الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Multiple sclerosis is an immune system demyelinating sickness brought about by interaction of hereditary and ecological components. Another period of examination has been set up through epigenetics which is characterized as heritable gene articulation changes that occur with no DNA grouping changes. Epigenetics incorporate histone changes, DNA methylation and non-coding RNAs. A subcategory of ncRNAs, circular RNA (circRNA), has been the focal point of logical examinations in the course of the most recent couple of years.
CircRNAs have been accounted for as promising for going about as biomarkers of different human sicknesses. Evidence implicated that circRNAs have specific roles in the pathogenesis of MS especially in working as microRNA sponges. Recent research demonstrated dysregulated profiles of circRNAs circ_0005402, expressed from ANXA2 gene located in chromosome 15, in peripheral blood mononuclear cells of MS patients. Interestingly, ANXA2 has been acknowledged as a target of miR-155 which is significantly increased in both PMNCs and active lesions and correlated with disease severity in MS patients.
Our study aimed at determining the role of circular RNA circ_0005402 and ANXA2 gene as potential biomarkers for MS. This study was carried out on thirty confirmed multiple sclerosis patients attending at multiple sclerosis clinic in El Hadara Alexandria University hospital in the period between January 2019 and February 2020, their age ranged from 25.0 to 61.0 years old , with exclusion of patients currently receiving any disease modifying therapy and patients with other associated autoimmune diseases to avoid any confounding factors . Thirty healthy persons with corresponding age and sex were incorporated as a control group.
Each person of the patient group was subjected to full history taking, complete neurological examination, assessment of EDSS score using the Kurtzke Expanded Disability Status Scale (The EDSS was utilized in blend with illness span to ascertain the MS Severity Score (MSSS)), other laboratory investigations as vasculitic profile were done in all patients and magnetic resonance imaging (MRI) of the brain was done as well. Relative quantification of circular RNA circ_0005402 expression was done using reverse transcription Real-time PCR for both cases and controls.
Worth mentioning is that our patient group demographics were comparable to the international registries. Regarding our target circular RNA circ_0005402, there was a highly significant increase in the Circular RNA expression in MS patients when compared to the control group (P<0.001) while there was no statistically significant difference between the two studied groups as regards ANXA2 gene expression.
A ROC curve was constructed in our analysis trying to assess the ability of Circular RNA circ_0005402 values to predict MS in the patient group vs. the control group and the corresponding areas under curve (AUC) was found to be 0.809*, (P<0.001). The best cut-off value for Circular RNA circ_0005402 when predicting MS in the patients group was >1.11#, where sensitivity= 90.0 % and specificity= 60.0%.Thus this target seems to have moderate specificity with high sensitivity