Estimation of Serum Interleukin- 12 (IL-12), Interleukin-17(IL-17) and Soluble Vascular Cell Adhesion Molecule (s-VCAM) in Multiple Sclerosis

Document Type : Original Article

Authors

1 Department of Medical Biochemistry, Faculty of Medicine, Cairo University

2 Department of Neurology, Faculty of Medicine, Cairo University

3 Department of Radiology Faculty of Medicine, Cairo University

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 and IL-17 (cytokines) and
sVCAM (an adhesion molecule) in different MS subtypes and to assess their
relationship to disease activity, disability and MRI findings of cerebral atrophy. We
analyzed serum levels of interleukins 12 and 17 (IL-12 and IL-17) and soluble
vascular cell adhesion molecule (sVCAM) in 53 patients; 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.
For each patient the following were performed: clinical evaluation assessment of
disability using Expanded Disability Status Scale Score (EDSS) and Magnetic
resonance imaging (MRI) assessment to detect the presence of cerebral atrophy and
the extent of lesion load. Results:The mean serum levels of each of studied
biomarkers IL-12, IL-17 and sVCAM were elevated in all MS groups compared to the
control group. Significantlyhigher levels were detected in SPMS versus RRMS
groups (whether in relapse or RRMS in remission) and were significantly higher in
RRMS in relapse versus RRMS in remission. The three biomarkers were significantly
correlated to each other. EDSS score showed significantly higher levels in SPMS
compared to both RRMS whether in relapse or remission. However no significant
difference was detected between RR in relapse and in remission. EDSS correlated
significantly with IL-12 and correlated weakly with each of IL-17 and sVCAM.
Patients with MRI signs of cerebral atrophy showed significant higher levels of EDSS
score and serum IL-12, IL-17 and sVCAM levels versus patients without cerebral
atrophy. A significant correlation was found between the presence of cerebral
atrophy and the EDSS score. However, no significant correlations could be detected
between cerebral atrophy and the biomarkers; IL- 12, IL-17 and sVCAM.
Conclusion:Serum levels of IL-12, IL-17 and sVCAM 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. Except for IL-12 a rather weakrelationship exists between the above-mentioned markers and the degree of disability induced by MS, thus excluding their
utility as reliable markers of disability.

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