Abstract
Objective: Multiple Sclerosis is an inflammatory demyelinating disease characterized by lymphocyte infiltration and demyelination of brain tissue and central nervous system.
 Materials and Methods: This study aimed to evaluate the interleukin (IL-17A, IL-17F, and IL-34 cytokine) levels in the cerebrospinal fluid of Relapsing-Remitting Multiple Sclerosis (n=23), radiologically isolated syndrome (n=5) and pseudotumor cerebri (n=15) cases. In this study, lumbar puncture cerebrospinal fluid obtained from the patients who were diagnosed with Multiple Sclerosis aged between 21-55. The PTC group included patients with pseudotumor cerebri aged 28-60 years. The levels of IL-17A, IL-17F, IL-34 cytokines were determined by ELISA kit.
 Results: In this study, Among the studied cytokines in the cerebrospinal fluid samples of the patients, median (min-max) values of IL-17A for the Demyelinated group and pseudotumor cerebri group were 50 (7-257) pg/ml and 2 (1-6) pg/ml respectively, a statistically significant difference (p<0.01) has been observed in between the two groups. Median (min-max) values of IL-17F for the Demyelinated group and pseudotumor cerebri group were 32 (6-891) pg/ml and 2 (1-3) pg/ml respectively, a statistically significant difference (p<0.01) has been observed between the two groups. Median (min-max) values of IL-34 for Demyelinated group and pseudotumor cerebri group were 16 (4-197) pg/ml and 2 (1-11) pg/ml respectively, a statistically significant difference (p<0.01) has been observed in between the two groups (Lower limit for the cytokine values have been determined as IL-17A: 3,93 pg/ml, IL-17F: 2,23 pg/ml, IL-34: 3,12 pg/ml). IL-34, was found to be high in Multiple sclerosis patients. This is important for the cerebral endothelial reaction in Multiple sclerosis.
 Conclusion: The high levels of IL-34 in cerebrospinal fluid samples suggest that it may be a new treatment strategy and an adjunct cytokine in the diagnosis of neuroinflammatory and neurodegenerative diseases such as multiple sclerosis and demyelinating disease. More extensive studies are needed to determine whether IL-34 can be a marker in the return of the disease from radiologically isolated syndrome to clinical MS.
Highlights
Multiple Sclerosis (MS) is an autoimmune and disease of the central nervous system (CNS) and may reveal itself with chronicle, inflammatory, episodic neurological deficits, as well as with a neuroanatomic localization [1,2]
Median values of IL-34 for Demyelinated group and pseudotumor cerebri group were 16 (4-197) pg/ml and 2 (1-11) pg/ml respectively, a statistically significant difference (p
IL-34, was found to be high in Multiple sclerosis patients. This is important for the cerebral endothelial reaction in Multiple sclerosis
Summary
Multiple Sclerosis (MS) is an autoimmune and disease of the central nervous system (CNS) and may reveal itself with chronicle, inflammatory, episodic neurological deficits, as well as with a neuroanatomic localization [1,2]. Oftentimes, neurological deficits and damages occur that get worse in time and result in the development of secondary progressive multiple sclerosis (SPMS) [3]. While evaluating the diagnostic criteria for MS, clinical and magnetic resonance (MR) findings play an important role in differentiating the MS cases from all other diseases. Apart from these, studies on cerebrospinal fluid (CSF) are in progress [5]. CSF, evaluation of oligoclonal bands (OCBs) pointing to immunoglobulin G (IgG) index sensitivity of 95% and specificity above 80% are among the preferred methods [6]
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