Erythrocyte glutathione perioxidase deficiency in multiple sclerosis

Monitoring the Redox Status in Multiple Sclerosis

Worldwide, over 2.2 million people suffer from multiple sclerosis (MS), a multifactorial demyelinating disease of the central nervous system. MS is characterized by a wide range of motor, autonomic, and psychobehavioral symptoms, including depression, anxiety, and dementia. The blood, cerebrospinal fluid, and postmortem brain samples of MS patients provide evidence on the disturbance of reduction-oxidation (redox) homeostasis, such as the alterations of oxidative and antioxidative enzyme activities and the presence of degradation products. This review article discusses the components of redox homeostasis, including reactive chemical species, oxidative enzymes, antioxidative enzymes, and degradation products. The reactive chemical species cover frequently discussed reactive oxygen/nitrogen species, infrequently featured reactive chemicals such as sulfur, carbonyl, halogen, selenium, and nucleophilic species that potentially act as reductive, as well as pro-oxidative stressors. The antioxidative enzyme systems cover the nuclear factor erythroid-2-related factor 2 (NRF2)-Kelch-like ECH-associated protein 1 (KEAP1) signaling pathway. The NRF2 and other transcriptional factors potentially become a biomarker sensitive to the initial phase of oxidative stress. Altered components of the redox homeostasis in MS were discussed in search of a diagnostic, prognostic, predictive, and/or therapeutic biomarker. Finally, monitoring the battery of reactive chemical species, oxidative enzymes, antioxidative enzymes, and degradation products helps to evaluate the redox status of MS patients to expedite the building of personalized treatment plans for the sake of a better quality of life.

Oxidative stress-related biomarkers in multiple sclerosis: a review

AIM

To provide an up-to-date review of oxidative stress biomarkers in multiple sclerosis and thus identify candidate molecules with greatest promise as biomarkers of diagnosis, disease activity or prognosis.

METHOD

A semi-systematic literature search using PubMed and other databases.

RESULTS

Nitric oxide metabolites, superoxide dismutase, catalase, glutathione reductase, inducible nitric oxide synthase, protein carbonyl, 3-nitrotyrosine, isoprostanes, malondialdehyde and products of DNA oxidation have been identified across multiple studies as having promise as diagnostic, therapeutic or prognostic markers in MS.

CONCLUSION

Heterogeneity of study design, particularly patient selection, limits comparability across studies. Further cohort studies are needed, and we would recommend promising markers be incorporated into future clinical trials to prospectively validate their potential.

Erythrocytes in multiple sclerosis - forgotten contributors to the pathophysiology?

Multiple sclerosis (MS) is an autoimmune disease characterised by lymphocytic infiltration of the central nervous system and subsequent destruction of myelin and axons. On the background of a genetic predisposition to autoimmunity, environmental triggers are assumed to initiate the disease. The majority of MS research has focused on the pathological involvement of lymphocytes and other immune cells, yet a paucity of attention has been given to erythrocytes, which may play an important role in MS pathology. The following review briefly summarises how erythrocytes may contribute to MS pathology through impaired antioxidant capacity and altered haemorheological features. The effect of disease-modifying therapies on erythrocytes is also reviewed. It may be important to further investigate erythrocytes in MS, as this could broaden the understanding of the pathological mechanisms of the disease, as well as potentially lead to the discovery of novel and innovative targets for future therapies.

Sodium selenite supplementation during pregnancy and lactation promotes anxiolysis and improves mnemonic performance in wistar rats' offspring

Selenium is a micronutrient which is part of selenoprotein molecules and participates in a vast number of physiological roles and, among them,we have fetal and neonatal development. Therefore, the aimof this studywas to evaluate possible behavioral changes in offspring of female rats supplemented during pregnancy and lactation with sodium selenite. To address that, we treated two groups of female rats by saline or sodium selenite at a dose of 1mg/kg through oral route and performed neurochemical and behavioral tests. In the offspring, the thyroid profile and hippocampal neurochemistrywere evaluated. Behavioral testswere performed in pups both during childhood and adulthood. We found out that selenium (Se) supplementation increased serum levels of triiodothyronine (25%, p b 0.001) and thyroxine (18%, p b 0.05) and promoted a tryptophan hydroxylase 2 (TPH 2) expression decrease (17%, p b 0.01) and tyrosine hydroxylase (TH) expression increase (202%, p b 0.01) in the hippocampus. The cholinesterase activity was decreased (28%, p b 0.01) in Se supplemented rats, suggesting a neurochemical modulation in the hippocampal activity. During childhood, the Sesupplemented offspring had a reduction in anxiety-like behavior both in elevated plus maze test and in light–dark box test. In adulthood, Se-treated pups had an increase in the locomotor activity (36%, p b 0.05) and in rearing episodes (77%, p b 0.001) in the open field test, while in the elevated plus maze test they also exhibited an increase in the time spent in the open arms (243%, p b 0.01). For the object recognition test, Se-treated offspring showed increase in the absolute (230.16%, p b 0.05) and relative index discrimination (234%, p b 0.05). These results demonstrate that maternal supplementation by sodium selenite promoted psychobiological changes both during childhood and adulthood. Therefore, the behavioral profile observed possibly can be explained by neurochemical changes induced by thyroid hormones during the critical period of the central nervous system ontogeny.

