Patients with multiple sclerosis (MS) presented with lower levels of orexin-A and transforming growth factor β (TGF-β) and higher levels of leptin than control individuals in a new study recently published in the Journal of Clinical Laboratory Analysis.

Leptin is an acute-phase proinflammatory protein. The increased levels of it in both serum and cerebrospinal fluid (CSF) of MS patients suggest it may contribute to disease severity and subsequent disability.

“Leptin has been shown to influence innate and adaptive immunity and inflammatory responses by increasing monocyte proliferation, macrophage phagocytic activity, and production of proinflammatory cytokines such as interleukin 6 (IL-6) and IL-12,” Moharami et al explained. Its level increases in response to inflammatory mediators to induce the release of cytokines.

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Orexin-A is a neuropeptide secreted by adipose tissue. It regulates several physiological processes, including glucose and energy metabolism, sleep, and eating behavior. According to the authors, the imbalance observed in the levels of orexin-A and leptin is likely to influence the eating behavior of patients.

TGF-β regulates the activity and growth of T helper cells and regulatory T cells, which are impaired in MS. Decreased serum levels of TGF-β in MS patients have also been reported in other studies.

In addition, Moharami et al in the present study observed a significant difference in the levels of triglycerides and cholesterol between MS patients and control individuals, but no difference in anthropometric variables. MS patients showed increased levels of triglycerides (mean, 242 mg/dL vs 107.8 mg/dL) and cholesterol (mean, 228.4 mg/dL vs 110.6 mg/dL).

The study enrolled 25 MS patients (21 with relapsing-remitting MS and 4 with clinically isolated syndrome) and 40 healthy individuals as a control group.


Moharami S, Nourazarian A, Nikanfar M, et al. Investigation of serum levels of orexin‐A, transforming growth factor β, and leptin in patients with multiple sclerosis. J Clin Lab Anal. Published online December 11, 2021. doi:10.1002/jcla.24170