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Background <p>Multiple sclerosis (MS) is a complex autoimmune disease characterized by the interplay of inflammatory dynamics and neurodegenerative mechanisms, making the assessment of disease severity and the prediction of its course an ongoing clinical challenge. Although individual biomarkers reflecting specific aspects of the pathological process—such as inflammatory cytokines e.g., Interleukin -6 (IL-6) and marker of neuronal damage, neurofilament light chain (NfL). Current evidence remains limited regarding the simultaneous quantitative integration of these markers within a single model capable of explaining individual variability in disease severity or improving the ability to distinguish between patients and healthy individuals. Furthermore, most previous studies have focused on evaluating each marker individually, without a comparative analysis that combines markers of inflammation and neurodegeneration, or without using nonparametric measures of effect size that reflect true differences in data with non-normal distributions.</p> Aim <p>The aim of this study was to evaluate the combined diagnostic and monitoring value of this panel of biochemical markers in patients with MS. By integrating these biochemical markers, the study seeks to provide a clearer and more comprehensive assessment, that my support rapid diagnosis and follow up of diseases activity and clinical status.</p> Methods <p>This study was conducted using a case-control. The study included 180 participants, divided into two groups: a patient group of 90 patients diagnosed with relapsing—remitting multiple sclerosis, and a control group of 90 healthy control participants with no history of neurological inflammatory, autoimmune or chronic systematic diseases. The established McDonald criteria were used to confirm the final diagnosis for the cases included in the study. Demographic and laboratory data were collected, and levels of NfL, IL-6, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and, Vitamin D3 (Vit D3) were measured. Comparisons were made between the two groups, using Cliff’s delta to estimate the effect size. Spearman’s correlation analysis, ROC curves, and adjusted logistic regression were also used after adjusting for age, sex, and body mass index.</p> Results <p>Levels of NfL, IL-6, CRP, and ESR were significantly elevated in patients with MS compared to controls; the median values were 30.58 versus 17.72 pg/mL, 23.1 versus 7.325 pg/mL, 9.65 versus 4.77 mg/L, and 24.5 versus 8 mm/h, respectively, while Vit D3 levels were significantly lower at 11.25 versus 34 ng/mL, all at <i>p</i> &lt; 0.001. ROC analysis demonstrated excellent diagnostic ability, particularly for NfL, Vit D3, and CRP, with AUC values of 0.9948, 0.994, and 0.993, respectively. NfL was also strongly correlated with IL-6 (r = 0.9021) and inversely correlated with Vit D3 (r = −&#xa0;0.5685), supporting the association of inflammation with neurodegeneration in patients with MS.</p> Conclusion <p>The results of the current study indicate the investigated biochemical markers (NfL, IL-6, CRP, and ESR) showed significant differences between MS patients and healthy controls. The current finding suggest that these biochemical markers may have diagnostics value in MS. Further studies with longer sample size are needed to confirm these results.</p>

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Integrated serum biochemical markers profiling in multiple sclerosis (MS): a case control analysis of neurofilament light chain, inflammatory markers, and vitamin D3 status

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  • 发表日期：

    2026年6月1日

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  • Mustafa Alburhan,
  • Ameer A. A. Aldafaay,
  • Bakr Aldoori,
  • Alaa Haleem Imran,
  • Abdulla Munthir Sulaiman

摘要

Background

Multiple sclerosis (MS) is a complex autoimmune disease characterized by the interplay of inflammatory dynamics and neurodegenerative mechanisms, making the assessment of disease severity and the prediction of its course an ongoing clinical challenge. Although individual biomarkers reflecting specific aspects of the pathological process—such as inflammatory cytokines e.g., Interleukin -6 (IL-6) and marker of neuronal damage, neurofilament light chain (NfL). Current evidence remains limited regarding the simultaneous quantitative integration of these markers within a single model capable of explaining individual variability in disease severity or improving the ability to distinguish between patients and healthy individuals. Furthermore, most previous studies have focused on evaluating each marker individually, without a comparative analysis that combines markers of inflammation and neurodegeneration, or without using nonparametric measures of effect size that reflect true differences in data with non-normal distributions.

Aim

The aim of this study was to evaluate the combined diagnostic and monitoring value of this panel of biochemical markers in patients with MS. By integrating these biochemical markers, the study seeks to provide a clearer and more comprehensive assessment, that my support rapid diagnosis and follow up of diseases activity and clinical status.

Methods

This study was conducted using a case-control. The study included 180 participants, divided into two groups: a patient group of 90 patients diagnosed with relapsing—remitting multiple sclerosis, and a control group of 90 healthy control participants with no history of neurological inflammatory, autoimmune or chronic systematic diseases. The established McDonald criteria were used to confirm the final diagnosis for the cases included in the study. Demographic and laboratory data were collected, and levels of NfL, IL-6, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and, Vitamin D3 (Vit D3) were measured. Comparisons were made between the two groups, using Cliff’s delta to estimate the effect size. Spearman’s correlation analysis, ROC curves, and adjusted logistic regression were also used after adjusting for age, sex, and body mass index.

Results

Levels of NfL, IL-6, CRP, and ESR were significantly elevated in patients with MS compared to controls; the median values were 30.58 versus 17.72 pg/mL, 23.1 versus 7.325 pg/mL, 9.65 versus 4.77 mg/L, and 24.5 versus 8 mm/h, respectively, while Vit D3 levels were significantly lower at 11.25 versus 34 ng/mL, all at p < 0.001. ROC analysis demonstrated excellent diagnostic ability, particularly for NfL, Vit D3, and CRP, with AUC values of 0.9948, 0.994, and 0.993, respectively. NfL was also strongly correlated with IL-6 (r = 0.9021) and inversely correlated with Vit D3 (r = − 0.5685), supporting the association of inflammation with neurodegeneration in patients with MS.

Conclusion

The results of the current study indicate the investigated biochemical markers (NfL, IL-6, CRP, and ESR) showed significant differences between MS patients and healthy controls. The current finding suggest that these biochemical markers may have diagnostics value in MS. Further studies with longer sample size are needed to confirm these results.