Exploring the relationships of physical, mental, and emotional symptoms and serum biomarkers of angiogenesis in multiple sclerosis.

BACKGROUND

Multiple sclerosis (MS) involves symptoms that may be impacted by angiogenesis. Vascular endothelial growth factor (VEGF), a potent pro-angiogenic molecule, is elevated in early MS, but its activity in later disease is understudied. [Met]-enkephalin (ENK) has anti-angiogenic activity and is decreased in persons with MS (PwMS).

OBJECTIVES

To determine salient symptoms of MS and evaluate relationships between common MS symptoms and angiogenesis-associated biomarkers.

METHODS

PwMS and non-MS control participants were identified for this cross-sectional study. Walking times and self-reported fatigue, anxiety, depression, and pain were measured. Serum VEGF and [Met] ENK levels were measured in a subset of PwMS.

RESULTS

PwMS ( = 66) had significantly greater fatigue than controls ( = 35). In PwMS, fatigue, anxiety, depression, and pain were positively intercorrelated; fatigue was positively correlated with slower walking. Serum ENK and VEGF had a trending negative relationship. Serum ENK, but not VEGF, had a trending negative relationship with the length of disease. Serum ENK and VEGF were not correlated to walking time or self-report measures.

CONCLUSION

Fatigue is a salient MS symptom when compared to non-MS controls. Imbalanced pro- and anti-angiogenic signaling may influence fatigue in established MS, but further studies with larger sample sizes are needed to elucidate this potential relationship.