Plasma Fibrinogen Level as a Biomarker of Disease Activity in Multiple Sclerosis

Background; Increasing evidence suggests that fibrinogen could play a pathogenic role in multiple sclerosis (MS). This study aimed to detect the relation between the plasma fibrinogen level and MS activities either clinically or radiologically. Methods; A case control study was conducted on 62 patients of MS and clinically isolated syndrome (CIS) and 70 healthy control subjects. Plasma fibrinogen level was measured for all participants of this study. Motor disability of the patients was assessed based on Expanded Disability status Score (EDSS) and 9-Hole Peg Test (9-HPT) scale. The relationship between plasma fibrinogen levels and the presence of active lesions on brain and spinal cord MRI was analyzed. Results; Plasma fibrinogen level was significantly higher in MS patients during relapse than healthy control subjects (p<0.001). Patients with active radiological lesions were found to have a significantly higher level of plasma fibrinogen level than patients with inactive lesions (p<0.05). Patients with high fibrinogen level showed marked motor disability when compared to the patients with normal fibrinogen level regarding their scores on EDSS (p<0.001 ) and 9-HPT (p=0.05). Multivariate regression analysis showed that elevated fibrinogen level during relapse significantly and independently raises the risk of disease activity in MS patients by 4.99 times (p=0.003). Conclusions; fibrinogen level could be a practical marker for monitoring MS activity. Key words: Multiple sclerosis; fibrinogen; relapse