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Sladojević M, Nikolić S, Živanović Ž, Simić S, Sakalaš L, Spasić I, Ilinčić B, Čabarkapa V. Determination of systemic inflammatory biomarkers in multiple sclerosis. J Med Biochem 2024; 43:257-264. [PMID: 38699700 PMCID: PMC11062333 DOI: 10.5937/jomb0-45083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/08/2023] [Indexed: 05/05/2024] Open
Abstract
Background Multiple sclerosis (MS) is one of the most common demyelinating diseases of the central nervous system. We aimed to investigate serum and cerebrospinal fluid levels of different laboratory inflammatory biomarkers in patients with MS. Methods A total of 120 subjects participated in the study, 60 of whom were diagnosed with MS, 30 with the final diagnosis of non-inflammatory diseases of the central nervous system (CNS), and 30 healthy subjects representing the control group. Regarding the progression of radiological findings after 2 years from the initial diagnosis, the MS group was divided into stationary radiological findings (n=30) and radiologically proven disease progression (n=30). In all patients, we analyzed levels of laboratory inflammatory biomarkers: C reactive protein (CRP), Neutrophil-to-lymphocyte ratio (NLR), Growth differentiation factor 15 (GDF15) in serum samples, and neurofilaments (NFs) in cerebrospinal fluid (CSF). NFs and GDF15 were analyzed initially, while CRP and NLR values were analyzed initially and after two years. Results We found statistically lower GDF15 values and initial CRP values in the MS group regarding the group with non-inflammatory diseases of the CNS (p<0.0001). On the other side, we determined a significant elevation of laboratory markers CRP and NLR, initially and after a two-year period, in the MS subgroup with the progression of magnetic resonance imaging (MRI) findings (p<0.0001 and p=0.050, respectively). Also, we found a positive correlation between CRP and NFs (r=0.243, p=0.04), as well as a positive correlation between CRP and GDF15 in patients with MS (r=0.769, p<0.0001). Conclusions We found a significant elevation of laboratory markers of systemic inflammation, CRP, and NLR in MS patients who developed disease progression based on MRI findings. There is a need for further studies to validate current parameters to be considered as useful markers of MS activity and disability.
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Affiliation(s)
| | | | | | | | | | - Igor Spasić
- Department of Laboratory Diagnostics Medlab, Novi Sad
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Drulović J, Tončev G, Nadj Č, Obradović D, Eraković J, Mesaroš Š, Čukić M, Aleksić D, Andabaka M, Ivanović J, Jovanović A, Kostić M, Marić G, Marković A, Martinović V, Parojčić A, Perić S, Sakalaš L, Suknjaja V, Vesić K, Vojvodić S, Vuković T, Benedict RHB, Pekmezović T. Validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in a Large Cohort of Relapsing-Remitting MS Patients. Acta Clin Croat 2022; 61:62-69. [PMID: 36398076 PMCID: PMC9616040 DOI: 10.20471/acc.2022.61.01.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/28/2021] [Indexed: 11/24/2022] Open
Abstract
Cognitive impairment is one of the most frequently reported symptoms in persons with multiple sclerosis (MS). The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) has been recommended as a standardized international screening and monitoring tool for brief cognitive assessment. The aim of our study was to assess the reliability and validity of the Serbian version of the BICAMS. A total of 500 relapsing-remitting MS (RRMS) patients and 69 age-, gender- and education-matched healthy control (HC) subjects were examined. All participants performed the BICAMS test battery, which includes the oral version of the Symbol Digit Modalities Test (SDMT), California Verbal Learning Test second edition (CVLT-II), and Brief Visuospatial Memory Test Revised (BVMTR). A randomly selected subset of patients were retested one to three weeks after baseline. Statistically significant differences between patients and HCs were evident on the SDMT and BVMTR (p<0.001). HCs had higher CVLT-II scores but this difference did not reach statistical significance (p=0.063). Cognitive impairment, defined as an abnormal test score on ≥1 subtest, was found in 62.9% of MS patients. There were statistically significant correlations between BICAMS scores and age, education, EDSS and disease duration in patient sample. Test-retest reliability was confirmed with Pearson correlation coefficient of 0.70 in all measures. This study supported the reliability and validity of the Serbian BICAMS, although the CVLT-II version tested here lacked sensitivity to detect MS compared to healthy volunteers.
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Affiliation(s)
- Jelena Drulović
- Department of CNS Immune-Mediated Disorders, Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Gordana Tončev
- Department of Neurology, Kragujevac Clinical Center, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Čongor Nadj
- Department of Neurology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Dragana Obradović
- Department of Neurology, Military Medical Academy, Medical Faculty, Defense University, Belgrade, Serbia
| | - Jevto Eraković
- Department of Neurology, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Šarlota Mesaroš
- Department of CNS Immune-Mediated Disorders, Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Mirjana Čukić
- Department of Neurology, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Dejan Aleksić
- Department of Neurology, Kragujevac Clinical Center, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Marko Andabaka
- Institute of Genetics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jovana Ivanović
- Department of CNS Immune-Mediated Disorders, Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Aleksa Jovanović
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marina Kostić
- Department of Neurology, Military Medical Academy, Medical Faculty, Defense University, Belgrade, Serbia
| | - Gorica Marić
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandar Marković
- Department of Neurology, Military Medical Academy, Medical Faculty, Defense University, Belgrade, Serbia
| | - Vanja Martinović
- Department of CNS Immune-Mediated Disorders, Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Aleksandra Parojčić
- Department of CNS Immune-Mediated Disorders, Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Stojan Perić
- Department of CNS Immune-Mediated Disorders, Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Lorand Sakalaš
- Department of Neurology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Vesna Suknjaja
- Department of Neurology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Katarina Vesić
- Department of Neurology, Kragujevac Clinical Center, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Sofija Vojvodić
- Department of Neurology, Military Medical Academy, Medical Faculty, Defense University, Belgrade, Serbia
| | - Tijana Vuković
- Department of Neurology, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Ralph H. B. Benedict
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Tatjana Pekmezović
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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