In addition, adipokines can regulate neuroinflammation, glial cell activation and oxidative stress—key processes in MS progression.13 14 Proinflammatory adipokine leptin has been associated with disease activity and disability progression in MS, whereas the role of anti-inflammatory adiponectin is less clear.10 15 Notably, adipsin, a component of the alternative complement pathway, has emerged as a potential biomarker of neurodegeneration and disease activity in MS.16 This evidence concerns the gene LEP and myeloid sarcoma.