Systemic inflammation worsens central inflammation and disability in multiple sclerosis

Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease characterized by the presence of infiltrating immune cells, demyelination, axonal degeneration and neuronal death in the CNS. Previous studies evidenced a link between metabolism, inflammation and neurodegeneration in MS. The aims of this thesis was to evaluate whether metabolic profile and systemic inflammatory biomarkers influence central inflammation in MS patients and disease severity. 323 drug-naïve MS patients underwent clinical assessment, BMI evaluation, MRI scan and blood and CSF collection in order to evaluate metabolic and inflammatory serum parameters and inflammatory cytokines in the CSF. A correlation emerged between BMI and EDSS, BMI and metabolism, BMI and systemic inflammation, altered lipid profile and EDSS, systemic inflammation biomarkers and EDSS, IL-6 and EDSS. It was found an association between high levels of blood glucose, lipids and ESR and enhanced levels of IL-1β in the CSF as well as an association between high levels of ESR, lipids and enhanced levels of IL-1β in the CSF. Obesity, altered lipid profile and systemic inflammation are associated with worse clinical disability and enhanced neuroinflammation, wich is associated with metabolic dysregulation and systemic inflammation, may lead to progression of clinical disability in MS patients.