Ataturk University, Faculty of Medicine, Department of Neurology, Erzurum, Turkey.
Kocaeli Medical Park Hospital, Department of Neurology, Kocaeli, Turkey.
Clin Neurol Neurosurg. 2021 Mar;202:106500. doi: 10.1016/j.clineuro.2021.106500. Epub 2021 Jan 18.
Multiple sclerosis (MS) is a demyelinating chronic inflammatory disease of the central nervous system (CNS). Recent studies have shown that oxidative stress plays an important role in MS pathogenesis. This study aimed to investigate the relationship between total oxidative stress (TOS) and total antioxidant capacity (TAC), which were reported to be effective in the pathogenesis of MS, and therapeutic efficacy of fingolimod used in the treatment of MS.
Serum TOS and total TAC levels of 25 patients with relapsing-remitting MS (RRMS) were measured before fingolimod treatment was initiated and in the third month of treatment and compared with those of 40 healthy individuals. Measurement of TOS activity was performed with TOS Assay Kit (Rel Assay Diagnostics, Turkey). Measurement of TAC activity was also performed with TAC Assay Kit (Rel Assay Diagnostics, Turkey).
A statistically significant increase was observed in the TOS levels measured before fingolimod treatment in the patient group compared to the control group. The TOS levels measured in the third month of the treatment were found to decrease significantly compared to the pre-treatment TOS levels. An increase was observed in TAC levels after the treatment; however, no significant difference was found between the groups in terms of TAC levels. There was a positive correlation between the pre- and post-treatment Expanded Disability Status Scale (EDSS) scores and TOS values whereas no significant correlation was observed between the pre- and post-treatment EDSS scores and TAC values.
The present study has revealed that fingolimod reduced oxidative stress. There was a positive correlation between the pre- and post-treatment EDSS and TOS values, which confirmed that there was a close correlation between the MS and oxidative stress. There are some limitations in this study. The small number of patients and the short follow-up times can be listed among these limitations. Our study does not contain a definitive answer to what is the mechanism of increased TOS in MS patients and how fingolimod reduces TOS levels. More detailed studies are needed on this subject.
多发性硬化症（MS）是一种中枢神经系统（CNS）脱髓鞘的慢性炎症性疾病。最近的研究表明，氧化应激在 MS 的发病机制中起重要作用。本研究旨在探讨总氧化应激（TOS）和总抗氧化能力（TAC）之间的关系，这两者被报道在 MS 的发病机制中有效，以及在 MS 治疗中使用芬戈莫德的治疗效果。
在开始使用芬戈莫德治疗前和治疗的第三个月，测量 25 例复发缓解型 MS（RRMS）患者的血清 TOS 和总 TAC 水平，并与 40 名健康个体进行比较。TOS 活性的测量使用 TOS 测定试剂盒（Rel Assay Diagnostics，土耳其）进行。TAC 活性的测量也使用 TAC 测定试剂盒（Rel Assay Diagnostics，土耳其）进行。
与对照组相比，患者组在开始芬戈莫德治疗前测量的 TOS 水平显著升高。治疗第三个月测量的 TOS 水平与治疗前的 TOS 水平相比显著降低。治疗后 TAC 水平升高；然而，两组之间的 TAC 水平没有显著差异。治疗前后扩展残疾状况量表（EDSS）评分与 TOS 值之间存在正相关，而治疗前后 EDSS 评分与 TAC 值之间无显著相关性。
本研究表明，芬戈莫德降低了氧化应激。治疗前后 EDSS 和 TOS 值之间存在正相关，这证实了 MS 和氧化应激之间存在密切的相关性。本研究存在一些局限性。患者数量少和随访时间短可以列为这些局限性之一。我们的研究并没有明确回答 MS 患者 TOS 增加的机制以及芬戈莫德如何降低 TOS 水平。需要对此主题进行更详细的研究。
