Abstract
Background and aim: Multiple sclerosis (MS) is a chronic inflammatory disease accompanied with lower quality of life due to disabling symptoms such as depression and fatigue. The pathologic basis of such symptoms is still unknown. This study was performed to assess pro-inflammatory and anti-inflammatory cytokine levels as well as oxidative stress (OS) biomarkers in MS patients with and without fatigue and depression in the remission course of disease. Material and methods: Forty eight patients with a definite diagnosis of relapsing –remitting MS were studied. All the patients have not experienced relapses at least for 6 months. We scored Expanded Disability Status Scale (EDSS) as well as the Beck depression inventory (BDI) questionnaire and Fatigue severity scale (FSS) to assess depressionrelated symptoms and fatigue severity in the participants, respectively. Furthermore, we analyzed fasting blood samples to determine serum TNF-α, IL-4, IL-6, TGF-β, INF-γ and MMP-9 levels as well as OS parameters including serum superoxide dismutase (SOD) and glutathione peroxidase (GPx) activity, total antioxidant capacity (TAC) and malondialdehyde (MDA). Results: No significant differences were observed in the levels of inflammatory and OS biomarkers in depressed and non-depressed MS patients. The same was noted for fatigued and non-fatigued patients. However, the EDSS score for fatigued and depressed patients was higher than the control group. Conclusion: Our study results indicated that the activation of inflammatory pass ways or OS stress cannot be regarded as the primary cause of depression and fatigue in MS patients with mild disability. This is the first report to assess the primary pathogenesis of fatigue and depression in MS patients.
Highlights
Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease which is associated with disabling symptoms and lower quality of life in the affected patients
Our study results indicated that the activation of inflammatory pass ways or oxidative stress (OS) stress cannot be regarded as the primary cause of depression and fatigue in MS patients with mild disability
This is the first report to assess the primary pathogenesis of fatigue and depression in MS patients
Summary
Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease which is associated with disabling symptoms and lower quality of life in the affected patients. Depression can affect the relationships and patients’ adaption with disease modifying treatments [2]. MS related depression feeds back to changes in neuroimmunology, neurophsycology, neurocytology aspects of disease and possibly to other variables as well, including fatigue, cognitive dysfunction, pain, social support, psychosocial factors, negative life events and stress [3]. Multiple sclerosis (MS) is a chronic inflammatory disease accompanied with lower quality of life due to disabling symptoms such as depression and fatigue. This study was performed to assess pro-inflammatory and anti-inflammatory cytokine levels as well as oxidative stress (OS) biomarkers in MS patients with and without fatigue and depression in the remission course of disease
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