AUTHOR=Krajnc Nik , Bsteh Gabriel , Kasprian Gregor , Zrzavy Tobias , Kornek Barbara , Berger Thomas , Leutmezer Fritz , Rommer Paulus , Lassmann Hans , Hametner Simon , Dal-Bianco Assunta 

TITLE=Peripheral Hemolysis in Relation to Iron Rim Presence and Brain Volume in Multiple Sclerosis

JOURNAL=Frontiers in Neurology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.928582

DOI=10.3389/fneur.2022.928582

ISSN=1664-2295

ABSTRACT=<sec><title>Background:</title><p>Iron rim lesions (IRLs) represent chronic lesion activity and are associated with a more severe disease course in multiple sclerosis (MS). How the iron rims around the lesions arise in patients with MS (pwMS), and whether peripheral hemolysis may be a source of iron in rim associated macrophages, is unclear.</p></sec><sec><title>Objective</title><p>To determine a potential correlation between peripheral hemolysis parameters and IRL presence in pwMS.</p></sec><sec><title>Methods</title><p>This retrospective study included pwMS, who underwent a 3T brain MRI between 2015 and 2020 and had a blood sample drawn at ± 2 weeks. Patients with vertigo served as a control group.</p></sec><sec><title>Results</title><p>We analyzed 75 pwMS (mean age 37.0 years [SD 9.0], 53.3% female) and 43 controls (mean age 38.3 years [SD 9.8], 51.2% female). Median number of IRLs was 1 (IQR 4), 28 (37.3%) pwMS had no IRLs. IRL patients showed significantly higher Expanded Disability Status Scale (EDSS) compared to non-IRL patients (median EDSS 2.3 [IQR 2.9] vs. 1.3 [IQR 2.9], <italic>p</italic> = 0.017). Number of IRLs correlated significantly with disease duration (<italic>r</italic><sub>s</sub> = 0.239, <italic>p</italic> = 0.039), EDSS (<italic>r</italic><sub>s</sub> = 0.387, <italic>p</italic> &lt; 0.001) and Multiple Sclerosis Severity Scale (MSSS) (<italic>r</italic><sub>s</sub> = 0.289, <italic>p</italic> = 0.014). There was no significant difference in hemolysis parameters between non-IRL, IRL patients (regardless of gender and/or disease type) and controls, nor between hemolysis parameters and the number of IRLs. Total brain volume was associated with fibrinogen (<italic>β</italic>= −0.34, 95% CI −1.32 to −0.145, <italic>p</italic> = 0.016), and absolute cortical and total gray matter volumes were associated with hemoglobin (<italic>β</italic> = 0.34, 95% CI 3.39–24.68, <italic>p</italic> = 0.011; <italic>β</italic> = 0.33, 95% CI 3.29–28.95, <italic>p</italic> = 0.015; respectively).</p></sec><sec><title>Conclusion</title><p>Our data do not suggest an association between hemolysis parameters and IRL presence despite a significant association between these parameters and markers for neurodegeneration.</p></sec>