Enzyme blood level disorder as a marker of metabolic processes severity in multiple sclerosis
Dynamics of membrane−bound enzymes activity changes in the blood of 67 patients with multiple sclerosis was investigated depending on the variety and duration of the disease. It was noted that the most pronounced enzymatic dysbalance was observed in patients with cerebrospinal multiple sclerosis and...
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| Date: | 2014 |
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Інститут проблем кріобіології і кріомедицини НАН України
2014
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| Cite this: | Enzyme blood level disorder as a marker of metabolic processes severity in multiple sclerosis / E.V. Markovskaya // Международный медицинский журнал. — 2014. — Т. 20, № 2. — С. 5-8. — Бібліогр.: 8 назв. — англ. |
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| citation_txt | Enzyme blood level disorder as a marker of metabolic processes severity in multiple sclerosis / E.V. Markovskaya // Международный медицинский журнал. — 2014. — Т. 20, № 2. — С. 5-8. — Бібліогр.: 8 назв. — англ. |
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| description | Dynamics of membrane−bound enzymes activity changes in the blood of 67 patients with multiple sclerosis was investigated depending on the variety and duration of the disease. It was noted that the most pronounced enzymatic dysbalance was observed in patients with cerebrospinal multiple sclerosis and in patients with the disease duration over 10 years, which is a marker of disease severity and degree of the pathological process generalization. Decreased CPK level in patients with all varieties of the disease, regardless of multiple sclerosis duration, reflects the degree of reduction of metabolic and energy processes rate in the cells of muscular and nervous tissues, possibly due to increased catabolism and, as a consequence, development of movement disorders.
Проведено исследование динамики изменения активности мембраносвязанных ферментов в крови 67 больных рассеянным склерозом в зависимости от формы и длительности заболевания. Отмечено, что наиболее выраженный ферментативный дисбаланс наблюдается при цереброспинальной форме рассеянного склероза и у пациентов с длительностью заболевания более 10 лет, что является маркером тяжести состояния больных и степени генерализации патологического процесса. Снижение уровня креатининфосфокиназы при всех формах заболевания, независимо от длительности рассеянного склероза, отражает степень уменьшения скорости метаболических и энергетических процессов в клетках мышечной и нервной тканей, возможно, из−за явлений повышенного катаболизма и, как следствие, развития двигательных нарушений.
Проведено дослідження динаміки зміни активності мембранозв'язаних ферментів у крові 67 хворих розсіяним склерозом залежно від форми й тривалості захворювання. Зазначено, що найбільш виражений ферментативний дисбаланс спостерігається при цереброспинальній формі розсіяного склерозу й у пацієнтів із тривалістю захворювання понад 10 років, що є маркером тяжкості стану хворих і ступеня генералізації патологічного процесу. Зниження рівня креатинінфосфокінази при всіх формах захворювання, незалежно від тривалості розсіяного склерозу, відображає ступінь зниження швидкості метаболічних і енергетичних процесів у клітинах м'язової й нервової тканин, можливо, через явища підвищеного катаболізму і, як наслідок, розвиток рухових порушень.
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5© E. V. MarkoVskaya, 2014
МЕЖДУНАРОДНЫЙ МЕДИЦИНСКИЙ ЖУРНАЛ, 2014, № 2
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UDC 616.832–004.2–074:577.15
ENZYME BLOOD LEVEL DISORDER AS A MARKER OF METABOLIC
PROCESSES SEVERITY IN MULTIPLE SCLEROSIS
E. V. MARKOVSKAYA
Kharkiv National Medical University
Dynamics of membrane-bound enzymes activity changes in the blood of 67 patients with multiple
sclerosis was investigated depending on the variety and duration of the disease. It was noted that
the most pronounced enzymatic dysbalance was observed in patients with cerebrospinal multiple
sclerosis and in patients with the disease duration over 10 years, which is a marker of disease se-
verity and degree of the pathological process generalization. Decreased CPK level in patients with
all varieties of the disease, regardless of multiple sclerosis duration, reflects the degree of reduction
of metabolic and energy processes rate in the cells of muscular and nervous tissues, possibly due to
increased catabolism and, as a consequence, development of movement disorders.
