neurology
- Biochemistry
- Immunology
Background:
- Relapsing-remitting Multiple Sclerosis (RRMS) involves myelin damage driven by inflammation.
- Coagulation factors, inflammation, and oxidative stress are implicated in MS pathogenesis.
- Monitoring these factors during disease phases may reveal therapeutic and diagnostic targets.
Purpose of the Study:
- To investigate differences in coagulation, inflammation, and oxidative stress markers between relapse and remission phases in RRMS patients.
- To compare these markers in RRMS patients against healthy controls.
- To explore the diagnostic potential of these markers in MS.
Main Methods:
- Blood samples were collected from 24 RRMS patients during relapse and again in remission after 3 months.
- 24 healthy individuals served as controls.
- Measured markers included coagulation factors (d-dimer, fibrinogen), inflammatory markers (IL-6, ferritin, CRP, ESR), and oxidative stress markers (TOS, MDA, TAC).
Main Results:
- Expanded Disability Status Scale (EDSS) scores were higher during relapse.
- D-dimer, ferritin, CRP, ESR, MDA, and TOS were significantly elevated in relapse versus remission.
- Fibrinogen, ferritin, IL-6, and TOS were significantly higher in RRMS patients compared to controls.
Conclusions:
- Fibrinogen, TOS, ferritin, and IL-6 show potential diagnostic utility for distinguishing MS patients from controls.
- Elevated coagulation, inflammatory, and oxidative stress markers during relapse highlight their role in disease activity.
- Future studies could explore these markers in cerebrospinal fluid (CSF).
