Assessment of Serum ACTH, Melatonin, and Cortisol Levels in Patients with Hormone Imbalance and Multiple Sclerosis.
Main Article Content
Abstract
Introduction: Multiple sclerosis (MS) is a long-term inflammatory disease that affects the central nervous system due to an abnormal immune response. Hormonal and enzyme changes in these patients can influence the progression and prognosis of the disease. In this research, the levels of cortisol, adrenocorticotropic hormone (ACTH), melatonin, and lactate dehydrogenase (LDH) in the blood of MS patients were studied.
Methods: This study involved 50 MS patients and 50 healthy individuals. The levels of ACTH, melatonin, and cortisol in the blood were measured using specific ELISA kits. The data obtained were then analyzed statistically using SPSS software.
Results: The findings revealed a significant increase in the levels of cortisol and LDH in MS patients (P<0.05), while the levels of melatonin and ACTH showed a significant decrease (P<0.05). The elevated cortisol levels may be attributed to chronic stress and inflammation associated with MS. An increase in LDH levels can indicate tissue damage caused by myelin destruction. On the other hand, decreased melatonin levels may lead to sleep disturbances and increased stress in these patients, while decreased ACTH levels may be linked to disruptions in the hypothalamic-pituitary-adrenal (HPA) axis.
Conclusion: The hormonal and enzyme changes observed in MS patients illustrate the wide-ranging impact of the disease on various body systems. The increase in cortisol and LDH as well as the decrease in melatonin and ACTH could serve as useful biomarkers for predicting disease progression and managing the condition. These findings align with previous studies and contribute to a deeper understanding of the pathological mechanisms of MS.
Article Details

This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Pisetsky, D.S., Pathogenesis of autoimmune disease. Nature Reviews Nephrology, 2023. 19(8): p. 509-524.
Deckx, N., et al., Neuroendocrine immunoregulation in multiple sclerosis. Journal of Immunology Research, 2013. 2013(1): p. 705232.
Marefat, A. and L. Sadeghi, Neurotoxic effects of phenytoin on primary culture of hippocampal neurons: Neural development retardation. Neurology, Psychiatry and Brain Research, 2020. 36: p. 52-56.
Hunter, S.F., Overview and diagnosis of multiple sclerosis. Am J Manag Care, 2016. 22(6 Suppl): p. s141-s150.
Ghareghani, M., et al., Inhibiting nighttime melatonin and boosting cortisol increase patrolling monocytes, phagocytosis, and myelination in a murine model of multiple sclerosis. Experimental & Molecular Medicine, 2023. 55(1): p. 215-227.
Feinstein, A., The neuropsychiatry of multiple sclerosis. The Canadian Journal of Psychiatry, 2004. 49(3): p. 157-163.
Regen, T. and A. Waisman, Modeling a complex disease: multiple sclerosis—update 2020. Advances in Immunology, 2021. 149: p. 25-34.
Sadeghi, L. and A. Marefat, Investigation of the Iron Oxide Nanoparticle Effects on Amyloid Precursor Protein Processing in Hippocampal Cells. Basic and Clinical Neuroscience, 2023. 14(2): p. 203.
Ross, A.P., Management of multiple sclerosis. Am J Manag Care, 2013. 19(16): p. S301-S306.
ALTAŞ, M., et al., Serum levels of irisin and nesfatin-1 in multiple sclerosis. Arquivos de Neuro-Psiquiatria, 2022. 80(02): p. 161-167.
Tavazzi, B., et al., Serum metabolic profile in multiple sclerosis patients. Multiple sclerosis international, 2011. 2011(1): p. 167156.
Vyas, S., et al., Chronic stress and glucocorticoids: from neuronal plasticity to neurodegeneration. Neural plasticity, 2016. 2016(1): p. 6391686.
Wróbel, A., et al., Association between levels of serotonin, melatonin, cortisol and the clinical condition of patients with rheumatoid arthritis. Rheumatology International, 2023. 43(5): p. 859-866.
Morey, J.N., et al., Current directions in stress and human immune function. Current opinion in psychology, 2015. 5: p. 13-17.
Stojanovich, L. and D. Marisavljevich, Stress as a trigger of autoimmune disease. Autoimmunity reviews, 2008. 7(3): p. 209-213.
Maydych, V., The interplay between stress, inflammation, and emotional attention: relevance for depression. Frontiers in neuroscience, 2019. 13: p. 384.