Key words: multiple sclerosis, enzymes.
At present multiple sclerosis (MS) is the second
disabling disorder among nervous system disorders in
Ukraine [1]. Medical and social significance of this
problem is caused, on the one hand, by steady growth
of the number of MS patients, among whom the vast
majority are young and middle-aged persons, on the
other hand, by the treatment complexity, which, de-
spite significant economic costs, not always allows
preserving ability to work and vitality [2–4].
Today the problem of pathophysiology of the de-
myelinating process is investigated in depth, as the
theory, according to which immunological disorders
are the dominant factor in myelin damage, undergoes
changes. Herein, more attention is paid to other causes
of demyelization and axonal damage, including disor-
ders of a number of metabolic processes in neurons and
their processes. It is known that when metabolism of
proteins, amino acids, hormones is disturbed, the activ-
ity of a number of enzymes and the content of certain
minerals change [5, 6]. Having a close relationship
with macro- and microelements, hormones, vitamins
and other biologically active substances, enzymes are
indispensable participants of all physiological processes
in the organism. The change in their activity suggests
of disorders of intracellular metabolic processes and
redox reactions. Thus, identification of enzyme dys-
balance and determination of its degree in the blood
of MS patients may be an indicator of cell dystrophy
and have some diagnostic and prognostic significance
for assessing severity of neuronal damage in MS.
The purpose of this work was to study the dy-
namics of the changes in activity of membrane-bound
enzymes in the blood of MS patients, depending on
the variety and duration of the disease.
This study involved 67 MS patients (main group),
of them 28 men and 39 women treated at the neuro-
logy department. The mean age was 30.1±9.3 years.
All patients were diagnosed MS according to
McDonald’s criteria (2010) [7], and underwent MRI
investigation which confirmed the presence of demy-
elinating foci in the central nervous system. Depend-
ing on the clinical manifestations cerebral MS was
diagnosed in 14 patients, spinal in 5 and cerebrospi-
nal in 48. Mean level of the functional disturbances
by EDSS (Expanded Disability Status Scale) [8] in
49 MS patients was under 5 points (moderate signs
of disability and moderate dependence) and over
5 points in 18 patients.
At the time of the examination the disease du-
ration under 5 years was present in 21 patients,
from 5 to 9 years in 26 patients, and over 10 years
in 20 patients.
The controls were 30 healthy age- and sex-matched
persons without any nervous system pathology.
Enzymes activity and the content of aspartate
aminotransferase (AST), alanine aminotransferase
(ALT), alkaline phosphatase (ALP), creatine phos-
phokinase (CPK), gamma-glutamyl transpeptidase
(GGT), lactate dehydrogenase (LDH) were studied
using enzymatic kinetic method with biochemical
analyzer Screen master lab (Hospitex Diagnostics,
Switzerland, Italy) using standard procedures.
The obtained data were statistically processed
with statistical software package Statistica 6. Mean
values and mean error were calculated. Parametric
Student’s test was used as a criterion for significance
of the samples difference; the differences were con-
sidered significant at p < 0.05.
The performed clinical neurological examina-
tion revealed that the study group presented pre-
dominantly with pyramidal disorders such as central
and hemiparaparesis (91 %), cognitive dysfunction
(80 %), cerebellar ataxic syndrome (74.5 %), sensi-
tive disorders (74 %), syndromes of the brain stem
and cranial nerves lesions (58.5 %), visual disorders
(44 %), sphincter disorders (39.5 % of cases).