Is a hypothetical melanoma-like neuromelanin the underlying factor essential for the aetiopathogenesis and clinical manifestations of multiple sclerosis?

Background

Multiple sclerosis (MS) has undergone a significant increase in incidence in the industrialised nations over the last 130 years. Changing environmental factors, possibly infections or a lack of or altered timing of them, determine the prevalence of the disease. Although a plethora of aetiological factors, clearly evident in a group of children with MS, appear relevant, there may nevertheless be a single factor essential for the aetiopathogenesis and clinical manifestation of MS.

Description and discussion

This hitherto unknown factor is postulated to be a ‘melanoma-like neuromelanin’ (MLN) dependent on the activation of a gene for syncytin-1. An involvement of MLN could explain the diverse findings in the epidemiology, immunology and pathology of MS, requiring a consideration of a complex infectious background, the human leucocyte antigens, as well as cosmic radiation causing geomagnetic disturbances, vitamin D deficiency, smoking, and lower levels of uric acid.

Summary

In principle, the MLN-based concept is a unifying one, capable of explaining a number of characteristics of the disease. To date, MLN has not been addressed in studies on MS and future work will need to be done on human patients, as there is little or no neuromelanin (the precursor of MLN) in the animals used as experimental models in the study of MS.

Decreased erythrocyte glutathione peroxidase activity in multiple sclerosis

The mean activity of glutathione peroxidase (GSH-PX) in erythrocytes of 22 Israel-Jewish patients with multiple sclerosis (19.3 +/- 4.5 U/gHb) was significantly lower than in a control group of 30 Jewish patients with various neurological disorders (24.3 +/- 5.1 U/gHb). This observation confirms a similar finding of a decreased activity of GSH-Px in erythrocytes of multiple sclerosis patients in Denmark (Shukla et al. 1977). These results are discussed in relation to the possibility of selenium deficiency and to the recently described genetic polymorphism and ethnic variation of GSH-Px activity in human red cells. It is concluded that additional investigations are required in order to elucidate the cause of the decreased activity of this enzyme in red cells of patients with multiple sclerosis.

Glyoxalase I A111E, paraoxonase 1 Q192R and L55M polymorphisms: susceptibility factors of multiple sclerosis?

Multiple sclerosis (MS) is characterized by chronic inflammation and demyelination of the central nervous system (CNS). Accumulating data indicate that oxidative stress, leading to reactive oxygen species (ROS) production and lipid peroxidation, as well as elevated levels of advanced glycation end products (AGE) in CNS neurons, might play a pivotal role in the pathogenesis of a number of diseases with a neurodegenerative aspect, such as MS. Therefore, polymorphisms of genes encoding endogenous free-radical scavenging systems, such as paraoxonase 1 (PON1), and anti-glycation defences, such as glyoxalase I (GI), could influence susceptibility to MS. In the present study, we have undertaken a case-control study to investigate the possible association of GI A111E, PON1 Q192R and L55M polymorphisms with the risk of MS. The three polymorphisms were characterized in 209 patients with relapsing-remitting MS (RRMS) and in 213 healthy controls by PCR/RFLP methods using DNA from lymphocytes. We found that individuals with the GI/AE-EE genotypes and PON55/LM-MM genotypes had a significantly higher risk of MS compared with the other genotypes. The two polymorphisms appear to be common genetic traits that are associated with an increased risk for MS--the analysis of both, in each single case, may be a revealing predictable factor for MS risk.

Iron and the folate-vitamin B12-methylation pathway in multiple sclerosis

Some subjects with multiple sclerosis (MS) present with low blood iron parameters. Anecdotal reports and a single patient study suggest that iron supplementation may be beneficial in these subjects. Myelin is regenerated continually, but prerequisites for this process are iron and a functional folate-vitamin B12-methylation pathway. The aim of this study was to determine iron status, folate and homocysteine in MS subjects, and to evaluate the effect on MS symptoms if deficiencies were addressed.

