{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T05:36:32Z","timestamp":1777354592780,"version":"3.51.4"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Multiple sclerosis (MS) is an autoimmune disorder with a complex and multifactorial etiology. Increasing evidence suggests that peptide hormones may significantly influence the pathogenesis of MS by affecting inflammatory processes and metabolic dysregulation. The aim of the study was to evaluate the levels of apelin and ghrelin, which are two peptide hormones, in patients with relapsing-remitting MS (RRMS) receiving natalizumab and fingolimod compared to healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled forty-nine patients with RRMS and thirty-eight healthy individuals. The participants were divided into three groups i.e., natalizumab-treated patients, fingolimod-treated patients, and healthy controls. We assessed the serum levels of apelin and ghrelin. Statistical analysis was performed using STATISTICA 12. In both groups, correlations between the duration of the disease and treatment, BMI and hormone concentrations were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The natalizumab-treated group showed significantly higher levels of apelin (p=0.0063), while the fingolimod-treated group showed significantly higher ghrelin levels compared to the controls (p=0.0035).\n                      <jats:italic>Post-hoc<\/jats:italic>\n                      analysis revealed that all women treated with natalizumab and fingolimod had higher apelin levels than healthy women (p=0.025). In the group of women with MS, ghrelin levels increased with disease duration (p=0.045, R\u00a0=\u00a00.357). Additionally, apelin levels correlated positively with BMI in the fingolimod-treated group (p=0.001, R\u00a0=\u00a00.694).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study demonstrates differences in serum apelin and ghrelin levels between RRMS patients treated with natalizumab or fingolimod and healthy controls, suggesting a potential association between immunomodulatory treatment, metabolic factors, and peptide hormone regulation in multiple sclerosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1701657","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:34:35Z","timestamp":1777350875000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Do apelin and ghrelin play a role in multiple sclerosis? The analysis of patients treated with immunomodulatory therapies"],"prefix":"10.3389","volume":"17","author":[{"given":"Bo\u017cena","family":"Adamczyk","sequence":"first","affiliation":[{"name":"Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice","place":["Zabrze, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Morawiec","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice","place":["Zabrze, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micha\u0142","family":"Rakoca","sequence":"additional","affiliation":[{"name":"Department of Neurology, 10th Military Research Hospital and Polyclinic","place":["Bydgoszcz, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agata","family":"Sowa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice","place":["Zabrze, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ksawier","family":"Sawa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice","place":["Zabrze, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Adamczyk-Sowa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice","place":["Zabrze, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1212\/con.0000000000001136","article-title":"Epidemiology and pathophysiology of multiple sclerosis","volume":"28","author":"Ward","year":"2022","journal-title":"Continuum: Lifelong Learn Neurol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2024.123161","article-title":"Environmental factors related to multiple sclerosis progression","volume":"464","author":"Gouider","year":"2024","journal-title":"J Neurol Sci"},{"key":"B3","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1080\/00207450290025725","article-title":"Th1\/Th2 cytokines in the central nervous system","volume":"3","author":"Sredni-Kenigsbuch","year":"2002","journal-title":"Int J Neurosci"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra052130","article-title":"Multiple sclerosis \u2014 the plaque and its pathogenesis","volume":"354","author":"Frohman","year":"2006","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/1973834","article-title":"New insights into the role of oxidative stress mechanisms in the pathophysiology and treatment of multiple sclerosis","volume":"2016","author":"Adamczyk","year":"2016","journal-title":"Oxid Med Cell Longev"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/4036232","article-title":"Multiple sclerosis and obesity: Possible roles of adipokines","volume":"2016","author":"Guerrero-Garc\u00eda","year":"2016","journal-title":"Mediators Inflammation"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/s0003-9993(03)00466-0","article-title":"Health behaviors, body composition, and coronary heart disease risk in women with multiple sclerosis 11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is\/are associated","volume":"84","author":"Slawta","year":"2003","journal-title":"Arch Phys Med Rehabil"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2013\/981070","article-title":"Body mass index in multiple sclerosis: Associations with CSF neurotransmitter metabolite levels","volume":"2013","author":"Markianos","year":"2013","journal-title":"ISRN Neurol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1569503","article-title":"Brain-derived blood biomarkers in multiple sclerosis\u2014current trends and beyond","volume":"16","author":"Anandan","year":"2025","journal-title":"Front Immunol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fnmol.2023.1210091","article-title":"Neurodegeneration and its potential markers in the diagnosing of secondary progressive multiple sclerosis. 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