Serum lactate and uric acid as biomarkers for disease activity and progression in multiple sclerosis

Background: Multiple sclerosis (MS) is a primary inflammatory demyelinating disease that could be associated with a secondary progressive neurodegenerative component. Objective: To investigate the serum levels of lactate and uric acid (UA) in MS patients and to explore their potential role as biological markers for monitoring the disease activity and progression. Methods: This case-control study was conducted on 89 Egyptian subjects (55 multiple sclerosis patients=Group I) and 34 normal healthy individuals (Control group = Group II). Group I patients were subjected to thorough history taking, detailed neurological examination and clinical assessment of the severity of the disease using Expanded Disability Status Scale (EDSS). Serum level of lactate and uric acid were measured in both groups. Results: In comparison to the control group, subjects with multiple sclerosis had statistically significant higher serum level of lactate (P=0.005), along with lower serum levels of UA (P=0.001), however, there was no statistically significant correlation between their levels and duration of illness, EDSS scores or number of attacks. Conclusion: MS patients have significantly higher serum lactate level. This can support the hypothesis that mitochondrial dysfunction has an important role in the underlying pathogenic mechanism of the disease. MS patients have also significantly lower uric acid level than normal control; reflecting its important role as an antioxidant in the prevention of disease activity. However, their potential value as markers for monitoring disease activity and progression is questionable.