Comparative Analysis of IL-18 Expression Across Therapeutic Modalities in Multiple Sclerosis

Abstract

Background: Multiple sclerosis represents a chronic autoimmune pathology associated with immune-related demyelination and neuro inflammation in the central nervous system. Recently, interleukin-18 appears to represent one of the major cytokines among other inflammatory mediators, responsible for innate and adaptive immunity cross-talk and involvement in disease development. Its behavior in diverse therapeutic regimes remains not sufficiently studied. Objective: The aim of this work was to evaluate seruminterleukin-18 concentration in multiple sclerosis patients under different treatments and assess its diagnostic value in terms of treatment efficacy and pathogenesis. All the subjects involved totaled 180, including 16 untreated patients,20 negative control groups, and patients under 60 on first 48, second 36, and third-line therapies. Methods: Measurement of serum interleukin-18 concentration was performed using the enzyme-linked immunosorbent assay method. Cytokine levels were correlated with clinical variables, such as disability score, disease duration, and relapse frequency. Data analysis was done using the software package SPSS. There were certain differences found in interleukin-18levels in distinct groups, suggesting its biomarker role as a marker of disease dynamics and therapy efficiency. To further explore clinical implications of our findings, further studies are required. Results: Significant differences in interleukin-18 levels were demonstrated among distinct groups. Untreated patients had moderate elevations, and healthy controls had the lowest levels. First-line therapies showed heterogeneous effects; some treatments were associated with lower cytokine levels and others with higher expression. The highest levels of interleukin-18 were found in patients receiving second-line treatments, followed by third-line treatments. Cytokine levels increased progressively with escalation of therapy and longer duration of disease. Correlation analysis revealed that disability scores (EDSS) was significantly associated with disease duration, relapse frequency, and disease severity, but not with serum IL-18 levels. Receiver operation characteristic analysis indicated moderate diagnostic ability. Conclusions: In summary, interleukin-18 indicates both the inflammatory burden and the immune modulation induced by therapy in multiple sclerosis. While it is not appropriate as an independent diagnostic marker, it may function as an adjunct biomarker for assessing disease activity and immunological variations during treatment regimens