Do apelin and ghrelin play a role in multiple sclerosis? The analysis of patients treated with immunomodulatory therapies.

Introduction: Multiple sclerosis (MS) is an autoimmune disorder with a complex and multifactorial etiology. Increasing evidence suggests that peptide hormones may significantly influence the pathogenesis of MS by affecting inflammatory processes and metabolic dysregulation. The aim of the study was to evaluate the levels of apelin and ghrelin, which are two peptide hormones, in patients with relapsing-remitting MS (RRMS) receiving natalizumab and fingolimod compared to healthy controls. Methods: We enrolled forty-nine patients with RRMS and thirty-eight healthy individuals. The participants were divided into three groups i.e., natalizumab-treated patients, fingolimod-treated patients, and healthy controls. We assessed the serum levels of apelin and ghrelin. Statistical analysis was performed using STATISTICA 12. In both groups, correlations between the duration of the disease and treatment, BMI and hormone concentrations were evaluated. Results: The natalizumab-treated group showed significantly higher levels of apelin (p=0.0063), while the fingolimod-treated group showed significantly higher ghrelin levels compared to the controls (p=0.0035). Conclusion: The study demonstrates differences in serum apelin and ghrelin levels between RRMS patients treated with natalizumab or fingolimod and healthy controls, suggesting a potential association between immunomodulatory treatment, metabolic factors, and peptide hormone regulation in multiple sclerosis.