Ashtari Fereshteh, Madanian Reyhanehsadat, Zarkesh Sayyed Hamid, Ghalamkari Arshia
Isfahan Neuroscience Research Center, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran.
Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2022 Sep 27;27:67. doi: 10.4103/jrms.jrms_796_21. eCollection 2022.
Interleukin-6 (IL-6) is an important mediator in the acute phase of inflammatory diseases such as neuromyelitis optica (NMO) and multiple sclerosis (MS). The level of IL-6 is higher in cerebrospinal fluid and serum of NMO patients compare to MS. Vitamin D has a regulatory effect on IL-6, so it may have a negative correlation with IL-6 in the acute phase of these diseases. This study was performed to evaluate the serum levels of IL-6 and Vitamin D in NMO and MS patients at the onset of disease to find differences that may help in early diagnosis.
This case-control study was done on patients with the first episode of optic neuritis, transverse myelitis, and area postrema syndrome who were referred to Kashani MS Center in Isfahan, Iran, between January 2018 and January 2020. The serum levels of Vitamin D and IL-6 were assessed using enzyme-linked immunosorbent assay in blood sample taken at the time of first presentation in patients who had a definitive diagnosis of NMO and MS during subsequent workup.
During a 2-year follow-up, definitive diagnosis of NMO was given in 25 cases, and they were compared with 25 cases that were randomly selected from patients with definite MS. Nineteen patients in the NMO group and 21 patients in the MS group were female. The mean age of patients in the NMO and MS groups was 29.64 ± 1.47 and 30.20 ± 1.42, respectively ( = 0.46). The mean of serum level of Vitamin D was 24.88 ± 15.2 in NMO patients and 21.56 ± 18.7 in MS patients without significant difference ( = 0.48). The mean of IL-6 was 30.1 ± 22.62 in the NMO group and 23.35 ± 18.8 in the MS group without significant difference ( = 0.28). The serum levels of Vitamin D were insufficient in both groups. No correlation between Vitamin D and IL-6 levels was found in our study ( > 0.05).
Our results showed that serum IL-6 levels were higher at the onset of NMO disease compared with MS. The serum levels of Vitamin D were low in both groups and there was no association between serum levels of Vitamin D and IL-6 in either group. Future studies with large sample size are needed to confirm these findings.
白细胞介素-6（IL-6）是视神经脊髓炎（NMO）和多发性硬化症（MS）等炎性疾病急性期的重要介质。与MS患者相比，NMO患者脑脊液和血清中的IL-6水平更高。维生素D对IL-6有调节作用，因此在这些疾病的急性期它可能与IL-6呈负相关。本研究旨在评估NMO和MS患者发病时血清中IL-6和维生素D的水平，以发现可能有助于早期诊断的差异。
本病例对照研究针对2018年1月至2020年1月间转诊至伊朗伊斯法罕卡沙尼MS中心的视神经炎、横贯性脊髓炎和最后区综合征首发患者。在后续检查中确诊为NMO和MS的患者首次就诊时采集血样，采用酶联免疫吸附测定法评估血清中维生素D和IL-6的水平。
在2年的随访期间，25例患者被确诊为NMO，并与从确诊为MS的患者中随机选取的25例患者进行比较。NMO组19例患者和MS组21例患者为女性。NMO组和MS组患者的平均年龄分别为29.64±1.47岁和30.20±1.42岁（P = 0.46）。NMO患者血清维生素D水平的平均值为24.88±15.2，MS患者为21.56±18.7，差异无统计学意义（P = 0.48）。NMO组IL-6的平均值为30.1±22.62，MS组为23.35±18.8，差异无统计学意义（P = 0.28）。两组患者血清维生素D水平均不足。本研究未发现维生素D与IL-6水平之间存在相关性（P>0.05）。
我们的结果表明，NMO疾病发病时血清IL-6水平高于MS。两组患者血清维生素D水平均较低，且两组血清维生素D水平与IL-6之间均无关联。需要进一步开展大样本量研究以证实这些发现。