RESULTS

In relapsing-remitting MS subjects, serum iron concentration correlated significantly with age at diagnosis (r=0.49; p=0.008). In Caucasian female MS subjects, serum iron and ferritin concentrations were significantly lower than in matched controls. In a 6-month pilot study, 12 subjects taking a regimen of nutritional supplements designed to promote myelin regeneration, improved significantly neurologically as measured by the Kurzke EDSS (Total Score means 3.50 to 2.45, 29.9%; p=0.021). These were significantly improved (p=0.002) compared to 6 control group patients taking multivitamins (Kurzke Score increased by 13.9% from 4.83 to 5.50). Both groups had significantly reduced homocysteine concentrations at 6 months, suggesting that methylation is necessary but not sufficient for myelin regeneration.

Demyelination: the role of reactive oxygen and nitrogen species

This review summarises the role that reactive oxygen and nitrogen species play in demyelination, such as that occurring in the inflammatory demyelinating disorders multiple sclerosis and Guillain-Barré syndrome. The concentrations of reactive oxygen and nitrogen species (e.g. superoxide, nitric oxide and peroxynitrite) can increase dramatically under conditions such as inflammation, and this can overwhelm the inherent antioxidant defences within lesions. Such oxidative and/or nitrative stress can damage the lipids, proteins and nucleic acids of cells and mitochondria, potentially causing cell death. Oligodendrocytes are more sensitive to oxidative and nitrative stress in vitro than are astrocytes and microglia, seemingly due to a diminished capacity for antioxidant defence, and the presence of raised risk factors, including a high iron content. Oxidative and nitrative stress might therefore result in vivo in selective oligodendrocyte death, and thereby demyelination. The reactive species may also damage the myelin sheath, promoting its attack by macrophages. Damage can occur directly by lipid peroxidation, and indirectly by the activation of proteases and phospholipase A2. Evidence for the existence of oxidative and nitrative stress within inflammatory demyelinating lesions includes the presence of both lipid and protein peroxides, and nitrotyrosine (a marker for peroxynitrite formation). The neurological deficit resulting from experimental autoimmune demyelinating disease has generally been reduced by trial therapies intended to diminish the concentration of reactive oxygen species. However, therapies aimed at diminishing reactive nitrogen species have had a more variable outcome, sometimes exacerbating disease.

[Diet and multiple sclerosis]

Beneficial effects from any particular diet have not been proven in multiple sclerosis (MS). Therefore, the general guidelines on nutrition should be followed. Obesity and various forms of malnutrition worsening the MS symptoms are frequently observed. There is some evidence from epidemiological studies that a high consumption of saturated animal fat is associated with an increased incidence of MS. The findings from such studies indicate that supplementation with unsaturated fatty acids, in particular omega-3 fatty acids, could positively influence the course of MS. However, controlled studies did not show clear beneficial effects from polyunsaturated fatty acids. The intake of vitamin D is associated with a lower incidence of MS. In contrast, the effects of therapy with vitamin D on the course of MS have not been ascertained. Patients with MS carry an enormous risk of osteoporosis, and therefore the indication for a preventive therapy with vitamin D and calcium should be established in every postmenopausal woman or after repeated steroid treatments.

The two faces of L-DOPA: benefits and adverse side effects in the treatment of Encephalitis lethargica, Parkinson’s disease, multiple sclerosis and amyotrophic lateral sclerosis

Parkinson's disease, encephalitis lethargica, multiple sclerosis and amyotrophic lateral sclerosis patients all display two distinct types of symptoms. Some of these are due directly to a deficiency of dopamine and are quickly reduced by laevodihydroxyphenylalanine (L-DOPA). The second set, however, are the result of neurological damage caused by metabolites of dopamine, which include dopachrome and other chrome indoles that are both hallucinogenic and neurotoxic. If this hypothesis is correct, three corollaries follow. Patients of all four disorders should display excessive oxidative stress, natural methyl acceptors should delay development and elevated antioxidant supplementation, given with L-DOPA, ought to prolong the "honeymoon" period in which the benefits of the drug out weigh its subsequent disadvantages. A literature review suggests that all three corollaries are probably correct.

