Complement regulator factor h as a serum biomarker of multiple sclerosis: Correlation with disease state and MRI findings

Background: Multiple sclerosis (MS) has a variable phenotypic presentation and subsequent disease course that, although unpredictable at disease onset, is of crucial importance in guiding interventions. Effective and accessible biomarkers are required in order to stratify patients and inform treatment. Objective: To determine the predictive value of serum complement factor H (FH) in MS patients and if they correlate with magnetic resonance imaging (MRI). Methods: We randomly studied sixty patients with MS. They were subjected to full clinical and neurological assessment, laboratory tests, and MRI study. Thirty healthy subjects matched patient group with age and sex were selected as a control group. Results: Serum complement FH levels were highly significantly elevated in all MS patients compared to controls (P-value = 0.000), with sensitivity and specificity of 98.3% and 93.3%, respectively. Within the relapsing remitting MS subgroup, serum complement FH levels in patients during remission were higher than control (P=0.000), and lower than patients during relapse (P=0.000). Moreover, serum complement FH concentration had highly significant value as a surrogate marker for prediction of relapse in patients and in distinguishing progressive MS from relapsing remitting MS. Patients with black hole and brain atrophy had significantly higher levels of complement FH than patients without. Conclusion: Serum complement factor H may be an effective indicator of progression and a practical and accessible biomarker in determining disease course, providing objective evidence to help therapeutic decisions.