The Relationship between Inflammatory Markers and Activity of Multiple Sclerosis

Background: The primary characteristics of multiple sclerosis (MS), a chronic autoimmune illness affecting the central nervous system (CNS), are inflammatory demyelination, widespread damage, and brain volume loss. These factors contribute to neurodegeneration and physical impairment. This study aimed to determine the relationship between Systemic immune inflammatory indices and Multiple sclerosis activity. Methods: This case-control study was conducted on 132 subjects; 62 clinically definite MS patients during relapse and 70 age and gender matched healthy control participants. The inflammatory markers NLR (neutrophil-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio) and C- Reactive protein (CRP) were measured for all participants and Magnetic resonance imaging (MRI) of brain and spinal cord was done for MS patients during relapse. Assessment of patients' physical disability was based on Expanded Disability Status Score (EDSS) and 9-hole Peg test (9-HPT). Results: We found that PLR and NLR were higher among MS patients than healthy control group (p≤ 0.001, p= 0.031). The best cutoff point of serum NLR to detect radiological activity in MS patients was ≥3.18 at sensitivity 70.6% and specificity 61.5% and the best cutoff point of PLR to detect radiological activity in MS patients was ≥128.155 with area under curve 0.746 (95% CI; 0.598 to 0.894) at sensitivity 76.9% and specificity 60.2%. CRP correlated significantly with 9 HPT scores (p=0.01) Conclusions: A high PLR and NLR may be promising predictive markers that detect activity of Multiple sclerosis.