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Background <p>Multiple sclerosis (MS) is the most common immune-mediated inflammatory demyelinating disease of the central nervous system. Axonal injury is also a prominent pathologic feature, especially in the later stages. Our aim is to determine serum levels of vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase activating polypeptide (PACAP) in MS patients versus healthy controls and to determine the correlation between serum levels of VIP and PACAP with demographic and clinical characteristics of MS patients. Eighty subjects were included in this study (40 definite multiple sclerosis patients and 40 healthy matched controls). Patients were diagnosed with definite MS according to 2017 revisions of the McDonald criteria, age ranged from 20 to 45&#xa0;years and both genders. The control subjects were healthy volunteers. All patients were subjected to: complete clinical assessment, evaluation of disability using expanded disability status scale (EDSS) of Kurtzke and laboratory workup including: routine blood tests and measurement of VIP and PACAP serum levels. The healthy controls were submitted to clinical evaluation, non-contrast computed tomography of the brain, routine laboratory tests and measurement of serum levels of VIP and PACAP.</p> Results <p>The mean serum level of VIP was significantly lower in MS patients compared to healthy controls (<i>P</i> value &lt; 0.001). Mean serum level of PACAP was also significantly lower in patients compared to controls (<i>P</i> value = 0.020). There was a statistically significant positive correlation between the serum level of VIP and that of PACAP (r = 0.444, <i>P</i> = 0.004). However, no significant correlation was detected between serum level of VIP with age, age at onset, disease duration, or EDSS, (<i>P</i> values = 0.729, 0.656, 0.899, and 0.212 respectively). Also, no significant correlation was detected between serum level of PACAP with age, age at onset, disease duration, or EDSS, (<i>P</i> values = 0.648, 0.823, 0.579, and 0.806, respectively). The ROC analysis for VIP indicated that the area under the curve was 0.733, with a <i>P</i> value of 0.0001, with a high predictability of VIP for diagnosis of MS.</p> Conclusion <p>Serum VIP and PACAP are significantly lower among multiple sclerosis patients compared to healthy controls. Both biomarkers can be used efficiently to diagnose patients with multiple sclerosis with high specificity and modest sensitivity especially serum VIP.</p>

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Vasoactive intestinal peptide and pituitary adenylate cyclase activating polypeptide as serum biomarkers in a sample of Egyptian multiple sclerosis patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月17日

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  • Ebtesam Mohamed Fahmy,
  • Amany Mahmoud Rabah,
  • Sahar Abd El-Atty Sharaf,
  • Sarah Heneidy,
  • Nora Mahmoud Selim,
  • Mostafa Yahya Garadah,
  • Shaimaa Shaheen Mohammed

摘要

Background

Multiple sclerosis (MS) is the most common immune-mediated inflammatory demyelinating disease of the central nervous system. Axonal injury is also a prominent pathologic feature, especially in the later stages. Our aim is to determine serum levels of vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase activating polypeptide (PACAP) in MS patients versus healthy controls and to determine the correlation between serum levels of VIP and PACAP with demographic and clinical characteristics of MS patients. Eighty subjects were included in this study (40 definite multiple sclerosis patients and 40 healthy matched controls). Patients were diagnosed with definite MS according to 2017 revisions of the McDonald criteria, age ranged from 20 to 45 years and both genders. The control subjects were healthy volunteers. All patients were subjected to: complete clinical assessment, evaluation of disability using expanded disability status scale (EDSS) of Kurtzke and laboratory workup including: routine blood tests and measurement of VIP and PACAP serum levels. The healthy controls were submitted to clinical evaluation, non-contrast computed tomography of the brain, routine laboratory tests and measurement of serum levels of VIP and PACAP.

Results

The mean serum level of VIP was significantly lower in MS patients compared to healthy controls (P value < 0.001). Mean serum level of PACAP was also significantly lower in patients compared to controls (P value = 0.020). There was a statistically significant positive correlation between the serum level of VIP and that of PACAP (r = 0.444, P = 0.004). However, no significant correlation was detected between serum level of VIP with age, age at onset, disease duration, or EDSS, (P values = 0.729, 0.656, 0.899, and 0.212 respectively). Also, no significant correlation was detected between serum level of PACAP with age, age at onset, disease duration, or EDSS, (P values = 0.648, 0.823, 0.579, and 0.806, respectively). The ROC analysis for VIP indicated that the area under the curve was 0.733, with a P value of 0.0001, with a high predictability of VIP for diagnosis of MS.

Conclusion

Serum VIP and PACAP are significantly lower among multiple sclerosis patients compared to healthy controls. Both biomarkers can be used efficiently to diagnose patients with multiple sclerosis with high specificity and modest sensitivity especially serum VIP.