Canonical Correlation Analysis Of TCM Syndrome And IL-17/IL-21 In Relapsing-remitting Multiple Sclerosis

Multiple Sclerosis (Multiple Sclerosis, MS) is an autoimmune disease characterized by inflammatory and demyelination of white matter in central nervous system.MS is a common neurological diseases in young adults,and it is the main reason that causes teenagers non-traumatic disability in Europe and American.Although China is a low-prone areas of MS, but at present the incidence of MS is on the rise.Relapsing-remitting multiple sclerosis (relapsing remitting MS, RRMS) is the most common type, accounting for approximately 85% of all incidence population.The pathogenesis of MS is not yet clear, and more is currently considered to be abnormal immune response in the acquired environmental factors,based on the innate genetic susceptibility.Cytokines as materials in the process of immune response, can mediate and adjust the immune and inflammatory process.There is no clinical drugs which can cure MS.Although western medicines have certain effects in the control of acute onset and symptoms, but therapy may last for months to years,the cost is expensive, the most important thing is different levels of side effects.Traditional Chinese medicine have a certain advantage in the treatment of MS.Treatment based on syndrome differentiation is the characteristic and advantage of traditional Chinese medicine, is a principle of the understanding and treatment of disease.In this paper,we are based on the traditional Chinese and western medicine research on the etiology and pathogenesis of MS.Combined with related literature, from the pathogenesis and exploration on the basic principle of TCM diagnosis evidence, we evaluated the correlation between syndrome in TCM and cytokine IL-17/IL-21 in relapsing-remitting multiple sclerosis on the basis of the pathogenesis and syndrome diagnosis. Objective:RRMS patients are the research objects.Through the observation of syndrome in patients, the related scale score and serum level of IL-17/IL-21, we aimed to evaluate the canonical correlation between IL-17/IL-21 and syndrome of traditional Chinese medicine. The correlation between various scale score was also wanted to know.Method:This study selected RRM patients in Department of Neurology, Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine from January 2012 to January 2016.To collect information (such as demographic data,relaspse and rating scale) of the patients on the first day.We collected serum of the patients(fasting state)on the morning of the day.We also collected the serum of normal person who match with RRMS patient in age and gender.We determinated serum IL-17/IL-21 by ELISA.SPSS21.0 software was used in the study to analyze all clinical data.Serum IL-17/IL-21 of RRMS patients were obtained and statistical analysis were calculated compared with healthy person.The correlations between syndrome in TCM and the levels of IL-17/21 were analyzed.At the same time, the correlations between clinical scale and human serum IL 17/IL-21 and the relationships between clinical scale were analyzed.Results:There were 30 RRMS patients in our study, including 10 cases in acute period,20 patients with remission.The study found that pathogenic damp-heat encumbering the spleen is the priority of syndrome of RRMS in acute stage,deficiency in liver and kidney is the major syndrome in remission.Deficiency complicated with excess is the basic pathogenesis of MS.There was no significant difference in serum IL-17 between RRMS patients and healthy person;there was also no significant differences between RRMS patients in acute phase and patients in remission,but there was a lower trend in patients in remission.There was also no significant difference in serum IL-21 between RRMS patients and healthy person;there was no significant differences between RRMS patients in acute phase and patients in remission.Data showed there was no significant correlation between content of IL-17/IL-21 and syndrome in TCM in RRMS patients.There is a certain correlation among various clinical scales.The EDSS scores in patients was positively correlated with HAMD scores and PDQ scores, and negatively correlated with BI index;BI index was negatively correlated with HAMD scores;HAMD scores was positively correlated with PDQ scores, negatively correlated with MSQOL-54.The content of human serum IL-17 had no obvious correlation with clinical scale scores.Content of human serum IL-21 was negatively correlated with EDSS scores,positively positively correlated with BI index.Conclusion:Deficiency complicated with excess is the basic pathogenesis of RRMS.The syndrome of RRMS patients in acute phase is likely to be excessive,whereas the syndrome in remission is likely to be deficient.There is a correlation among various clinical scales.The relationships prove that neurological deficits,depression with other mental conditions and cognitive deficits can affect activities of daily living and quality life of MS patients.The levels of serum IL-17/IL-21 of RRMS patients have no difference with the healthy controls.There is also no relation between the content of human serum IL-17, IL-21 and TCM syndrome.The levels of serum IL-17 has no relation with neurologic impairment and course of disease.The activities of daily living and neurologic impairment have some effects on IL-21 secretion.