A Novel Perspective on Multiple Sclerosis: Morphological Shifts in Immune Cell Populations

ABSTRACT This study aims to investigate expanded hematological data in multiple sclerosis (MS) and evaluate their association with disease severity. A total of 190 patients participated in the study. For this purpose, expanded hemocytometry data were compared between 120 patients diagnosed with MS and 70 healthy controls. Neurological deficit was assessed during the relapse period using the Kurtzke Expanded Disability Status Scale (EDSS), and patients were divided into two groups based on EDSS scores: mild (EDSS < 5) and moderate‐severe (EDSS ≥ 5). The distribution width of the complexity of monocyte (Mo‐WX) was significantly decreased in MS patients compared to the controls ( p = 0.011). In contrast, dispersion of the lymphocyte‐Y signal (Ly‐WY; p = 0.017), dispersion of the Ly‐Z signal (Ly‐WZ; p = 0.021), and dispersion of the Mo‐Z signal of monocytes (Mo‐WZ; p = 0.049) were significantly increased in MS patients compared to the controls. Percentage of neutrophils (Ne%; p < 0.0001), percentage of monocyte (Mo%; p = 0.002), and percentage of immature granulocytes (IG%; p = 0.011) were higher in patients than in controls, whereas percentage of lymphocyte (lymphocyte%; p < 0.0001) and absolute lymphocyte count (lymphocyte#; p < 0.0001) were significantly lower. Furthermore, increasing EDSS scores were associated with higher dispersion of the neutrophil NE‐SSC signal (NE‐WX; p = 0.003), neutrophil% ( p = 0.005), IG% ( p = 0.014), and absolute IG count (IG#; p = 0.003), while lymphocyte% ( p = 0.018) and reactive lymphocyte percentage (Re‐Ly%; p = 0.016) were significantly reduced. We identified morphological changes in immune cells of MS patients that highlight unique immunological profiles and potential markers for MS. Further research and validation of these parameters may enhance their clinical significance by providing valuable insights for personalized treatment and diagnostic strategies in managing MS.