Mean EDSS values in patients with different va-
rieties and duration of the disease revealed the lowest
НЕВРОЛОГИЯ
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НЕвРОЛОгИя
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rate in patients with cerebral MS (3.0–3.5), and the
highest in patients with cerebrospinal MS (4.0–6.0
points). Directly proportional relationship in dete-
rioration of the functional state of MS patients as-
sessed by EDSS and increase of the disease duration
were noted. Thus, in patients with disease duration
under 5 years, mean values of the functional condi-
tion ranged within 3.0–4.0 points, in patients with
disease duration of 5–9 years it ranged within 4.0–5.5
points, while at disease duration over 10 years the
total on the scale of disability reached 5.0–6.0 points.
The analysis of the values of enzyme activity
in MS in the whole showed significant reduction
of CPK by 56.5 % and elevation of ALT by 38.9 %
vs. the controls, as well as a tendency to reduction
of AST levels (by 12.5 %), ALP (by 10.6 %) and in-
creased GGT (by 23.9 %) (Table 1).
The direction and intensity of enzymatic dys-
balance depended on the variety and duration of
the disease. Thus, a significant reduction of AST by
32.2 % and CPK by 72.3 % as well as a tendency to
reduction of LDH levels by 16.5 %, increase in ALT
levels by 50.4 % and GGT by 14.4 % vs. the controls
(Table 2) were revealed in patients with cerebral MS.
In patients with spinal MS only a significant reduc-
tion in CPK levels by 71.0 % was present. Increased
activity of AST, ALT, ALP and GGT vs. the controls
was not statistically significant, but demonstrated
a definite tendency (Table 2).
The most pronounced changes in enzyme ac-
tivity were observed in patients with cerebrospinal
MS, which differed not only from the controls, but
also significantly differed from those in other vari-
eties of the disease. Enzymatic dysbalance in these
patients was characterized by a significant decrease
of activity of ALP, CPK, LDH by 16.9; 67.3 and
16.6 %, respectively, 28.9 % higher vs. the controls
ALT levels (Table 2).
The analysis of the findings on the blood enzymes
content depending on MS duration demonstrated
that in patients with the disease duration under 5
years ALT level was significantly elevated by 34.5 %
and CPK was reduced by 55 % vs. the controls. In-
creased GGT (by 43 %) and reduced ALP level (by
14.7 %) in these patients generally had a clear ten-
dency though not significant. AST and LDH activ-
ity values ranged greatly vs. the controls, therefore
in general these patients did not have any changes
in these values (Table 3).
The analysis of the biochemical findings in pa-
tients with MS duration ranging within 5–9 years
showed a significant reduction in the levels of AST,
Table 1
The content of membrane-bound enzymes in the blood serum of MS patients
Group AST ALT ALP CPK LDH GGT
Main, n = 67 23.16±2.11 24.41±2.23* 189.71±12.54 35.55±6.89* 363.65±26.22 21.82±3.01
Controls,
n = 30 26.48±1.81 17.58±0.63 212.18±11.07 81.71±9.13 379.78±21.99 17.61±1.18
* p < 0.05 as to the controls. The same in Table 2, 3.
Table 2
Enzyme activity dynamics in patients with MS depending on the disease variety
MS variety AST ALT ALP CPK LDH GGT
Cerebral, n = 14 17.96±3.74* 26.44±5.26 191.88±24.61 22.61±4.52* 317.01±38.81 20.14±5.39
Spinal, n = 5 30.82±11.03 35.15±9.67 242.68±75.65 23.68±6.12* 382.73±31.15 21.88±4.17
Cerebrospinal,
n = 48 24.04±1.71 22.66±2.21* 176.29±10.98* 26.73±5.49* 316.73±16.21* 21.08±2.89
Controls, n = 30 26.48±1.81 17.58±0.63 212.18±11.07 81.71±9.13 379.78±21.99 17.61±1.18
Table 3
Enzyme activity values in patients with MS depending on the disease duration
MS duration AST ALT ALP CPK LDH GGT
Under 5 years,
n = 21 25.08±3.32 23.65±3.02* 180.92±17.01 36.79±10.59* 343.89±21.85 25.22±5.01
5–9 years,
n = 26 19.06±2.68* 24.24±4.03 190.57±16.98 28.81±7.57* 301.18±25.31* 19.68±4.21
Over 10 years,
n = 20 26.73±4.52 12.97±6.24 163.01±12.87* 22.02±3.22* 318.06±29.92 18.19±2.36
Controls,
n = 30 26.48±1.81 17.58±0.63 212.18±11.07 81.71±9.13 379.78±21.99 17.61±1.18
7
НЕвРОЛОгИя
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CPK, LDH by 28; 64.7 and 20.7 %, respectively,
vs. those in the controls. Further increase in dis-
ease duration was accompanied by a progressive re-
duction in enzyme activity according to significant
reduction in the levels of ALP by 23.2 % and CPK
by 73 % vs. the controls and a clear tendency to re-
duction of ALT (by 26.2 %) and LDH (by 16.3 %) in
patients with MS duration over 10 years (Table 3).
