Endothelial dysfunction is recognized as one of the leading factors in the pathogenesis of diseases of the central nervous system of various etiologies. Numerous studies have shown the role of hyperhomocysteinemia in the development of endothelial dysfunction and the prothrombogenic state. The most important condition in the development of multiple sclerosis (MS) is a dysregulation of the blood-brain barrier (BBB) and transendothelial leukocyte migration. It has been proven that homocysteine also contributes to the damage of neurons by the mechanism of excitotoxicity and the induction of the apoptosis of neurons. These processes can be one of the factors of neurodegenerative brain damage, which plays a leading role in the progression of MS. This review describes the pleiotropic effect of homocysteine on these processes and its role in MS pathogenesis.

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The genotypes of IL-4 (rs2243250)*C/C and CLEC16A (rs6498169)*G/G were associated with PPMS in Russians. The association between the HLA-DRB1*15 and PPMS found out in other populations was confirmed in Russians.

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Objective: to study the probable laboratory predictors of aggressive multiple sclerosis.Materials and methods. Antibodies to myelin oligodendrocyte glycoprotein (MOG), antibodies to thyroperoxidase and markers of endothelial dysfunction in blood serum were determined in patients with multiple sclerosis (MS). These indicators were analyzed for different courses of the demyelinating process, for different severity of neurological disorders, and for various sizes of focal lesions on magnetic resonance images.Results. In patients with aggressive multiple sclerosis, higher titers of antibodies to both myelin oligodendrocyte glycoprotein and thyroperoxidase were detected. A relationship between von Willebrand factor (vWf) and matrix metalloproteinase-9 (MMP-9) and the stage of multiple sclerosis was identified. A higher level of matrix metalloproteinase-9 was detected in MS patients with active foci of the disease on magnetic resonance images.Conclusion. Thus, antibodies to myelin oligodendrocyte glycoprotein, antibodies to thyroperoxidase, the levels of von Willebrand factor, matrix metalloproteinase-9 and adhesion molecule sPECAM-1 can be used as laboratory predictors of the malignant course of multiple sclerosis.