Evaluation of hematological markers and disease activity in relapsing-remitting multiple sclerosis

Aims: Multiple sclerosis (MS) is an immune-mediated chronic disease of the central nervous system that causes demyelination and neuroaxonal damage. Systemic inflammation is thought to cause chronic neurodegeneration. It plays an essential role in the pathogenesis of MS. This study aims to compare the inflammatory parameters such as neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio, platelet-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII) and systemic inflammatory response index (SIRI) in relapsing-remitting multiple sclerosis (RRMS) patients during relapse and remission periods with the healthy control group and to investigate the relationship between these parameters and disease activity in MS patients. Methods: This study involved one hundred four patients between the ages of 18 and 47 who applied to Kastamonu Training and Research Hospital with an MS attack and were diagnosed with RRMS according to the 2017 McDonald criteria were included in the study. The patients’ hemogram results were compared in the relapse and remission periods. In addition, the hemogram results in the relapse and remission periods were compared with the hemogram results of the healthy control group. Results: A total of 104 MS patients and 64 healthy controls were included in the study. 70 (67%) of MS patients were female, and 24 (33%) were male. The average disease duration of the patients was calculated as 4.7±3.7, and the average Expanded Disability Status Scale score was 2.17. NLR, PLR, SIRI, and SII were significantly higher during the attack period compared to the healthy group. Also, NLR, PLR, SII, and SIRI were significantly higher in the remission period compared to the healthy control group. However, there was no significant difference in NLR, PLR, SII, and SIRI levels in MS patients between the attack and remission phases. Conclusion: Elevated inflammatory markers in MS patients compared to healthy controls suggest inflammation’s role in the disease. Notably, similar levels during relapse and remission periods may indicate possible chronic inflammation. Larger prospective studies are needed to confirm these findings.