RR MULTIPL SKLEROZLU BİREYLERDE NÖROVASKÜLER ÜNİTE BİOMARKERLARI İLE KLİNİK PROGRESYONU DEĞERLENDİREN DEĞİŞKENLER ARASINDAKİ İLİŞKİNİN İNCELENMESİ

Öz

Giriş: Multipl Skleroz, inflamasyon, demiyelinizasyon, akson hasarı ile karakterize otoimmün nörodejeneratif bir hastalıktır. Amaç: Bu çalışma RR MS’li bireylerde nörovasküler ünite işleyişini değerlendiren biomarkerlar ile klinikte progresyon değerlendirmeleri için kullanılan fiziksel parametreler arasında olan ilişkiyi incelemek amacıyla tasarlanmıştır. Yöntem: Çalışmaya kesin MS tanısı almış olan ve dahil edilme kriterlerini sağlayan 30 RRMS hastası dahil edilmiştir. Hastalara başlangıçta SMMT uygulanarak 24 puan ve üzeri alan hastalara demografik veri formu ve klinikte MS progresyonunu değerlendiren EDSS skalası, 6 Dakika yürüme testi, Zamanlı Kalk Yürü Testi ve 9 Delikli Peg Testi uygulanmıştır. Sonrasında hastalardan alınan kan örnekleriyle nörovasküler ünite fonksiyonunu değerlendiren GFAP, VEGF ve NfL biomarkerlarının ELİSA analizleri yapıldı. Bulgular: Serum NfL düzeyi ile "son atak üzerinden geçen süre" değişkeni arasında pozitif yönde anlamlı ilişki saptandı (rho=0,366, p=0,047). Serum NfL, serum VEGF-a ve serum GFAP düzeyleri ile EDSS, DDPT (Dominant ve Non-Dominant), ZKYT ve 6DYT skorları arasında anlamlı bir ilişkisi olmadığı saptandı (p>0,05). Sonuç: Sonuçlar serum VEGF-a, GFAP ve serum NfL seviyelerinin MS’de nörovasküler ünite disfonksiyonu ile karakterize hastalık progresyonunu belirleyen biomarkerlar olmayabileceğini ancak serum NfL’nin uzun dönem progresyonu ve Sekonder Progresif MS’e geçişi değerlendirmede önemli bir belirteç olabileceğini göstermektedir.

Anahtar Kelimeler

• Multipl skleroz
• klinik progresyon belirteçleri
• nörovasküler ünite

INVESTIGATION OF THE RELATIONSHIP BETWEEN NEUROVASCULAR UNIT BIOMARKERS AND VARIABLES ASSESSING CLINICAL PROGRESSION IN INDIVIDUALS WITH RR MULTIPLE SCLEROSIS

Öz

Objective: Multiple sclerosis is an autoimmune neurodegenerative disease characterised by inflammation, demyelination and axonal damage. The present study was designed to examine the relationship between biomarkers assessing Neurovascular Unit functioning in individuals with RR MS and physical parameters used for progression assessment in the clinic. Methods: Thirty RRMS patients who had a definitive diagnosis of MS and met the inclusion criteria were included in the study. Initially, the SMMT was administered to patients who scored 24 or higher. These patients completed a demographic data form and clinically assessed MS progression using the EDSS scale, the 6-Minute Walk Test, the Timed Up and Go Test, and the 9-Hole Peg Test. Blood samples were then collected for ELISA analysis of GFAP, VEGF, and NfL biomarkers, which assess Neurovascular Unit function. Results: A positive and significant relationship was detected between serum NfL level and the “time since last attack” variable (rho=0.366, p=0.047). No significant relationship was detected between serum NfL, serum VEGF-a, and serum GFAP levels and EDSS, 9DPT (Dominant and Non-Dominant), TUG, and 6MWT scores (p>0.05). Conclusions: The results suggest that serum VEGF-a, GFAP, and serum NfL levels may not be biomarkers for disease progression characterized by Neurovascular Unit dysfunction in MS, but serum NfL may be an important marker for assessing long-term progression and transition to Secondary Progressive MS.

Anahtar Kelimeler

• Multiple sclerosis
• clinical progression markers
• Neurovascular Unit

Destekleyen Kurum

The study did not receive any support from any funder.

Etik Beyan

For the implementation of the study, approval was obtained from the Lokman Hekim University Scientific Research Ethics Committee (Number: 2024313, dated 31.01.2025) and written permission was obtained from the relevant institution where the research was conducted. Written informed consent was obtained from all participants prior to the commencement of the study.

Kaynakça

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