Lipoperoxides as an index of free radical activity in bone marrow transplant recipients. Preliminary observations

It has been previously demonstrated that the conditioning therapy given to bone marrow transplant (BMT) recipients creates a high oxidant stress, resulting in a measured reduction in antioxidants, such as glutathione peroxidase (GSH-Px), vitamin E, and cell peroxide fragilities. As part of a current intervention trial of antioxidant therapy in BMT recipients, plasma thiobarbituric acid reactive substances (TBARS) were measured to assess peroxidation and free radical activity. Measurements were performed before and after conditioning therapy, and then at weekly intervals for a period of 6 wk after transplantation in 20 patients (10 controls and 10 antioxidant therapy [AOT] recipients). The TBARS results were compared with concurrent measurements of more specific elements of the antioxidant pathways, such as red blood cell glutathione peroxidase (RBC-GSH-Px), plasma vitamin C, and serum vitamin E. In all cases, TBARS concentration was significantly increased after conditioning compared with baseline levels (p < 0.001), an increase that correlated inversely with RBC-GSH-Px (r = -0.81; p < 0.01). The TBARS concentration fell gradually after conditioning in all patients. The fall in the AOT group was more rapid than in the control group, and it paralleled the gradual return toward normal levels of the other antioxidants. The change in TBARS concentration occurred faster than changes in other indices, suggesting that TBARS might be a better index of overall free radical activity. Although the patient numbers are small, there is some evidence to suggest that MDA may act as a prognostic marker.(ABSTRACT TRUNCATED AT 250 WORDS)

Increased generation of superoxide radicals in the blood of MS patients

Increased generation of superoxide radical (O2-) in the blood stimulated with phorbol myristate acetate (PMA) has been found in multiple sclerosis (MS) patients. All the subjects studied were non-smokers and received the same hospital diet. In the MS group treated with prednisone superoxide radical generation was lower than in untreated patients, but was still above the level of O2- generation in controls. Plasma lipid peroxidation products, measured as thiobarbituric-reactive substances, were slightly elevated in both prednisone treated and non-treated MS patients in comparison with controls. Erythrocyte superoxide dismutase activity (SOD) was at the same level in MS and control groups. These results suggest that increased generation of reactive oxygen species may occur in MS patients during acute relapse. This phenomenon may be involved in the pathomechanism of demyelinating disorders.

Serum selenium concentration, glutathione peroxidase activity and lipid peroxides in a co-twin control study on multiple sclerosis

Serum selenium concentration, glutathione peroxidase activity and lipid peroxides were determined in patients with multiple sclerosis (MS). The series consisted of 13 same-sexed twin pairs derived from the Finnish Twin Cohort of 15,815 pairs. Fourteen subjects had a definite and 1 a probable MS, and their 11 co-twins showed no evidence of central nervous system disease. No statistical differences were observed, but the 3 patients with active progressive MS had a higher mean level of lipid peroxides than the rest of the patients. We suggest that serum lipid peroxidation may be involved in the activity of MS.

25-Hydroxycholesterol promotes myelin basic protein-induced leakage of phospholipid vesicles

Among several cholesterol oxidation products, 25-hydroxycholesterol is particularly potent in enhancing basic protein-induced carboxyfluorescence leakage from liposomes. Both myelin basic protein and poly(L-arginine) are effective at submicromolar concentrations in stimulating this vesicle rupture. Leakage is greatly augmented by the presence of only 1% of the 25-hydroxycholesterol. The possible relevance of these findings to myelin pathology is discussed.

Hyperbaric oxygenation and erythrocyte antioxidant enzymes in multiple sclerosis patients

Erythrocyte glutathione peroxidase, catalase, and superoxide dismutase activities were measured in 18 patients with clinically definite MS, and results compared with those from neurological controls. These studies indicated that glutathione peroxidase activity in erythrocytes of MS patients was not different from that of the neurological controls. However, superoxide dismutase was lower in the MS patients compared to neurological controls. The effect of hyperbaric oxygenation on these erythrocyte enzymes in MS patient's was also investigated. Exposure of MS patients to 2 ata with either 10% O2 or 100% O2 had no effect on glutathione peroxidase activity. Comparison of each individual MS patient's pre- and post-treatment superoxide dismutase values indicated a significant increase after 100% O2. Similar examination of each individual's catalase activity indicated an increase after exposure to both 10% O2 and 100% O2 at 2 ata. These data suggest that erythrocyte enzyme response to oxygen stress does not involve changes in activity of all the antioxidant enzymes. Instead, only specific enzymes appear to be affected by HBO.

