Abstract
BackgroundMultiple sclerosis (MS) is an inflammatory demyelinating disorder that affects the central nervous system (CNS) of females more than males. The objective of the current study was to assess serum level of prolactin (PRL) and tumor necrosis factor alpha (TNFα) in patients with relapsing remitting multiple sclerosis (RRMS) and to explore their role in disease activity.Subjects and methodsFifty females were included in this study, 40 patients with RRMS were evaluated during relapse and remission and 10 age-matched healthy subjects who served as controls. All patients were subjected to neurological evaluation including Expanded Disability Status Scale (EDSS), brain, and spine magnetic resonance image (MRI); serum PRL and TNFα levels were measured for all patients (during relapse and remission) and controls.ResultsMedian serum PRL level was significantly higher in MS patients during relapse than remission and control subjects (P = 0.041). TNFα level was significantly higher in MS patients in relapse than remission (P = 0.026) as well as the healthy controls (P = 0.001). The area under the receiver operating characteristic curve (AUROC) was analyzed for prediction of MS relapse, AUROC of serum TNFα was 0.811 and that of serum PRL was 0.678. Both serum PRL and TNFα were positively correlated in MS patients in relapse with each other (r = 0.672, P < 0.001) and also with age, EDSS, number of relapses, and MRI lesion number (P value = 0.001).ConclusionElevated serum PRL and TNFα levels are associated with relapse in MS patients. Moreover, they are positively correlated with EDSS, disease duration, and MRI lesion number.
Highlights
Multiple sclerosis (MS) is a chronic autoimmune disorder of the central nervous system (CNS)
The area under the receiver operating characteristic curve (AUROC) was analyzed for prediction of MS relapse, AUROC of serum Tumor necrosis factor alpha (TNFα) was 0.811 and that of serum PRL was 0.678. Both serum PRL and TNFα were positively correlated in MS patients in relapse with each other (r = 0.672, P < 0.001) and with age, Expanded Disability Status Scale (EDSS), number of relapses, and magnetic resonance image (MRI) lesion number (P value = 0.001)
Elevated serum PRL and TNFα levels are associated with relapse in MS patients
Summary
Multiple sclerosis (MS) is a chronic autoimmune disorder of the central nervous system (CNS). The Pregnancy in Multiple Sclerosis (PRIMS) study showed that MS relapse rates increase in the first 3 months postpartum [4], which is thought to be driven by rapid drop of estrogen and progesterone levels and the elevated levels of hormones involved in breastfeeding during that period [3]. Human PRL gene is located on the short arm of chromosome 6, near the HLADRB1 region and tumor necrosis factor alpha (TNFα) which are involved in PRL gene expression [6]. Multiple sclerosis (MS) is an inflammatory demyelinating disorder that affects the central nervous system (CNS) of females more than males. The objective of the current study was to assess serum level of prolactin (PRL) and tumor necrosis factor alpha (TNFα) in patients with relapsing remitting multiple sclerosis (RRMS) and to explore their role in disease activity
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