Coordinated oxidative shift during relapse and recovery in multiple sclerosis: A paired analysis of multiple biomarkers
Journal of Neuroimmunology, cilt.420, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 420
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.jneuroim.2026.579030
- Dergi Adı: Journal of Neuroimmunology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Chemical Abstracts Core, EMBASE, MEDLINE, Psycinfo
- Anahtar Kelimeler: Asymmetric dimethylarginine, Biomarkers, Ischemia-modified albumin, Multiple sclerosis, Oxidative stress, Protein carbonyl, Redox imbalance, Relapse, Total sulfhydryl
- Van Yüzüncü Yıl Üniversitesi Adresli: Evet
Özet
Background Oxidative stress plays a central role in the pathogenesis of multiple sclerosis (MS), contributing to inflammation, demyelination, and neurodegeneration. Acute relapse periods may represent a critical phase characterized by intensified oxidative imbalance; however, comprehensive evaluation of multiple oxidative pathways during relapse remains limited. Objective To investigate dynamic changes in oxidative stress markers in patients with MS during relapse and after clinical recovery. Methods Fifty patients with relapsing–remitting MS were evaluated during relapse and one month after clinical recovery. Blood samples were obtained prior to corticosteroid treatment. Ischemia-modified albumin (IMA), asymmetric dimethylarginine (ADMA), total sulfhydryl groups (TSH), and protein carbonyl (PC) levels were measured. Paired comparisons between relapse and post-relapse periods were performed, and results were additionally compared with 50 age- and sex-matched healthy controls. Correlation analyses with Expanded Disability Status Scale (EDSS) scores, effect size analyses, and sensitivity analyses according to disease-modifying therapy categories were also conducted. Results All oxidative stress markers showed significant changes across study groups. IMA, ADMA, and PC levels were significantly elevated during relapse compared with both post-relapse and control groups ( p < 0.001 for all comparisons). Although these markers significantly decreased following clinical recovery, they remained higher than control levels. TSH levels were significantly increased during relapse, suggesting a compensatory antioxidant response. Paired analyses demonstrated a significant reduction in all markers following clinical recovery, with large effect sizes observed across oxidative stress parameters. Sensitivity analyses showed that the overall relapse-associated oxidative profile remained largely consistent across disease-modifying therapy categories. Exploratory Spearman correlation analyses demonstrated weak-to-moderate positive correlations between ADMA and TSH levels and EDSS scores. Conclusion MS relapse is associated with a broad but partially reversible oxidative stress response involving ischemia-related, endothelial dysfunction–associated, antioxidant, and protein oxidation pathways. The observed biomarker changes support the presence of a relapse-associated redox imbalance linked to acute inflammatory activity in MS.