title: Clinical and laboratory study of pro-inflammatory and antiinflammatory cytokines in women with multiple sclerosis.
abstract: Multiple sclerosis (MS) is an autoimmune demyelinating disorder of the central nervous system characterised with a complex system of interactions between proinflammatory and anti-inflammatory cytokines in its course.
  
  
  OBJECTIVE
  The aim of the present study was to investigate the serum levels of cytokines TNF-a, IFN-gamma, IL-4 and IL-10 in female patients with MS and healthy individuals, the changes occurring in the relapse and remission phases of the disease and their correlation with the severity of the neurological deficit.
  
  
  METHODS
  Thirty-five women with relapsing-remitting MS were examined. The patients' age ranged between 18 and 50 years and MS was verified clinically and by magnetic resonance imaging according to the McDonald criteria. Thirteen of the patients were treated with interferon-beta-1b. The serum concentrations of TNF-a, IFN-y, IL-4 and IL-10 were determined twice - in relapse and in remission - using an enzyme-linked immunosorbent assay (ELISA). The control group consisted of 35 age-matched healthy females.
  
  
  RESULTS
  The comparison of cytokine serum concentrations during the two phases of the disease showed significant elevation of the TNF-alpha serum levels in the relapse phase and of IL-4 - in the remission phase. The comparison between the patients and the healthy control subjects demonstrated statistically significant lower concentrations of TNF-a in remission patients and higher concentrations of IL-10 in relapse patients. The patients with interferon-beta-lb treatment showed different profile of cytokine secretion from the patients without interferon-beta-1b treatment. Interferon-beta-1b-treated patients showed significantly lower serum levels of TNF-a and IFN-gamma during the relapse phase and higher TNF-a and IL-10 serum levels during the remission phase compared with the untreated patients.
  
  
  CONCLUSIONS
  Serum levels of TNF-a and IL-4 objectively reflect the immune response during relapse and remission of the disease. The severity of neurological deficit as estimated with the expanded disability status scale (EDSS) does not depend on the serum levels of TNF-a, IL-10 and IFN-gamma in the two phases of MS.
authors.affiliation: Department of Neurology, Medical University, Plovdiv, Bulgaria. atrenova@yahoo.com
authors.forename: Anastasiya G
authors.initials: AG
authors.lastname: Trenova
authors.forename: Mariya G
authors.initials: MG
authors.lastname: Manova
authors.forename: Ivanka I
authors.initials: II
authors.lastname: Kostadinova
authors.forename: Mariana A
authors.initials: MA
authors.lastname: Murdjeva
authors.forename: Dimka R
authors.initials: DR
authors.lastname: Hristova
authors.forename: Tonka V
authors.initials: TV
authors.lastname: Vasileva
authors.forename: Zahari I
authors.initials: ZI
authors.lastname: Zahariev
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000097:blood*; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood*; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000627:therapeutic use*; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000097:blood* / Q000188:drug therapy; D011446:Prospective Studies; D011994:Recombinant Proteins; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: D000276:Adjuvants, Immunologic; D015415:Biomarkers; D016207:Cytokines; D011994:Recombinant Proteins; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D000068576:Interferon beta-1b; D015847:Interleukin-4; D016899:Interferon-beta; D007371:Interferon-gamma