Lipid peroxidation products and antioxidant proteins in plasma and cerebrospinal fluid from multiple sclerosis patients

Lipid peroxidation (LPx) products were measured as thiobarbituric acid-reactive substances (TS) and lipid-soluble fluorescent pigments (FP) in both plasma and CSF from MS patients and controls. Although no significant changes were found in MS plasma, we report here for the first time increases in both TS and FP in MS CSF (p less than 0.05 and p less than 0.01, respectively, compared with patients with other neurological diseases), indicating that increased LPx in CNS may be a feature of MS. Levels of transferrin were normal but caeruloplasmin (CP), a major antioxidant plasma protein, was significantly raised in MS patients (p less than 0.01) and this may represent an adaptive response to increased oxidative challenge. Neither of these proteins was detectable in CSF using radial immunodiffusion. There was no significant correlation between the severity or duration of the disease nor the period since the last relapse and either LPx products or CP suggesting that the changes observed in this work are not simply the direct result of demyelination and tissue damage.

Erythrocyte antioxidant enzymes in multiple sclerosis and the effect of hyperbaric oxygen

The activities of catalase, glutathione peroxidase, and glutathione reductase, were not significantly different from normal whereas that of superoxide dismutase was decreased (P less than 0.05) in erythrocytes from patients with multiple sclerosis. Assay of the lipid peroxidation product, malondialdehyde, after incubation of erythrocytes with 10 mM H2O2 under carefully controlled conditions (peroxide stress test) demonstrated that MS erythrocytes are significantly (P less than 0.001) less susceptible to H2O2-induced lipid peroxidation in vitro. This finding suggests that the level of an endogenous antioxidant, possibly vitamin E, may be elevated in MS red cells. After treatment with hyperbaric O2, the activity of MS erythrocyte catalase is significantly (P less than 0.01) elevated by 2-6-fold.

Red blood cell glutathione peroxidase activity in multiple sclerosis

Glutathione peroxidase (GSH-Px) activity of red blood cells of 23 multiple sclerosis (MS) patients (10 men and 13 women, aged 22-64 years) was examined and compared to the enzyme activity of 26 healthy persons (15 men and 11 women, aged 19-50 years). It was found that the mean GSH-Px activity was significantly higher (P less than 0.001) in red blood cells of MS patients (39.1 +/- 8.1 IU/g Hb) as compared to the group of healthy persons (25.9 +/- 5.2 IU/g Hb). There was no difference according to sexes in both the MS patients and the control group. The results are discussed based on the hypothesis that organic peroxides play a role in the etiology of multiple sclerosis.

Superoxide dismutase, reduced glutathione and TBA-reactive products in erythrocytes of patients with multiple sclerosis

Superoxide dismutase, reduced glutathione and lipid peroxides levels were determined in the erythrocytes of multiple sclerosis patients. Superoxide dismutase activity and the malonyldialdehyde production rate were found to be significantly enhanced. The isoelectric focusing pattern of superoxide dismutase from multiple sclerosis and normal subjects erythrocytes was substantially overlapping. Our results indicate the occurrence of a higher susceptibility of multiple sclerosis erythrocytes to lipid peroxidation.

Erythrocyte membrane glycerophospholipid organization is normal in multiple sclerosis

The phospholipid composition of erythrocyte membranes from patients with multiple sclerosis (MS) was found to be normal, in agreement with previous reports. The transbilayer asymmetry of the glycerophospholipids in MS red cells was probed using bee venom phospholipase A2 and was also found not to be significantly different from normal. Abnormal membrane glycerophospholipid organisation is therefore not involved in the increased red cell size, osmotic fragility, and electrophoretic mobility associated with MS.

Selenium and experimental allergic encephalomyelitis. The effects of different levels of dietary selenium on clinico-pathological findings

There are reports in which multiple sclerosis (MS) seems to be associated with abnormalities in selenium (Se) metabolism and erythrocyte glutathione-peroxidase (GSH-px) activity. Ordinary experimental allergic encephalomyelitis (EAE), which reflects some features of human MS, was induced in guinea pigs maintained with high, low and normal levels of Se in the diet. Evidence was obtained to indicate the following results: (i) a direct correlation between dietary Se levels and whole blood Se levels. (ii) Erythrocyte GSH-px activity was not found to be correlated with the blood Se content. (iii) The animals fed with low or normal levels of Se showed the same survival rates and developed EAE in a similar way and percentage. (iv) The animals fed with high non-toxic levels of Se showed a high incidence of death and some developed EAE with a subacute course, when compared with the other experimental groups. The results are discussed on the basis of findings in the literature.

