INTRODUCTION
The initial phase of multiple sclerosis (MS) typically manifests as
clinically isolated syndrome (CIS), which constitutes the first clinical
episode bearing resemblance to MS. Predominantly observed in young
adults, CIS impacts the optic nerve, brainstem, or spinal cord.
Specifically, CIS is characterized by an acute or subacute occurrence of
neurological symptoms, persisting for a duration exceeding 24 hours
[1]. The subsequent progression of the disease post-CIS exhibits
significant variability. While around a third of patients exhibit a
benign trajectory marked by minimal disability, another half develops
secondary progressive MS [2]. Within the CIS stage, the
identification of patients at heightened risk of MS development stands
as a pivotal objective. The potential progression of the disease can
significantly influence the formulation of treatment strategies.
Consequently, numerous prognostic markers, such as chitinase 3 like 1,
neurofilament heavy chains, and interleukins, have been subject to
investigation for their predictive value [3].
Cerebrospinal fluid (CSF) analysis, in conjunction with the assessment
of the patient’s clinical state and MRI results, holds a crucial role in
multiple sclerosis diagnosis. A defining feature of CSF-related
alterations is the presence of limited oligoclonal bands (OCBs),
observable in the vast majority of MS patients [4]. The role of B
cells in connection with MS and its progression has been substantiated
through the scrutiny of B cell-associated biomarkers in CSF [5, 6].
Among these markers, one such example is CXCL13, a chemotactic molecule
that attracts B cells, which are deemed pivotal in MS pathogenesis.
CXCL13 is generated within ectopic lymphoid follicles, linked to
inferior MS outcomes. Elevated CXCL13 levels might aid in predicting the
conversion of patients with clinically isolated syndrome (CIS) to
full-fledged MS [7, 8].
An additional noteworthy marker tied to MS activity is IL-8, produced by
various cell types such as monocytes, lymphocytes, granulocytes,
astrocytes, and epithelial cells. IL-8 is an inflammatory chemokine
primarily responsible for attracting and activating neutrophilic
granulocytes, basophilic granulocytes, and specific lymphocyte subsets.
Notably, IL-8 also exerts robust angiogenic effects [9]. Research
has demonstrated significantly raised levels of CSF IL-8 in MS patients
[10].
Our study aimed to assess the significance of CXCL13 and IL-8 as
prognostic indicators in patients diagnosed with CIS, in comparison with
a control group. The evaluation occurred at the juncture when the
initial clinical manifestations of the disease were registered.