In response to various stimuli, neutrophils may release extracellular network (NET-neutrophil extracellular trap) consisting of DNA, proteolytic enzymes and other components of the cell nucleus. The NETosis process was first described in 2004 by Brinkmann et al. as animmunological response to Gram-positive bacteria, Gram-negative bacteria. Other sources provide data referring to the created network in response to the activity of fungi, protozoa and viruses. It is a mechanism of programmed cell death that leads to chromatin decondensation in the nucleus, disintegration of cell organelles and mixing of their constituent, as well as cell membrane permeabilization. The ability to release similar networks is also demonstrated by mast cells (MCET-mast cell extracellular trap), eosinophils (EET-eosinophil extracellular trap) and macrophages (METmacrophage extracellular trap). Various microscopy techniques, for example, immunofluorescence microscopy, transmission electron microscopy, and scanning electron microscopy, flow cytometry and ELISA tests are used to better illustrate and evaluate the NETosis markers. Current knowledge regarding the formation of NETs suggests in-vitro qualitative microscopic examination. So far, measurements based on flow cytometry allow for quick and objective evaluation of several thousand cells simultaneously. The application of cytometry facilitates indirect detection of NET producing cells in blood samples. While ELISA technique, due to the simplicity of making measurements and wide availability of validated tests, may contribute to its routine usage as a tool in screening tests.

Background. Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system (CNS). It mostly affects young people. Pathological lesions cause destruction of myelin sheath around axons and impede transmission of nerve impulses in CNS. The diagnosis of MS is based on clinical evaluation, biochemical blood tests and cerebrospinal fluid tests as well as on imaging. The study aim was assessment of blood counts of MS patients. Materials and methods. The study group comprised 189 people (77 healthy) and 112 MS patients treated at the Department of Neurology of the Medical University of Lublin. Parameters of EDTA anticoagulated whole blood were determined on the Advia 2012i analyzer. Statistica 12.5 program was used for statistical analysis. Results. Patients evaluated with regard to clinical condition and disease progression demonstrate differences in RBC count, hemoglobin, hematocrit and mean corpuscular volume (MCV). RBC count of patients with relapsing-remitting MS (RRMS) was lower (Me = 4.73 million/μl) than for patients with secondary progressive MS (SPMS) (Me = 5.03 million/μl). Additionally, differences in hemoglobin level were observed between RRMS patients (Me = 13.9 g/dl) and SPMS patients (Me = 14.7 g/dl). Significant differences were also observed in hematocrit; (Me = 40.5%) for RRMS and (Me = 44%) for SPMS patients. Differences in MCV between the examined groups of MS patients and the control group were not statistically significant. The same referred to differences in WBC count; (Me = 6.95 thousand/μl) for MS patients and (Me = 6.59 thousand/μl) for control group as well as platelet count; (Me = 237.5 μs/μl) for SM patients and (Me = 252 thousand/μl) for controls. Conclusion. Analysis of blood parameters reveals significant differences between MS patients and controls as well as differences between RRMS and SPMS patients with regard to red blood cells. An in-depth analysis also in terms of disease duration and stage of clinical advancement may be a valuable source of information on the overall condition of MS patients.