Development of the cytosolic defence system against microsomal lipid peroxidation in rat liver

Ascorbate-induced lipid peroxidation in rat liver microsomes reaches the adult level in 2-3 days. NADPH-induced peroxidation develops more gradually, in parallel with the activity of NADPH-cytochrome P-450 reductase, attaining adult levels by 10-12 days. The glutathione-dependent cytosolic enzyme activity which inhibits peroxidation is inhibited by bromosulphophthalein. The development of this system lags behind the development of microsomal lipid peroxidation between the ages of 2 and 20 days, allowing peroxidation to proceed.

Comparison of membrane structure, osmotic fragility, and morphology of multiple sclerosis and normal erythrocytes

Erythrocyte membranes from multiple sclerosis (MS) patients and normal individuals were studied by electron spin resonance spectroscopy, osmotic fragility tests, scanning electron microscopy (SEM) and fatty acid analysis of membrane lipids. There was no significant difference in the membrane fluidity between MS and normal erythrocytes using fatty acid spin labels with the nitroxide moiety on carbons 5, 12, or 16 from the carboxyl group. Linoleic acid, which has been reported to decrease the absolute electrophoretic mobility of only MS erythrocytes, increased the fluidity of MS and normal erythrocyte membranes to a similar extent. The osmotic fragility of MS erythrocytes obtained from outpatients was similar to normal control cells but the osmotic fragility of erythrocytes obtained from hospitalized MS patients was greater than normal. Scanning electron microscopy of MS erythrocytes revealed no gross abnormalities. Cells incubated with linoleic acid had transformed from discocytes into sphero-echinocytes with prominent membrane surface indentations but MS and normal erythrocytes appeared identical. Of the fatty acid content of the total lipid extract, erythrocytes from most, but not all, MS hospitalized patients and some patients with other demyelinating diseases had relatively less (P less than .001) 18:2 than the normal cells. These results indicate that at least some of the abnormalities reported in MS erythrocytes may only be found in hospitalized patients and may be due to other complications of the disease. They also indicate that the reported abnormal effects of linoleic acid on the electrophoretic mobility of MS erythrocytes may be caused by some other mechanism than an effect on the fluidity of the bilayer.

Glutathione peroxidase activity in various types of blood cells in multiple sclerosis

Previous studies demonstrated a significantly lower mean activity of glutathione peroxidase (GSH-Px) in erythrocytes of patients with multiple sclerosis than in control groups of normal subjects or patients with various neurological disorders. The present investigation has demonstrated that, in contradistinction to erythrocytes, a normal activity of GSH-Px is found in lymphocytes, granulocytes and platelets of multiple sclerosis patients. These results were obtained both with hydrogen peroxide, which serves as a specific substrate for selenium dependent GSH-Px, and t-butyl hydroperoxide which reacts both with selenium dependent and independent GSH-Px.

Leucocyte glutathione peroxidase activity and selenium level in multiple sclerosis

In continuation of our previous studies, which demonstrated a decreased glutathione peroxidase (GSH-Px) activity of erythrocytes from multiple sclerosis (MS) patients the activity of some enzymes regulating the peroxide level (GSH-PX and glutathione reductase (GSSG-Rd)) in leucocytes and erythrocytes respectively, the selenium level of whole blood and the beta-glucuronidase activity of serum (marker of lysosomal membrane damage) were assayed in this group of patients. GSH-Px activity in lymphocytes and granulocytes from MS patients was significantly (2 alpha smaller than or equal to 0.01) decreased by 35-50%. Erythrocyte glutathione reductase activity was only insignificantly decreased in MS patients. Erythrocyte GSH-Px : GSSG-Rd ratio was 11.0 for the control group, but 8.0 for the MS group. The selenium content of whole blood and serum from Danish MS patients was normal. The selenium level in erythrocytes from Danish MS patients was however higher than the selenium level in erythrocytes from controls.

Levels of linoleate and arachidonate in red blood cells of healthy individuals and patients with multiple sclerosis

The major fatty acids were measured in total lipid extracts of red blood cells from 23 control subjects and 31 patients with multiple sclerosis. In the healthy control subjects an inverse correlation (r = -0.83) was found between the percentages of linoleate and arachidonate. In the patients such an inverse correlation was not found. The results suggest an abnormality in the red blood cells of patients with multiple sclerosis specifically with regard to the regulation of the relative amounts of unsaturated fatty acids, and this has implications for the possible treatment of multiple sclerosis with dietary supplements.