Serum Redox Status, Cytokines and Vitamin D Levels of Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder in Sri Lanka: A Comparative Pilot Study

Abstract

Multiple sclerosis (MS) and Neuromyelitis Optica Spectrum Disorder (NMOSD) are autoimmune demyelinating diseases of the central nervous system (CNS), with distinct pathophysiological significance. Understanding the cellular and immunological status may provide insight into the differential pathophysiology of these conditions and may improve the accurate diagnosis and management. This pilot study compares MS and NMOSD in Sri Lankan patients in terms of redox status, cytokines and serum vitamin D levels. A total of 71 participants; 22 MS patients, 19 NMOSD patients, 15 disease controls (OND) and 15 healthy controls (HC) were recruited to compare serum oxidative parameters (OP); Nitric oxide (NOx) & Lactate dehydrogenase (LDH), antioxidant parameters (AP); Total antioxidant status (TAS) & Catalase (CAT), cytokines (Th1; INFɤ and Th2; IL-10) and vitamin D levels. Serum levels of NOx (p=0.001) differed significantly between the study groups and the MS patients exhibited significantly higher levels compared to NMOSD patients (P=0.002).  Serum LDH levels were comparable between both MS and NMOSD patients (P=0.07). However, serum TASs significantly differed among the study groups (P=0.001) and MS patients had near significantly lower levels compared to that of NMOSD patients (P=0.052). Catalase activity levels did not show a significant difference among the groups (P=0.07). The levels of IL-10 cytokines of MS patients were comparable to that of NMOSD patients (P=0.07), however, it was significantly greater than OND (P=0.020) and HC (P=0.032) groups. The mean value of IFN-ɤ in MS patients was 0.87pg/ml (±0.145) while IFN-ɤ levels of other groups were less than the detection level of the standard ELISA kit. Vitamin D levels of MS and NMOSD were very similar (P=1.000) and showed a resemblance to HC. We conclude that oxidative stress and Th1 cytokines contribute more towards MS than NMOSD and that Vitamin D does not play a major role in disease pathogenesis in Sri Lankan patients.