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Background: The Multiple Sclerosis (MS) disease is considered as chronic, demyelinating, immune --mediated disease of the central nervous system (CNS) . The immunity mediated by T-lymphocyte plays the most effective destructive process in the CNS in MS. High levels of circulating soluble form of Inter Cellular Adhesion Molecule-1 (sICAM-1) have been detected in the serum of MS patients . The inflammatory marker neutrophil-lymphocytic ratio (NLR) is an index, had been reported to be cheap, readily available, and easy to measure. The estimation of immunoglobulin M (IgM) molecules is predictive for a more severe disease course with a shorter time period to the next relapse, and higher grade of disability. Also, C-Reactive Protien CRP was elevated in response to inflammation as acute phase protein reactant, CRP can be used as useful marker for the detection of inflammation-mediated MS. Aim of work: to estimate ICAM-1 levels in remitting-relapsing multiple sclerosis (RRMS) during remission and to evaluate its correlation with neurological disability, and then assess correlation of some inflammatory markers (CRP, NLR, IgM) with neurological disability in MS patients. Subjects and methods: This study consist of 85 subjects, and classified in to three groups, 50 relapsing remitting MS patients who subdivided into 25 patients without neurological disability and 25 patients with disability(their age range from 19 to 42 year, subdivided to 33 females and 17 males, duration of MS disease is ranged from 1 to 14 years ) and 35 healthy control (their age range from 20 to 40 year and subdivided to 24 females and 11 males) . All cases were examined neurologically, and then assessment of neurological disability according to Expanded Disability Status Scale (EDSS). Blood levels of ICAM-1, CRP, IgM and NLR were done to all subjects. Results: There was a significant decrease of ICAM-1 level in MS patients (with and without disability) when compared to healthy control group. There was an increasing of ICAM-1 levels among MS patients with disability compared to MS patients without disability. There is high significant positive correlation between EDSS and CRP, ICAM-1, IgM and NLR. There is an increase in ICAM-1, NLR, CRP and IgM concentration with Cerebellar, brain stem compared to other lesions. Conclusion: The ICAM-1 levels were decreased in MS patients in RRMS during remission as compared to healthy controls, MS patients with neurological disability had high concentrations of ICAM-1 when compared to patients without disability, Increased levels of CRP, NLR and IgM in MS patients with disability with Cerebellar, brain stem dysfunction When compared to patients without disability [ABSTRACT FROM AUTHOR]

Purpose: Malignant pleural mesothelioma (MPM) has a poor prognosis in general. Here we sought to evaluate prognostic factors and predictors of response to chemotherapy in good performance (PS=0-I) patients. Methods: We retrospectively reviewed our database and enrolled patients with MPM who received platinum containing chemotherapy (2012-2014). Clinico-pathological and laboratory data were retrieved and Cox and logistic regression multivariate analyses (MVA) were respectively used to identify predictors of survival and response to chemotherapy. Comparison of good vs poor performance status (PS≥II) was accomplished using the Chi (X2) test. Kaplan–Meier survival curves were also obtained and propensity-score matching was performed for survival comparison. Results: Among 114 patients listed during the study period, 82 had good PS=0-I (median age 45years, 43 men, 30 smokers, median weight=77Kg, pretreatment haemoglobin (Hb) level=12g/dL, platelet count=372,000/μL, leukocytes=9,700/μL, neutrophils=6,100/μL, lymphocytes=1,890/μL and neutrophil/lymphocyte ratio (NLR)=3.60 ). Some 65 had asbestosis, 23 had chronic disease, 55 (67.1%) were responders to platinum containing first line chemotherapy. A total of 49 (59.8%) had epithelial MPM. Median-OS and PFS in good PS cases were 17 and 9 months, respectively, as compared to 16 and 8 months for the poor PS group. After matching, better OS was observed among good PS vs poor PS patients (p=0.024) but there was no PFS difference (p=0.176). Significant decrease in PFS was observed among those with advanced nodal N disease (median PFS in N0 and N+ was 10 and 5 months, respectively), non-responders (p=0.012), NLR (p=0.026) and those with an epithelial pathology (p=0.062). MVA demonstrated that advanced (N) status (p=0.015), being a non-responder (p<0.001), NLR (p=0.015) and smoking (p=0.07) adversely affected the prognosis. The only predictor of response was absence of metastasis (M0; p=0.04). Conclusions: In addition to previously recognized factors, like nodal status, response, smoking and NLR, better median survival was evident in our patients with a good PS. Early detection before development of metastasis warrants greater focus to allow better responses to be obtained., (Creative Commons Attribution License)