Assessment of serum zonulin as a marker of altered intestinal permeability in patients with multiple sclerosis

Abstract Background Here we enrolled patients into 3 groups: Relapsing remittent MS in relapse (RRMS) [N = 26], progressive MS (progressive) [N = 19] and relapsing remittent MS in remission (remission) [N = 18] Control group matching age and sex [N = 20] P-Value was <0.001, which is significant in RRMS group in relation to progressive, remission and control groups. P-Value was 0.849, which is insignificant in progressive group in relation to remission group. P-Value was 0.584, which is insignificant in progressive group in relation to control group. P-Value was 0.973, which is insignificant in remission group in relation to control group. Aim of the Work To investigate the possible association between IP changes and MS through measurement serum zonulin in different population of MS for possible implication on treatment. Patients and Methods A. Subjects Type of the Study A case control observational cross sectional study Study Setting The Neurology department of Ain Shams University hospitals. Study Period 6 months to 1 year Study Population This study will enroll 92 subjects who will be divided into 4 groups; group 1 including 24patients with the diagnosis of relapsing remittent MS (RRMS) who are in relapse phase within one week from the time of sample withdrawal, group 2 including 24 patients with the diagnosis of RRMS who are in remission phase, group 3 including 24 patients with secondary progressive MS (SPMS) and group 4 including 20 age- and sex-matched healthy controls. Results In the RRMS group of this study, serum Zonulin varying between (12_ 93) with mean 28.692 and +\-22.894 SD. In the progressive group of this study, serum Zonulin varying between (2_ 18) with mean 8.021 and +\-3.866 SD. In the remission group of this study, serum Zonulin varying between (1.5_ 11) with mean 4.522 and +\-3.026 SD. In the control group of this study, serum Zonulin varying between (1.3_ 6) with mean 2.690 and +\-1.292 SD. P-Value was <0.001, which is significant in RRMS group in relation to progressive, remission and control groups. P-Value was 0.849, which is insignificant in progressive group in relation to remission group. P-Value was 0.584, which is insignificant in progressive group in relation to control group. P-Value was 0.973, which is insignificant in remission group in relation to control group. Conclusion this study included 62 patients diagnosed as multiple sclerosis that are divided into 3 groups and serum Zonulin level was assessed in each group and the results were significant in the relapse group which indicates autoimmune theory of MS and link between gut barrier and CNS also illustrated the role of gut microbiota in the MS. It also supported disintegration of intestinal barrier during the attack of MS for further work up studies regarding oral medication in the acute attack of MS.