The revealed enzymatic changes suggested of
disorders in various intracellular metabolic processes
that occurred in MS patients. Herewith, increase of
ALT (p < 0.05) and GGT (p > 0.05) levels in the
examined group in total and depending on the variety
and duration of the disease reflected destruction of
nerve cells and protein metabolism disorder. Marked
reduction in CPK activity in all patients regardless
of the variety and duration of MS is a marker of
inhibition of metabolic and energy processes in the
cells, mainly muscular and nerve tissues, which was
associated with the restriction and/or a sharp de-
crease in the motor activity of MS patients due to
disorders of the muscular tissue nerve supply. More
pronounced enzymatic disorders in cerebrospinal
MS compared to other varieties of the disease in
the form of increased ALT levels and reduced ALP,
CPK and LDH values, were apparently associated
with aggravation of disorders in metabolism and re-
dox reactions in the cells during development of the
multi-level pathological process. Hypofermentemia
elevation with increase in the disease duration re-
flected aggravation of metabolic disorders associated
with predominance of catabolic processes, depletion
of reserve capacity of the organism with development
and progression of MS and was a poor prognostic sign.
Thus, our findings allow us to draw the follow-
ing conclusion.
MS patients have a resistant dysfermentemia,
severity and direction of which depend on the vari-
ety and duration of the disease.
The most pronounced reduction in the activity
of the marker membrane-bound enzymes is observed
in cerebrospinal MS and at disease duration over
10 years, which is a marker of the condition sever-
ity, generalization of the pathological process and
depletion of the reserve capacity of the organism.
Reduced levels of CPK in all varieties of the
disease, regardless of MS duration reflect the degree
of deceleration of metabolic and energy processes in
the cells of the nervous and muscular tissue, probably
due to the development of motor disturbances.
С п и с о к л и т е р а т у р ы
1. Міщенко Т. С. Проблема патології нервової системи
в Україні та стан вітчизняної служби на межі де-
сятиріччя / Т. С. Міщенко // Здоров’я України.—
2010.— № 3 (14).— С. 3–4.
2. Мальцев Д. В. Рассеянный склероз: нерешенные про-
блемы и перспективы исследований / Д. в. Мал�-и перспективы исследований / Д. в. Мал�-перспективы исследований / Д. в. Мал�- / Д. в. Мал�-/ Д. в. Мал�-Д. в. Мал�-Мал�-
цев // Укр. неврологический журн.— 2013.— № 2
(27).— С. 8–16.
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potential clinical applications / �. Pittocks, C. F. Luc- / �. Pittocks, C. F. Luc-/ �. Pittocks, C. F. Luc-�. Pittocks, C. F. Luc-Pittocks, C. F. Luc-C. F. Luc-Luc-
chinetti // Neurologist.— 2007.— Vol. 13.— P. 45–56.
4. Yex E. A. Multiple sclerosis: predicting risk and delay-
ing progression / E. A. Yex, Weinstock-Guttman //
�. Lancet Neurol.— 2010.— Vol. 9 (1).— P. 7–9.
