Evaluation of maresin 1 levels in patient with relapsing remitting multiple sclerosis

Objectives: Multiple sclerosis (MS) is a chronic, inflammatory and autoimmune disease of the central nervous system with demyelination and late axonal damage. Although it is mostly white matter disease, it can also affect the cortex and deep gray matter structures(1). Although it can be seen mostly between the ages of 20- 40, it can also start at earlier and later ages. It is the most common cause of disability after trauma at this age(2). The etiology and exact mechanisms of MS disease are not fully understood yet(3). In the light of current knowledge, it has shown that the immune system is an autoimmune process that involves the abnormal activation of T cells against axons targeting the myelin sheath(4). It has long been known that MS disease is a severe inflammatory disease. However, there are still no treatment options that will provide effective long-term recovery after MS damages the central nervous system(5, 6). MaRs (one of the macrophage mediators in inflammation resolution) is the fourth family of docosahexaenoic acid (DHA) derivative of SPMs. Maresin 1 (MaR1) inhibits neutrophil infiltration without affecting the natural response by directly transitioning from macrophage M1 to M2 phenotype and does phagocytosis and efferocytosis by promoting anti-inflammatory and pro-resolution activities to scavenge inflammation residues(7, 8). It was aimed to determine whether MaR1 has a role in the pathogenesis of MS, the importance of autoimmune inflammation in the resolution process of MS disease, and to investigate its value as a diagnostic marker for MS, considering its distinct features in this inflammation resolution and the lack of sufficient studies on this subject. v Material and Methods: Participants consist of 50 patients in remission period who were followed up by Dicle University Medical Faculty Hospital Neurology Clinic and previously diagnosed with RRMS according to the 2017 Modified Mc Donald criteria and 40 healthy volunteers who are compatible with this group in terms of age and gender. Age, gender, body mass index, smoking, disability (EDSS) scores determined at the time of taking blood sample, the number of attacks in the last 1 year, the total number of areas involved in MRI and the treatments they received were evaluated with the parameters studied. Results: Maresin-1 level, which was examined as the primary parameter of the study, was compared between the groups. Accordingly, the mean level of Maresin-1 was 2.13 ng / mL in the patient group and 1.98 ng / mL in the control group. It was determined that there was a significant difference between the two groups in favor of the patient group (p: 0.017). In addition, the CRP level and mean body mass index were significantly lower in the patient group (p: 0.029 and p: 0.012, respectively). There was no significant correlation with other clinical, laboratory and demographic characteristics. When the cut-off value of Maresin-1 levels was taken as 1.185, its sensitivity was calculated as 72% and specificity as 60%. With these results, it was determined that it predicts MS disease. Conclusion: In our study, MaR1, a pro-resolving lipid mediator, was found to be significantly higher in RRMS patients compared to the healthy control group. However, no significant correlation was observed with clinical and demographic characteristics. Our study supports the hypothesis that MaR1 has an effect on MS pathogenesis. We also suggest that MaR1 can be used as a moderate biomarker. Key Words: Relapsing-Remitting Multiple Sclerosis, Maresin 1, SPM