Objective: We aimed to investigate the alteration of differential WBC counts, apoptosis-associated speck-like protein (ASC) and B-cell lymphoma protein (BCL-6) in Egyptian multiple sclerosis (MS) patients in response to disease modifying therapy (DMT) Methods: The present study was conducted on a total of 58 relapsingremitting MS (RRMS) patients who were classified into 21 untreated naïve patients and 37 treated patients as well as 30 healthy individuals. Assessment of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) was performed. Peripheral blood mononuclear cells (PBMCs) were isolated and cultured in the presence of lipopolysaccharide (LPS) for the detection of inflammasome adaptor protein ASC and BCL-6 using ELISA. Results: The results revealed that untreated RRMS patients showed a significant increase in neutrophils and BCL-6 levels together with a marked decrease in monocytes and MLR compared to both treated patients and healthy controls. A marked increase in ASC levels was observed in all patients compared to healthy controls where ASC was negatively correlated with BCL6. We also demonstrated that both NLR and ASC were positively correlated with IgG index. Conclusions: It can be concluded that altered peripheral blood cells, ASC and BCL-6 may have vital roles in RRMS pathogenesis suggesting their possible diagnostic and therapeutic potentials in RRMS.