Molecular Detection of Fungal APR۱ Gene in Serum of Multiple Sclerosis Patients: A Personalized Medicine Research

Due to the lack of reliable biomarkers and a thorough understanding of the etiology of multiple sclerosis (MS), the treatment strategy in MS requires a personalized medicine framework that goes beyond the precision medicine idea. A patient-centered approach is necessary for personalized treatment, and the identification of pathophysiological processes should be employed to help classify diseases. Intracellular aspartic proteinase-A enzyme is expressed by the APR۱ gene and is one of the important factors in the development of systemic candidiasis caused by Candida albicans. The aim of this study was molecular detection of fungal DNA in serum of MS patients and to evaluate the expression of the APR۱ gene in C. Albicans isolates obtained from patients with multiple sclerosis (MS) and controls. The samples were obtained from ۱۰۰ MS patients with candidiasis and ۱۰۰ matched controls of healthy individuals during ۲۰۱۸ - ۲۰۱۹. The evaluation of APR۱ gene expression was performed using the reverse transcriptase-polymerase chain reaction (RT-PCR) method. There was a statistically significant difference in APR۱ gene expression of C. Albicans strains between MS patients (mean± SD: ۰.۵۰۰۸ ± ۰.۰۹۵۱۸) and the control group (mean± SD: ۰.۷۵۱۳±۰.۱۰۵۰۵) (P = ۰.۰۰۰). The mean values of EDSS were ۱.۴۰۷۴ ± ۰.۰۰۸۲ after antifungal treatment and ۲.۰۵۱۹ ± ۰.۱۱۲۳ before antifungal treatment (P = ۰.۰۰۰). Differences in active fungal infection between patients and controls indicate the importance and possible role of fungi in MS patients. The results suggested that APR۱ gene expression in C. Albicans strains isolated from MS patients may be an important factor for invasive C. Albicans strains in the progression of MS disease. Because fungal infections in the serum causes more activity of the body’s immune and defense system and directly affect the activity of the immune system, it further destroys the central nervous system.

Keywords:

Personalized Medicine , multiple sclerosis , Detection of Fungal DNA , Candida albicans