| Multiple sclerosis is a common neuroinflammatory disease of the central nervous system causing
nervous system defects and severe physical disability. IL-21 is a proinflammatory cytokine
produced mainly by Th-17 and Tfh cells which its exact role in MS was not yet clearly understood.
In the present study we aimed to investigate the possible correlation of IL-21 gene expression,
methylation, and its serum levels with MS severity and progression. The results showed that IL-
21 mRNA level and serum level were significantly increased in patient group compared with
control group (p=0.02 and p<0.0001 respectively). Moreover, we found a strong positive
correlation between IL-21 mRNA levels and EDSS scores (r=0.637, P<0.0001), IL-21 mRNA
levels and Progression Index (r=0.540, P<0.0001), IL-21 serum levels and EDSS scores (r=0.617,
P<0.0001), and IL-21 serum levels and Progression Index (r=0.527, P<0.0001) in MS patients.
Additionally, we found that the methylation level of IL-21 promoter region was decreased in patient group
compared with the control group (p< 0.0001). We also found that methylation level of IL-21 gene promoter
is negatively correlated with the IL-21 mRNA level (r= -0.263, p= 0.02), serum level (r= -0.249, p=
0.03), EDSS scores (r= -0.276, p= 0.01) and Progression Index (r= -0.430, p= 0.0001). Data showed
that the increased percentages of IL-21-producing Tfh-like, Th-17 and Th1 cells in patients are
positively correlated with MS severity and progression. The results of our study suggest a proinflammatory
and booster role for IL-21 in the MS pathogenesis and progression. |