Do apelin and ghrelin play a role in multiple sclerosis? The analysis of patients treated with immunomodulatory therapies

Introduction Multiple sclerosis (MS) is an autoimmune disorder with a complex and multifactorial etiology. Increasing evidence suggests that peptide hormones may significantly influence the pathogenesis of MS by affecting inflammatory processes and metabolic dysregulation. The aim of the study was to evaluate the levels of apelin and ghrelin, which are two peptide hormones, in patients with relapsing-remitting MS (RRMS) receiving natalizumab and fingolimod compared to healthy controls. Methods We enrolled forty-nine patients with RRMS and thirty-eight healthy individuals. The participants were divided into three groups i.e., natalizumab-treated patients, fingolimod-treated patients, and healthy controls. We assessed the serum levels of apelin and ghrelin. Statistical analysis was performed using STATISTICA 12. In both groups, correlations between the duration of the disease and treatment, BMI and hormone concentrations were evaluated. Results The natalizumab-treated group showed significantly higher levels of apelin (p=0.0063), while the fingolimod-treated group showed significantly higher ghrelin levels compared to the controls (p=0.0035). Post-hoc analysis revealed that all women treated with natalizumab and fingolimod had higher apelin levels than healthy women (p=0.025). In the group of women with MS, ghrelin levels increased with disease duration (p=0.045, R = 0.357). Additionally, apelin levels correlated positively with BMI in the fingolimod-treated group (p=0.001, R = 0.694). Conclusion The study demonstrates differences in serum apelin and ghrelin levels between RRMS patients treated with natalizumab or fingolimod and healthy controls, suggesting a potential association between immunomodulatory treatment, metabolic factors, and peptide hormone regulation in multiple sclerosis.