Stampanoni Bassi Mario, Iezzi Ennio, Buttari Fabio, Gilio Luana, Simonelli Ilaria, Carbone Fortunata, Micillo Teresa, De Rosa Veronica, Sica Francesco, Furlan Roberto, Finardi Annamaria, Fantozzi Roberta, Storto Marianna, Bellantonio Paolo, Pirollo Pamela, Di Lemme Sonia, Musella Alessandra, Mandolesi Georgia, Centonze Diego, Matarese Giuseppe
Unit of Neurology and Neurorehabilitation, IRCCS Neuromed, Pozzilli, Italy.
Service of Medical Statistics & Information Technology, Fondazione Fatebenefratelli per la Ricerca e la Formazione Sanitaria e Sociale, Lungotevere de' Cenci 5, Rome, Italy.
Mult Scler. 2020 Sep;26(10):1237-1246. doi: 10.1177/1352458519853473. Epub 2019 Jun 4.
Previous studies evidenced a link between metabolic dysregulation, inflammation, and neurodegeneration in multiple sclerosis (MS).
To explore whether increased adipocyte mass expressed as body mass index (BMI) and increased serum lipids influence cerebrospinal fluid (CSF) inflammation and disease severity.
In this cross-sectional study, 140 consecutive relapsing-remitting (RR)-MS patients underwent clinical assessment, BMI evaluation, magnetic resonance imaging scan, and blood and CSF collection before any specific drug treatment. The CSF levels of the following cytokines, adipocytokines, and inflammatory factors were measured: interleukin (IL)-6, IL-13, granulocyte macrophage colony-stimulating factor, leptin, ghrelin, osteoprotegerin, osteopontin, plasminogen activator inhibitor-1, resistin, and Annexin A1. Serum levels of triglycerides, total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were assessed.
A positive correlation emerged between BMI and Expanded Disability Status Scale score. Obese RR-MS patients showed higher clinical disability, increased CSF levels of the proinflammatory molecules IL-6 and leptin, and reduced concentrations of the anti-inflammatory cytokine IL-13. Moreover, both the serum levels of triglycerides and TC/HDL-C ratio showed a positive correlation with IL-6 CSF concentrations.
Obesity and altered lipid profile are associated with exacerbated central inflammation and higher clinical disability in RR-MS at the time of diagnosis. Increased adipocytokines and lipids can mediate the negative impact of high adiposity on RR-MS course.
先前的研究证明了多发性硬化症（MS）中代谢失调、炎症和神经退行性变之间的联系。
探讨以体重指数（BMI）表示的脂肪细胞质量增加和血清脂质升高是否会影响脑脊液（CSF）炎症和疾病严重程度。
在这项横断面研究中，140例连续的复发缓解型（RR）-MS患者在接受任何特异性药物治疗之前，接受了临床评估、BMI评估、磁共振成像扫描以及血液和脑脊液采集。检测了以下细胞因子、脂肪细胞因子和炎症因子的脑脊液水平：白细胞介素（IL）-6、IL-13、粒细胞巨噬细胞集落刺激因子、瘦素、胃饥饿素、骨保护素、骨桥蛋白、纤溶酶原激活物抑制剂-1、抵抗素和膜联蛋白A1。评估了血清甘油三酯、总胆固醇（TC）和高密度脂蛋白胆固醇（HDL-C）水平。
BMI与扩展残疾状态量表评分之间呈正相关。肥胖的RR-MS患者表现出更高的临床残疾程度、促炎分子IL-6和瘦素的脑脊液水平升高，以及抗炎细胞因子IL-13的浓度降低。此外，甘油三酯的血清水平和TC/HDL-C比值均与IL-6脑脊液浓度呈正相关。
肥胖和脂质谱改变与RR-MS诊断时中枢炎症加剧和更高的临床残疾程度相关。脂肪细胞因子和脂质增加可介导高肥胖对RR-MS病程的负面影响。
