Increased IL-27 Cytokine Levels in the Cerebrospinal Fluid but Not in the Blood of Multiple Sclerosis Patients (P02.083)

Hypothalamo-pituitary-adrenal (HPA) axis activity is altered in patients with multiple sclerosis (MS), resulting in elevated basal levels and enhanced response of cortisol in stimulation tests. HPA axis hyperactivation in MS is thought to be the result of complex interactions of genetic, immunologic, and neuroendocrinological mechanisms. In order to investigate whether cytokine levels in the central nervous system are associated with the activation of the HPA axis in MS, we measured cortisol, interleukin (IL)-6, IL-10 and TNF-α levels in postmortem cerebrospinal fluid (CSF) of 18 patients with severe MS and 50 controls. We also investigated the cortisol and cytokine levels in the CSF of a group of MS patients and controls who died with sepsis, in order to see whether acute infectious situations affect the association between cortisol and cytokines. The cortisol levels in MS patients were increased by 80% in comparison to controls (p =0.008). There was no difference in IL-6 levels between the groups, while IL-10 and TNF-α levels of the majority of subjects were below detection limits. There was a positive correlation between cortisol and IL-6 only in control patients with sepsis (r=0.89, p =0.019), but not within the MS patients with sepsis or MS and control groups without sepsis. Cortisol levels in postmortem serum and CSF were highly correlated (r >0.78, p <0.001). We concluded that the basal level of cortisol is significantly increased in the CSF of MS patients and that IL-6 is not responsible for this rise. The relationship between cortisol and IL-6 in sepsis is discussed.

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Investigation of IL-17A, IL-17F, IL-34 Levels of Patient with Multiple Sclerosis and Pseudotumor Cerebri

Acta Medica ◽

10.32552/2021.actamedica.498 ◽

2021 ◽

pp. 1-8

Author(s):

Hayriye Soytürk ◽

Şeyda Karabörk ◽

Şule Aydın Türkoğlu

Keyword(s):

Multiple Sclerosis ◽

Cerebrospinal Fluid ◽

Demyelinating Disease ◽

Pseudotumor Cerebri ◽

Radiologically Isolated Syndrome ◽

Significant Difference ◽

Cytokine Levels ◽

New Treatment ◽

Multiple Sclerosis Patients ◽

Relapsing Remitting Multiple Sclerosis

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.

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