Background: Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the brain
and spinal cord, which affects about 2.2 million people worldwide, primarily young adults from 20 to
40 years of age. Overproduction of reactive oxygen species (ROS) and impaired iron metabolism are
considered to be possible factors in the pathogenesis of Multiple sclerosis (MS). Nicotinamide adenine
dinucleotide phosphate (NADPH) oxidases are the primary sources of regulated ROS production. The
NADPH oxidase (NOX) family consists of seven catalytic homologues, NOX1–5 and two dual
oxidases. NOX1 and NOX5 are associated with endothelial dysfunction and inflammation but NOX4
has a protective effect on vascular function. Aim of study: to investigate the status of serum endothelial
NOXs (NOX5 and NOX 4) and its relationship with iron metabolism biomarkers in relapsing-remitting
MS patients, also to study the possible correlation between NOXs (NOX5 and NOX 4) and iron
metabolism biomarkers with disease severity. Methods and Results: The study included 40 RRMS
patients and 40 control subjects of matched age and gender. Serum NOX4,5, ferritin, iron, iron binding
capacity, C-reactive protein (CRP), compelet blood count (CBC) and erythrocyte sedimentation rate
(ESR) levels were measured in all the study subjects.All the participants were subjected to complete
history taking, general and full neurological examination, Expanded Disability Status Scale (EDSS).
Results: Higher serum NOX5 (p < 0.0001), CRP (p < 0.0001), ferritin (p < 0.0001) and lower serum
NOX4 (p < 0.0001) and iron (p < 0.0001) concentrations were found in the patients than in controls.
No correlation was found between NOXs, CRP, WBCs, ESR and iron metabolism biomarkers in
patients. Conclusion: Our data suggest that increased NOX5 expression and decreased levels of NOX4
might be related with oxidative stress related vascular changes and BBB disruption in MS patients. We
also demonstrated that lower concentrations of iron and TIBC in RRMS patients. Because of the
importance of iron on myelination and oligodendrocytes functions serum iron levels should be closely
monitored in MS patients . |