Allen, M.J. and S. Sharma, Physiology, adrenocorticotropic hormone (ACTH). 2018.
Hasenmajer, V., et al., Non-canonical effects of ACTH: insights into adrenal insufficiency. Frontiers in Endocrinology, 2021. 12: p. 701263.
Angelousi, A., A.N. Margioris, and C. Tsatsanis, ACTH Action on the Adrenals. Endotext [Internet], 2020.
Marketon, J.I.W. and R. Glaser, Stress hormones and immune function. Cellular immunology, 2008. 252(1-2): p. 16-26.
Sadeghi, L., et al., Spectroscopic and computational studies on the binding interaction of biologically active thioridazine and perphenazine with human Matrix metalloproteinases 9. Journal of Molecular Structure, 2024. 1313: p. 138548.
Shoenfeld, Y., et al., The mosaic of autoimmunity: hormonal and environmental factors involved in autoimmune diseases--2008. The Israel Medical Association Journal, 2008. 10(1): p. 8.
Hasannia, E., F. Derakhshanpour, and M.A. Vakili, Effects of melatonin on salivary levels of cortisol and sleep quality of hemodialysis patients: a randomized clinical trial. Iranian Journal of Psychiatry, 2021. 16(3): p. 305.
Anderson, G. and M. Rodriguez, Multiple sclerosis: the role of melatonin and N-acetylserotonin. Multiple sclerosis and related disorders, 2015. 4(2): p. 112-123.
Lin, G.-J., et al., Modulation by melatonin of the pathogenesis of inflammatory autoimmune diseases. International journal of molecular sciences, 2013. 14(6): p. 11742-11766.
Erten, S., et al., A male patient with systemic lupus erythematosus presenting with fulminant hepatitis. Gastroenterology Research, 2011. 4(6): p. 283.
Katzke, V., et al., Circulating liver enzymes and risks of chronic diseases and mortality in the prospective EPIC-Heidelberg case-cohort study. BMJ open, 2020. 10(3): p. e033532.
Galetta, K.M. and S. Bhattacharyya, Multiple sclerosis and autoimmune neurology of the central nervous system. Medical Clinics, 2019. 103(2): p. 325-336.
Koriem, K.M.M., Multiple sclerosis: New insights and trends. Asian Pacific Journal of Tropical Biomedicine, 2016. 6(5): p. 429-440.
Vega-Beyhart, A., et al., Cortisol: analytical and clinical determinants, in Advances in Clinical Chemistry. 2023, Elsevier. p. 235-271.
Fassbender, K., et al., Mood disorders and dysfunction of the hypothalamic-pituitary-adrenal axis in multiple sclerosis: association with cerebral inflammation. Archives of neurology, 1998. 55(1): p. 66-72.
Stevens, A. and A. White, ACTH: cellular peptide hormone synthesis and secretory pathways. Cellular Peptide Hormone Synthesis and Secretory Pathways, 2010: p. 121-135.
Wei, T. and S.L. Lightman, The neuroendocrine axis in patients with multiple sclerosis. Brain: a journal of neurology, 1997. 120(6): p. 1067-1076.
Kümpfel, T., et al., Hypothalamo-pituitary-adrenal axis activity evolves differentially in untreated versus treated multiple sclerosis. Psychoneuroendocrinology, 2014. 45: p. 87-95.
Aulinas, A., Physiology of the pineal gland and melatonin. 2019.
Gunata, M., H. Parlakpinar, and H. Acet, Melatonin: A review of its potential functions and effects on neurological diseases. Revue neurologique, 2020. 176(3): p. 148-165.
Sandyk, R. and G.I. Awerbuch, The pineal gland in multiple sclerosis. International journal of neuroscience, 1991. 61(1-2): p. 61-67.
Karaaslan, C. and S. Suzen, Antioxidant properties of melatonin and its potential action in diseases. Current topics in medicinal chemistry, 2015. 15(9): p. 894-903.
Carrascal, L., et al., Role of melatonin in the inflammatory process and its therapeutic potential. Current pharmaceutical design, 2018. 24(14): p. 1563-1588.
Sharma, D., M. Singh, and R. Rani. Role of LDH in tumor glycolysis: regulation of LDHA by small molecules for cancer therapeutics. in Seminars in cancer biology. 2022. Elsevier.
Nijland, P.G., et al., Differential expression of glucose-metabolizing enzymes in multiple sclerosis lesions. Acta neuropathologica communications, 2015. 3: p. 1-13.