الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
M
ultiple sclerosis is a chronic autoimmune disease and considered the most common cause of neurological disability among young adults. Its diagnosis depends mainly on clinical picture, MRI findings and CSF OCB.
Membrane bound CD163 is a hemoglobin-haptoglobin transmembrane scavenger receptor and it is expressed mainly on monocytes and macrophages. As a result of its shedding process, sCD163 is produced. The soluble form of CD163 can be found in plasma and other body fluids such as CSF and it can be used as a useful biomarker for the intrathecal microglial and macrophage activation and to monitor disease activity and therapeutic response.
Our case control observational study aimed to investigate the serum level of sCD163 as an immunological non-invasive marker of the disease activity among MS patients. We included a total of 88 subjects were divided in to three groups: group I: included 30 patients diagnosed as RRMS in relapse, group II: included 30 patients diagnosed as RRMS in remission and group III: 28 age and sex matched apparently healthy individuals as a control group. Relapsing remitting MS patients were diagnosed by McDonald’s criteria 2017, the relapse was diagnosed according to clinical examination and evidence of activity in MRI. Patients in remission were clinically free with EDSS<3 and there was no evidence of activity in MRI. We excluded patients with other neurological diseases or other chronic inflammatory diseases. All individuals were subjected to full history taking, neurological examination was done to all MS patients by EDSS assessment and the serum levels of sCD163 were measured by ELISA. The samples were collected before steroid therapy to avoid changes in the marker levels.
There were no significant statistical differences between all cases and controls as regard sex and age. Comparative statistics between the group of relapse and the group of remission revealed statistically highly significant differences between both groups as regard EDSS, EDSS degree, MRI findings and number of relapses during the last year. Serum level of sCD163 showed a highly significant statistical difference between all MS patients and healthy controls with no significant difference between the relapsing and the remitting MS patient groups.
These results suggested that sCD163 serum level can be used as a non-invasive immunological biomarker in the diagnostic panel of MS reflecting the inflammatory process occurring in MS lesions rather than the activity status of the patients.
Finally, the presented results support the use of the innate immune system markers in the diagnosis of MS and reflection of the inflammatory status of MS lesions which can be useful in the future studies to perform a novel noninvasive panel for diagnosis of MS. Further studies are recommended to individuate new immunological markers reflecting disease activity with larger number of MS cases.