Low levels of alpha-synuclein in peripheral tissues are related to clinical relapse in relapsing-remitting multiple sclerosis: a pilot cross-sectional study

J Neurol Sci. 2019 Jan 15;396:87-93. doi: 10.1016/j.jns.2018.11.003. Epub 2018 Nov 3.


The protein alpha-synuclein (α-Syn) has been linked to neuroinflammatory conditions. We investigated whether the presence of α-Syn in peripheral tissues is a surrogate of brain inflammatory status in a small group of relapsing-remitting multiple sclerosis (RRMS) patients in a pilot cross-sectional study. Skin biopsies and peripheral blood were sampled from 34 healthy controls and 23 MS patients for measurement of α-Syn levels. Within the RRMS group 15 patients were in remission, and 8 patients were in the relapsing phase. The protein α-Syn was evaluated by means of immunohistochemistry and flow cytometry in skin and nucleated blood cells, respectively. In the skin, α-Syn levels were lower in relapsing MS than in the other groups, both in positive area (p = .021) and staining intensity (p = .004). In blood, the percentage of α-Syn-positive lymphocytes and monocytes were not statistically different between study groups. Moreover, the use of systemic steroids did not affect α-Syn positivity in MS-relapse patients. Finally, epidermic Langerhans cells did not stain positively for α-Syn. Overall, the levels of α-Syn positivity were lower in inflammatory relapse of RRMS patients when measured in peripheral tissues. We discuss the role of α-Syn levels in inflammation according to the obtained results.

Keywords: Flow cytometry; Immunohistochemistry; Multiple sclerosis; Peripheral blood mononuclear cells; Skin; α-Synuclein.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antigens, CD / metabolism
  • Biopsy
  • Blood Cells / pathology
  • Blood Cells / ultrastructure
  • Cell Nucleolus / metabolism
  • Cell Nucleolus / pathology
  • Cross-Sectional Studies
  • Female
  • Flow Cytometry
  • Follow-Up Studies
  • Giant Cells, Langhans / metabolism
  • Giant Cells, Langhans / pathology
  • Humans
  • Lectins, C-Type / metabolism
  • Male
  • Mannose-Binding Lectins / metabolism
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / blood
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy
  • Multiple Sclerosis, Relapsing-Remitting / pathology*
  • Pilot Projects
  • Skin / drug effects
  • Skin / metabolism*
  • Statistics, Nonparametric
  • Steroids / therapeutic use
  • Young Adult
  • alpha-Synuclein / blood
  • alpha-Synuclein / metabolism*


  • Antigens, CD
  • CD207 protein, human
  • Lectins, C-Type
  • Mannose-Binding Lectins
  • Steroids
  • alpha-Synuclein