Assessment of the serum level of lnterlukin-12 and soluble vascular adhesion molecule-1 in multiple sclerosis patients

ABSTRACT

Multiple sclerosis [MS] is a complex and heterogeneous disease, and our understanding of the disease initiation mechanism and its wide clinical variability is limited. Cytokines and leukocyte endothelial adhesion play an important role in the initiation and maintenance of the inflammatory reaction in multiple sclerosis. The present study aimed to estimate the serum levels of IL-12 [a cytokine] and sVCAM-1 [an adhesion molecule] in different MS clinical subtypes and to assess their relationship to disease activity, grade of disability and MRI findings of cerebral atrophy. The study included 53 female patients suffering from definite MS [20 relapsing-remitting in remission [RRMS in remission], 16 relapsing-remitting in relapse [RRMS in relapse], and 17 secondary progressive [SPMS]] and 15 healthy age and sex matched controls. Patients were subjected to thorough clinical evaluation, clinical grading of disability using Expanded Disability Status Scale [EDSS] and Magnetic resonance imaging [MRI] of the brain. For patients and controls, the serum levels of interleukin 12 [IL-12] and soluble vascular cell adhesion molecule-1 [sVCAM-1] were estimated. The mean serum levels of IL-12, and sVCAM-1 were significantly elevated in all MS groups compared to the control group. Significantly higher serum levels of IL-12, and sVCAM-1 were detected in SPMS versus RRMS groups [whether RRMS in relapse or in remission], and were significantly higher in RRMS in relapse versus RRMS in remission. The two biomarkers were significantly correlated to each other. Significant positive correlation was detected between mean EDSS score with mean serum levels of IL-12 and sVCAM-1. MRI signs of cerebral atrophy were detected in 17 patients, mainly from SPMS group. Patients with cerebral atrophy showed significantly higher serum levels of IL-12, and sVCAM-1 compared to patients without cerebral atrophy. Serum levels of IL-12 and sVCAM-1 are elevated in remission-relapse and progressive subtypes of MS and in MS associated with brain atrophy denoting that the inflammatory status in MS tends to persist in early and advanced stages of the disease. Immunomodulatory therapy targeting the above parameters might seem to be beneficial to delay disease progression and/or reduces lesion activity. Moreover, serum levels of IL-12, and sVCAM-1 were significantly correlated with the degree of disability induced by MS, thus suggesting their utility as reliable markers of disability in MS patients