Abstract
The role of nitric oxide and its reactive derivatives (NO (x) ) is well known in the pathogenesis of multiple sclerosis, which is an inflammatory disease while NO (x) seems to be important in coordinating inflammatory response. The purpose of the present study was to assess serum NO (x) as one of the nitrogen species and inflammatory parameters in relapsing-remitting multiple sclerosis patients and to compare the effectiveness of various types of disease-modifying therapies that reduce nitric oxide and inflammatory biomarkers. Elevated NO (x) level was observed in patients who received the first-line disease-modifying therapy (interferons beta-1a and beta-1b) in comparison with the subjects treated with the second-line disease-modifying therapy (natalizumab; fingolimod) and healthy controls without significant differences in C-reactive protein and interleukin-1 beta. A negative correlation was observed between serum NO (x) level and the duration of multiple sclerosis confirmed in the whole study population and in subjects treated with the first-line agents. Only serum NO (x) , concentration could reveal a potential efficacy of disease-modifying therapy with a better reduction in NO (x) level due to the second-line agents of disease-modifying therapy.