5. Окислител�ный стресс у пациентов с ремиттиру-у пациентов с ремиттиру-пациентов с ремиттиру-с ремиттиру-ремиттиру-
ющей и вторично-прогредиентной �ормами рассе-и вторично-прогредиентной �ормами рассе-вторично-прогредиентной �ормами рассе-
янного склероза / Н. в. Кротенко, Л. П. Смирнова,
Н. М. Кротенко [и др.] // Неврологический журн.—
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Л. Б. Оринчак // Укр. неврологический журн.—
2013.— № 2 (27).— С. 28–33.
7. Diagnostic criteria for multiple sclerosis: 2010 revisions
to the McDonald criteria / C. H. Polman, S. C. Re- / C. H. Polman, S. C. Re-/ C. H. Polman, S. C. Re-C. H. Polman, S. C. Re-Polman, S. C. Re-S. C. Re-Re-
ingold, G. Edan [et al.] // Ann. Neurol.— 2011.—
Vol. 69.— P. 292–302.
8. Kurtzke J. F. Rating neurologic impairment in multiple
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�. F. Kurtzke // Neurology.— 1983.— Vol. 33.— P. 1444–
1452.
ДИСФЕРМЕНТЕМИЯ КАК МАРКЕР ТЯЖЕСТИ ОБМЕННЫХ ПРОЦЕССОВ
ПРИ РАССЕЯННОМ СКЛЕРОЗЕ
Е. в. МАРКОвСКАя
Проведено исследование динамики изменения активности мембраносвязанных ферментов в кро-
ви 67 больных рассеянным склерозом в зависимости от формы и длительности заболевания.
Отмечено, что наиболее выраженный ферментативный дисбаланс наблюдается при цереброспи-
нальной форме рассеянного склероза и у пациентов с длительностью заболевания более 10 лет,
что является маркером тяжести состояния больных и степени генерализации патологического
процесса. Снижение уровня креатининфосфокиназы при всех формах заболевания, независимо
от длительности рассеянного склероза, отражает степень уменьшения скорости метаболических
и энергетических процессов в клетках мышечной и нервной тканей, возможно, из-за явлений
повышенного катаболизма и, как следствие, развития двигательных нарушений.
Ключевые слова: рассеянный склероз, ферменты, маркер обменных процессов.
8
НЕвРОЛОгИя
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ДИСФЕРМЕНТЕМІЯ ЯК МАРКЕР ТЯЖКОСТІ ОБМІННИХ ПРОЦЕСІВ
ПРИ РОЗСІЯНОМУ СКЛЕРОЗІ
О. в. МАРКОвСЬКА
Проведено дослідження динаміки зміни активності мембранозв’язаних ферментів у крові 67 хво-
рих розсіяним склерозом залежно від форми й тривалості захворювання. Зазначено, що найбільш
виражений ферментативний дисбаланс спостерігається при цереброспинальній формі розсіяного
склерозу й у пацієнтів із тривалістю захворювання понад 10 років, що є маркером тяжкості стану
хворих і ступеня генералізації патологічного процесу. Зниження рівня креатинінфосфокінази при
всіх формах захворювання, незалежно від тривалості розсіяного склерозу, відображає ступінь
зниження швидкості метаболічних і енергетичних процесів у клітинах м’язової й нервової тка-
нин, можливо, через явища підвищеного катаболізму і, як наслідок, розвиток рухових порушень.
Ключові слова: розсіяний склероз, ферменти, маркер обмінних процесів.
