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Adipokines Offer Clues for MS Diagnosis and Treatment

In multiple sclerosis, the immune system attacks the central nervous system, which consists of the brain and spinal cord. While multiple sclerosis is known as a central nervous system disease, it actually involves the effect of immunometabolic influences beyond the central nervous system. One type of these molecules is the adipokines.

What are adipokines?
Adipokines are bioactive molecules secreted by adipose tissue (body fat). These molecules have roles in regulating immune and metabolic pathways and have implications in multiple sclerosis. Some examples include:
  • Resistin, leptin, and chemerin, which are pro-inflammatory
  • Adiponectin, which is anti-inflammatory and has neuroprotective effects

Potential for Future Biomarkers and Treatment

In multiple sclerosis, these adipokines become dysregulated. Therefore, adipokines can be biomarkers for multiple sclerosis – possibly aiding in diagnosis and monitoring disease or assessing the effectiveness of therapies. Work in this area is ongoing and would require more validation to become widely adopted clinically.

It’s also feasible that in the future, treating multiple sclerosis could involve modulating the activity or levels of adipokines. For example, this could be done by blocking pro-inflammatory adipokines or increasing adiponectin’s anti-inflammatory activity. It’s also possible that lifestyle modifications can help regulate adipokine secretion without the use of medication. For example, a Mediterranean diet can lower pro-inflammatory adipokines while increasing adiponectin.

Figure 1. Proposed hypothesis: Obesity and MS can lead to altered adipokine release from white adipose tissue (WAT) into circulation. This results in the activation of inflammatory pathways and increased infiltration of immune cells in the CNS. On the other hand, increased levels of pro-inflammatory cytokines in MS such as tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and interferon γ (IFN-γ) further stimulate the release of pro-inflammatory adipokines from the WAT and disrupt adipokine signaling, creating a detrimental positive feedback loop. MS, multiple sclerosis; BBB, blood–brain barrier.

Rijnsburger, M., et al. (2021). Adipokines as Immune Cell Modulators in Multiple Sclerosis. International journal of molecular sciences, 22(19), 10845. https://doi.org/10.3390/ijms221910845
Citations

Ghaffary EM, Bjørklund G, Bhat RS, Mirmosayyeb O. Adipokines in multiple sclerosis: Immune dysregulation, neuroinflammation, and therapeutic opportunities. Autoimmun Rev. 2025;24(8):103825. doi:10.1016/j.autrev.2025.103825

Rijnsburger, M., Djuric, N., Mulder, I. A., & de Vries, H. E. (2021). Adipokines as Immune Cell Modulators in Multiple Sclerosis. International journal of molecular sciences, 22(19), 10845. https://doi.org/10.3390/ijms221910845