INTRODUCTION Multiple sclerosis (MS) is an autoimmune, inflammatory, demyelinating neurodegenerative disease progressing with attacks. Alpha-synuclein (α-Syn), a neuronal protein, has been previously associated with the inflammation and development of neurodegenerative diseases. Although the cause of neurodegeneration in multiple sclerosis is mainly associated with inflammation, α-Syn may play a role in the pathogenesis of MS, as in other classical neurodegenerative diseases such as synucleinopathies. In multiple sclerosis, α-Syn has been directly studied in central nervous system lesions and cerebrospinal fluid (CSF). However, there are few studies approaching variations in peripheral α-Syn in MS. The aim of our study was to investigate the correlation between disease progression and other clinical parameters by measuring serum α-Syn and oligomer α-Syn levels in MS patients. MATERIAL AND METHOD The study included 60 MS patients aged 18 years or older who were admitted to the Department of Neurology between 01.02.2020-01.04.2020 and diagnosed with MS according to the 2010 MC Donald criteria, and 60 age- and sex-matched healthy controls. Those who were in the MS attack period and received cortisone treatment in the past three months were excluded from the study. The serum α-Syn and oligomer α-Syn levels of the individuals in both groups were measured. The correlation between the serum α-Syn, oligomer α-Syn, oligomer α-Syn/α-Syn ratio levels of the MS patients and their age, disease duration, number of attacks, annualized relapse rate (ARR), disease type, EDSS scores and immunomodulatory drug type used was investigated. Statistical analysis was performed using the SPSS 22.0 software. RESULTS In our study, 73.3% of the MS patients were female and the mean age of the patients was 36.18 ± 9.5 years. The most common MS disease type was RRMS with 83.3%. Serum α-Syn (79.52 ± 34.81) and oligomer α-Syn (18.79 ± 10.48) levels were significantly lower in the MS patients compared to the control group (p < 0.001). Serum oligomer α-Syn/α-Syn ratio was higher in the MS patients compared to the control group and in SPMS compared to RRMS, but was not statistically significant. There was no significant correlation between the serum α-Syn, oligomer α-Syn and oligomer α-Syn/α-Syn ratio ratio of the MS patients and their age, disease duration, disease type, EDDS, ARR and immunomodulatory treatments. There was a significant positive correlation between α-Syn and oligomer α-Syn in MS patients (r: 0.29, p: 0.02). CONCLUSION In our study, serum α-Syn and oligomer α-Syn levels were lower in the MS patients compared to the control group. Low levels of α-Syn in MS may play a role in the development of neuroinflammation and may be a result of the diffuse neuronal and synaptic loss. There is a need for further studies on this subject.

中文翻译：

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多发性硬化症患者的低血清 Α-SYNUCLEIN 和低聚物 Α-SYNUCLEIN 水平

引言 多发性硬化症 (MS) 是一种自身免疫性、炎症性、脱髓鞘性神经退行性疾病，随着发作而进展。α-突触核蛋白 (α-Syn) 是一种神经元蛋白质，以前与神经退行性疾病的炎症和发展有关。尽管多发性硬化症中神经变性的原因主要与炎症有关，但 α-Syn 可能在 MS 的发病机制中发挥作用，就像在其他经典神经退行性疾病（如突触核蛋白病）中一样。在多发性硬化症中，已在中枢神经系统病变和脑脊液 (CSF) 中直接研究了 α-Syn。然而，很少有研究接近 MS 外周 α-Syn 的变化。我们研究的目的是通过测量 MS 患者的血清 α-Syn 和寡聚体 α-Syn 水平来研究疾病进展与其他临床参数之间的相关性。材料和方法 该研究包括 60 名年龄在 18 岁或以上的 MS 患者，他们在 2020 年 2 月 2 日至 2020 年 4 月 1 日期间入住神经内科并根据 2010 年 MC Donald 标准诊断为 MS，以及 60 名年龄和性别匹配的患者健康对照。那些处于 MS 发作期并在过去三个月内接受可的松治疗的人被排除在研究之外。测量两组个体的血清α-Syn和寡聚体α-Syn水平。MS患者血清α-Syn、寡聚α-Syn、寡聚α-Syn/α-Syn比值水平与其年龄、病程、发作次数、年复发率（ARR）的相关性，研究了疾病类型、EDSS 评分和使用的免疫调节药物类型。使用SPSS 22.0软件进行统计分析。结果 在我们的研究中，73.3% 的 MS 患者为女性，患者的平均年龄为 36.18 ± 9.5 岁。最常见的 MS 疾病类型是 RRMS，占 83.3%。与对照组相比，MS 患者的血清 α-Syn (79.52 ± 34.81) 和寡聚体 α-Syn (18.79 ± 10.48) 水平显着降低 (p < 0.001)。与对照组相比，MS 患者的血清寡聚物 α-Syn/α-Syn 比值更高，SPMS 患者的血清寡聚体 α-Syn/α-Syn 比值高于 RRMS，但无统计学意义。MS患者血清α-Syn、寡聚体α-Syn和寡聚体α-Syn/α-Syn比值与年龄、病程、疾病类型、EDDS、ARR和免疫调节治疗无显着相关性。MS 患者中 α-Syn 和寡聚体 α-Syn 之间存在显着的正相关（r：0.29，p：0.02）。结论在我们的研究中，与对照组相比，MS 患者的血清 α-Syn 和寡聚体 α-Syn 水平较低。MS 中低水平的 α-Syn 可能在神经炎症的发展中起作用，并且可能是弥漫性神经元和突触丢失的结果。有必要对这个问题进行进一步的研究。