Поступила 11.04.2014
|
| id | nasplib_isofts_kiev_ua-123456789-113531 |
| institution | Digital Library of Periodicals of National Academy of Sciences of Ukraine |
| issn | 2308-5274 |
| language | English |
| last_indexed | 2025-12-07T17:25:38Z |
| publishDate | 2014 |
| publisher | Інститут проблем кріобіології і кріомедицини НАН України |
| record_format | dspace |
| spelling | Markovskaya, E.V 2017-02-10T14:46:09Z 2017-02-10T14:46:09Z 2014 Enzyme blood level disorder as a marker of metabolic processes severity in multiple sclerosis / E.V. Markovskaya // Международный медицинский журнал. — 2014. — Т. 20, № 2. — С. 5-8. — Бібліогр.: 8 назв. — англ. 2308-5274 https://nasplib.isofts.kiev.ua/handle/123456789/113531 616.832–004.2–074:577.15 Dynamics of membrane−bound enzymes activity changes in the blood of 67 patients with multiple sclerosis was investigated depending on the variety and duration of the disease. It was noted that the most pronounced enzymatic dysbalance was observed in patients with cerebrospinal multiple sclerosis and in patients with the disease duration over 10 years, which is a marker of disease severity and degree of the pathological process generalization. Decreased CPK level in patients with all varieties of the disease, regardless of multiple sclerosis duration, reflects the degree of reduction of metabolic and energy processes rate in the cells of muscular and nervous tissues, possibly due to increased catabolism and, as a consequence, development of movement disorders. Проведено исследование динамики изменения активности мембраносвязанных ферментов в крови 67 больных рассеянным склерозом в зависимости от формы и длительности заболевания. Отмечено, что наиболее выраженный ферментативный дисбаланс наблюдается при цереброспинальной форме рассеянного склероза и у пациентов с длительностью заболевания более 10 лет, что является маркером тяжести состояния больных и степени генерализации патологического процесса. Снижение уровня креатининфосфокиназы при всех формах заболевания, независимо от длительности рассеянного склероза, отражает степень уменьшения скорости метаболических и энергетических процессов в клетках мышечной и нервной тканей, возможно, из−за явлений повышенного катаболизма и, как следствие, развития двигательных нарушений. Проведено дослідження динаміки зміни активності мембранозв'язаних ферментів у крові 67 хворих розсіяним склерозом залежно від форми й тривалості захворювання. Зазначено, що найбільш виражений ферментативний дисбаланс спостерігається при цереброспинальній формі розсіяного склерозу й у пацієнтів із тривалістю захворювання понад 10 років, що є маркером тяжкості стану хворих і ступеня генералізації патологічного процесу. Зниження рівня креатинінфосфокінази при всіх формах захворювання, незалежно від тривалості розсіяного склерозу, відображає ступінь зниження швидкості метаболічних і енергетичних процесів у клітинах м'язової й нервової тканин, можливо, через явища підвищеного катаболізму і, як наслідок, розвиток рухових порушень. en Інститут проблем кріобіології і кріомедицини НАН України Международный медицинский журнал Неврология Enzyme blood level disorder as a marker of metabolic processes severity in multiple sclerosis Дисферментемия как маркер тяжести обменных процессов при рассеянном склерозе Дисферментемія як маркер тяжкості обмінних процесів при розсіяному склерозі Article published earlier |
| spellingShingle | Enzyme blood level disorder as a marker of metabolic processes severity in multiple sclerosis Markovskaya, E.V Неврология |
| title | Enzyme blood level disorder as a marker of metabolic processes severity in multiple sclerosis |
| title_alt | Дисферментемия как маркер тяжести обменных процессов при рассеянном склерозе Дисферментемія як маркер тяжкості обмінних процесів при розсіяному склерозі |
| title_full | Enzyme blood level disorder as a marker of metabolic processes severity in multiple sclerosis |
| title_fullStr | Enzyme blood level disorder as a marker of metabolic processes severity in multiple sclerosis |
| title_full_unstemmed | Enzyme blood level disorder as a marker of metabolic processes severity in multiple sclerosis |
| title_short | Enzyme blood level disorder as a marker of metabolic processes severity in multiple sclerosis |
| title_sort | enzyme blood level disorder as a marker of metabolic processes severity in multiple sclerosis |
| topic | Неврология |
| topic_facet | Неврология |
| url | https://nasplib.isofts.kiev.ua/handle/123456789/113531 |
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