Clinical and immunological aspects of the first attack of multiple sclerosis (clinically isolated syndrome)
https://doi.org/10.21886/2219-8075-2026-17-1-87-96
Abstract
Objective: to identify clinical and immunological predictors of early conversion in patients with CIS. Materials and methods: analysis of medical records and laboratory data of 320 patients, data processing - one- and two-way analysis of variance (ANOVA), nonparametric chi-square test, parametric and nonparametric (Spearman) correlation analysis, Mann-Whitney rank test. Results: age of onset: 13–71 years, mean — 36.4±8 years; Me=36 years. In 60 patients (18.7%) the onset was at the age of 50 years and older. Polyfocal onset was detected in 84.4%, in most patients conversion occurred after 12 months or more. In innate immunity: an increase in CD16+Gr+, % 7.8 [5.2; 9.1], CD14+289+ 12 [4; 20], inversion of the HBT test 155 [139; 171] (p < 0.05). In adaptive immunity: an increase in CD3+HLA DR+, % 3 [2; 5.4], CD8+Gr+ 20 [15; 27], CD19+, % 9 [7; 12], an increase in the CIC, AU. 60 [47;84] (p < 0.05), decrease in CD4+CD25+, % 1.3 [1.0;2.2], CD19+CD5+, % 0.6 [0.3;0.9] (p < 0.05). a wide range of the age of onset was revealed, with a tendency towards an increase in the average age, and prevalence of polyfocal debut. In innate immunity, an increase in monocytes expressing CD14+289+ with a decrease in the ability of antibacterial protection, a decrease in the activation capacity of monocytes, an increase in the cytotoxic functions of natural killers, a decrease in the adaptive reserves of the neutrophil link with inversion of the NBT test. Changes in adaptive immunity lead to inversion of IRI (an increase in cells with a cytotoxic effect, a violation of the B1/B2 lymphocyte ratio and their discoordination). Discoordination of antibody production processes in the humoral immunity. Conclusion: clinical and immunological markers of early conversion of CIS to MS have been identified.
About the Authors
L. P. Sizyakina
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Ludmila P. Sizyakina, MD, Professor, Head of the Department of Clinical Immunology and Allergology, Faculty of Advanced Training and Professional Development
Rostov-on-Don
Competing Interests:
Sizyakina L.P. is Member of the Editorial Board of the Journal «Medical Herald of the South of Russia». The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
Z. A. Goncharova
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Zoya A. Goncharova, MD, PhD, Professor, Head of the Department of Nervous System Diseases and Neurosurgery
Rostov-on-Don
Competing Interests:
The author did not declare any other conflicts of interest.
N. M. Yarosh
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Natalya M. Yarosh, neurologist, Department of Neurology
Rostov-on-Don
Competing Interests:
The author did not declare any other conflicts of interest.
E. A. Markova
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Elena A. Markova, neurologist, Department of Neurology
Rostov-on-Don
Competing Interests:
The author did not declare any other conflicts of interest.
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For citations:
Sizyakina L.P., Goncharova Z.A., Yarosh N.M., Markova E.A. Clinical and immunological aspects of the first attack of multiple sclerosis (clinically isolated syndrome). Medical Herald of the South of Russia. 2026;17(1):87-96. (In Russ.) https://doi.org/10.21886/2219-8075-2026-17-1-87-96
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