Association of Baseline Lipopolysaccharide-Binding Protein with EDSS Dynamics in Patients with Relapsing–Remitting Multiple Sclerosis

Objectives
Multiple sclerosis (MS) is a chronic autoimmune inflammatory condition of the central nervous system (CNS) marked by the destruction of myelin and subsequent damage to axons, leading to a deterioration in both motor and sensory abilities. Relapsing-remitting multiple sclerosis (RRMS) is the most common form of MS, characterized by episodes of neurological symptoms (relapses) followed by periods of recovery (remissions). Predicting the disease course during the early inflammatory phase of RRMS is crucial for timely treatment adjustments, minimizing clinical relapses and disability, and achieving improved long-term outcomes.
Materials and Methods
This study included 58 individuals diagnosed with RRMS, all exhibiting an Expanded Disability Status Scale (EDSS) score of less than 4. Baseline magnetic resonance imaging (MRI) was conducted to evaluate brain and spinal cord lesions, while disability levels were assessed using the EDSS both at baseline and during follow-up assessments. Additionally, enzyme-linked immunosorbent assays (ELISA) were utilized to quantify blood-based inflammation markers in plasma at baseline.
Results
Findings revealed a significant correlation between baseline levels of lipopolysaccharide-binding protein (LBP) and increases in EDSS scores over a short follow-up period of 8 to 10 months. Notably, this prognostic relevance
of LBP was predominantly observed in patients who had undergone disease-modifying treatments (DMT) prior to the study.
Conclusions
The study suggests that the level of LBP may be among the predictors of disability progression in RRMS over short follow-up periods, particularly in those receiving treatment. It highlights the possible effect of endotoxins in the pathogenesis of RRMS and neurological disability despite the use of DMT and the absence of new relapses during follow-up. However, further research is needed to better understand the mechanisms through which endotoxins affect disease progression and to explore potential interventions that could mitigate their impact on patients with RRMS.