الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Multiple sclerosis (MS) is a chronic demyelinating disorder of the central nervous system. Pro-inflammatory cytokines are major drivers for the development and progression of this debilitating disorder. Hence, addressing and characterizing the role of unstudied inflammatory cytokines may efficiently aid in MS monitoring and therapy. Extensive cytokine profiles that provide reliable, rather than conflicting, correlations of MS are still limited. In the current study, we evaluated the extent of correlation between serum ILs-22, 32α and 34 concentrations and the expanded disability status score (EDSS) to see how reliable these parameters are for prediction of the disease activity. This study comprised 150 Egyptian individuals (Table 1), who were randomly recruited from several centers in the period from June 2016 till September 2018. All the participants were asked to sign a written consent prior contribution in the study. The study was approved by the ethical committee at the Faculty of Pharmacy, Mansoura University. Our results indicated that: Serum IL-22 concentration in untreated RRMS patients was elevated In comparison to healthy individuals. Meanwhile, the increase of serum ILs-32α and 34 concentrations were not statistically significant in untreated RRMS patients, compared to healthy individuals. Furthermore, the average of EDSS (2.72) for these untreated RRMS patients was significantly higher than those of healthy individuals. Interferon β-1a/b and fingolimod treatments led to a significant decrease of serum concentration of ILs-22 and 32α, but not 34, at 6 and 12months of treatment, compared to their initial concentrations before therapy. Moreover, IFNβ-1b and fingolimod-induced decreases in ILs-22 and 32α were partially concordant with decreasing MS severity to some extent in the MRI of the shown patients at 6months, despite no significant changes of all DMDs on the means of total volume of plaques at 6 and 12months. The correlation analysis revealed that the elevation of serum IL-22 and, to a lesser extent, IL-32α concentration was moderately consistent with that of EDSS which in turn means worsening in the patient disability and aggregation of disease severity. The elevation of serum IL-34 concentration was weakly correlated with that of EDSS which suggests a lack of relationship between both. The correlation analysis of serum IL-22 concentration and EDSS score showed strong positive relation in patients receiving IFNβ-1a and fingolimod while a medium positive correlation in IFNβ-1b-treated patients. Similarly, serum IL-32α concentration and EDSS score correlated better in IFNβ-1a and fingolimod-treated patients than IFNβ-1b-treated patients. In conclusion, IL-22 and, to a lesser extent IL-32α, may be considered as potential markers for MS disease severity and efficacy of DMDs. Meanwhile, there is no relation between the therapeutic mechanism of the used DMDs and the concentration of IL-34 in the blood circulation.