| Background and ObjectiveMultiple sclerosis (MS) is an autoimmune disease characterized as the demyelination in the central nerve system,with multiple lesions and the relapsing-remitting course as its mainly clinical character.The accurate etiology and pathogenesis of MS were still far from being fully understood, it may be mainly concern with virus infection,immunal irregulation,heredity and environment factors and so on. Currently, many scholers are incline to believe that MS is a disease with multiple factors which may conern with identity of congenital genetic predisposition under the exposure of the influence of environmental factors, such as infection,pregnancy,surgical operation, et al. MBP and other autoantigens which once were hidden under the immune system, were exposed to the immune system. The immune system is not able to induce autoimmune tolerance; the autoantige interact with immunal cells and there by induce the specific immunal response, ultimatly, cause the disease of MS. Many cytokines, such as interleukin,interferon,growth factor and some hormone are participate in the course of onset,development and relapse. As there being exists immune-nerve-endocrine regulatory net, provides us a new way of thinking in study the pathogenesis of MS.Prolactin(PRL) is one of the immunal active hormones, which was thought to be participated in the course of autoimmune disease. Hyperprolactinemia is one of the risk factors for autoimmune disease. The immune regulatory mechanisms of PRL in the pathogenesis of multiple sclerosis is complex. Up to now, there is still no common understanding of the role that PRL plays in MS relapse. Therefore, it is necessary to study the correation between PRL levels and MS relapse. This issue was designed to detect the levels of prolactin (PRL),myelin basic protein (MBP),interferon-γ(IFN-γ),interleukin-10 (IL-10) in the serum of female MS patients with initial attack and recurrent attack, investigate the correlation between them and explore the relationship between the serum PRL level and the relapse and the disease severity of female patients with multiple sclerosis, provide basis for the basic and clinical research of MS.Material and MethodsThe ELISA method was used to detect the MBP and PRL levels in the sera of 30 female MS patients with initial attack and 30 female MS patients with recurrent attack. In addition, normal female controls were also detected with the same method. The case groups were the patients in the neurology department of the frist affiliated hospital of ZhengZhou university during the year 2006～2009, all of them were diagnosed according to the Poser's creteria, all of them were clinical defined MS or laboratory-supported defined MS. The health controls were 30 health adult women examined in the outpatient medical center of our hospital. In this study, all subjects were well informed of all experimental purposes, the experiment was carried on only after the consent of all subjects was gotten and signed a consent form thereafter. The age of each groups were matched, such as pregnancy,departure,laction,aboration and any other disease that would change the level of serum PRL were excluded. Statistical analysis:the results were expressed as mean±SD, the datum were processed with the statistical software of SPSS13.0. One-way AN OVA was used to statistical analysis, SNK method was used to compare different groups. Based on the data types, Pearson product-moment, Spearman rank correlation were used for correlation analysis, and the significant difference was set at P<0.05.Results1 The PRL level in serum of each group:The PRL level in the serm of the female MS patients with initial attack was 19.17±6.11μg/L, The PRL level in the serum of the female MS patients with recurrent attack was 25.09±10.16μg/L, the PRL level in the serum of health control group was 14.14±4.80μg/L. Analysis of variance reveal that the PRL level in the serm of the female MS patients with initial attack and patients with recurrent attack were significantly higher than that of normal controls (P<0.05), and the recurrent group was also significantly higher than the initial group (P<0.05).2 The MBP level in serum of each group:The MBP level in the serm of the female MS patients with initial attack was 4.42±1.38μg/L, The MBP level in the serum of the female MS patients with recurrent attack was 4.70±1.25μg/L, the MBP level in the serum of health control group was 1.26±0.21μg/L. Analysis of variance reveal that the MBP level in the serm of the female MS patients with initial attack and the patients with recurrent attack were significantly higher than that of normal controls (P<0.05), and there was no significant difference between the initial group and the recurrent group (P>0.05).3 The IFN-y level in serum of each group:The IFN-γlevel in the serm of the female MS patients with initial attack was 12.57±5.52pg/ml, The IFN-γlevel in the serum of the female MS patients with recurrent attack was 17.17±4.40 pg /ml, the IFN-γlevel in the serum of health control group was 8.04±2.11 pg/ml. Analysis of variance reveal that the IFN-γlevel in the serm of the female MS patients with initial attack and patients with recurrent attack were significantly higher than that of normal controls (P<0.05), and the recurrent group was also significantly higher than the initial group (P<0.05)4 The IL-10 level in serum of each group:The IL-10 level in the serm of the female MS patients with initial attack was 45.09±8.29pg/ml, The IL-10 level in the serum of the female MS patients with recurrent attack was 33.19±9.13 pg /ml, the IL-10 level in the serum of health control group was58.44±7.80 pg/ml. Analysis of variance reveal that the IL-10 level in the serm of the female MS patients with initial attack and patients with recurrent attack were significantly lower than that of normal controls (P<0.05), and the recurrent group was also significantly lower than the initial group (P<0.05).5 The serum PRL levels was positively correlated with the level of MBP in the MS patients (r=0.880 P<0.01);The serum PRL levels was negatively correlated with the level of IL-10 in the MS patients(r=—0.566 P<0.01); The serum PRL levels was also positively correlated with the level of IFN-y in the MS patients (r=0.890 P<0.01); Serum PRL levels and disease recurrence were also positively correlated (r=0.553 P<0.01).Conclusion1.MBP may be one of the major autoantigen that induce MS pathogenesis.2.IFN-γplay a destructive role to the body in the MS disease process.3.IL-10 play a protective role to the body in the MS disease process.4.PRL levels may be related to the relapse and disease severity of female patients with multiple sclerosis, patients with hyperprolactinemia are more susceptible to multiple sclerosis.5.The increased PRL level that elevated the level of IFN-γ, drop the level of IL-10, causing destruction of myelin, therefor MBP levels increased, may be one of the reasons of the relapse of MS.
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