Tumour Necrosis Factor-Alpha Alone is not Predictive of Relapses in Multiple Sclerosis.

Abstract

Background: A specific marker of disease activity in multiple sclerosis (MS) has notyet been identified. Objective: For this reason this longitudinal prospective study has been carried out in order to determine whether tumour necrosis factor-a (TNF-?) is a predictor of relapse in MS patients and to evaluare the effect of inrerferon ß (IFN-ß) therapy on the TNFa production capacitiy. Material and Methods: Thirty-six relapsing remitting MS (RRMS) patienrs were included in the study and divided into four groups. Group la consisted of 10 relapse presenting patients who were not receiving IFN-ß1b. in Group lb (n- 16), rhe patients were remitting RRMS without any medication. Group lla (n=S), consisted of patients who were under IFN-ß1 b therapy and presented relapse. In Group lıb, there was 5 remitting MS patients receiving IFN-ß1b. Blood samples were collected once a week for about 16 weeks and the samples are stimulated by phytohemagglutinine. The TNF-? production capacitiy of the activated white bfood cells was measured by the ELlSA method. Findings: A total of 139 TNF-? peaks were determined during the follow up and only 9 peaks predicred relapses in 7 RRMS patients. The other 130 TNF-? peaks were possibfy related with infections of the respiraroıy tract (9,2 %), menstrual period (4,6%) and aflegic reactions (0,76 %). No reasons could be determined in the 85% of the 130 peaks. The mean TNF-? production capacity of the Group llb was lower than Group lb (p<0,05). Conclusion: The resufts of this study indicated that TNF-? production capacity was affected by IFN-ß1b treatment, but the periodicaf measurement of TNF-? production capacity ın RRMS patients did not seem to be a sensitive marker in predicting the relapses.