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

Abnormal fatty acid pattern in the superior temporal gyrus distinguishes bipolar disorder from major depression and schizophrenia and resembles multiple sclerosis

This study investigated the fatty acid composition of the postmortem superior temporal gyrus (STG), a cortical region implicated in emotional processing, from normal controls (n=15) and patients with bipolar disorder (BD, n=15), major depressive disorder (MDD, n=15), and schizophrenia (SZ, n=15). For comparative purposes, STG fatty acid composition was determined in a separate cohort of multiple sclerosis patients (MS, n=15) and normal controls (n=15). Compared with controls, patients with BD, but not MDD or SZ, exhibited abnormal elevations in the saturated fatty acids (SFA) palmitic acid (16:0), stearic acid (18:0), the polyunsaturated fatty acids (PUFA) linoleic acid (18:2n-6), arachidonic acid (20:4n-6), and docosahexaenoic acid (22:6n-3), and reductions in the monounsaturated fatty acid (MUFA) oleic acid (18:1n-9). The total MUFA/SFA and 18:1/18:0 ratios were lower in the STG of BD patients and were inversely correlated with total PUFA composition. MS patients exhibited a pattern of fatty acid abnormalities similar to that observed in BD patients including elevated PUFA and a lower 18:1/18:0 ratio. Collectively, these data demonstrate that BD patients exhibit a pattern of fatty acid abnormalities in the STG that is not observed in MDD and SZ patients and closely resembles MS patients.

Erythrocyte membrane fatty acids in patients with multiple sclerosis

Background

Reports on fatty acids levels in multiple sclerosis remain inconclusive.

Objective

To determine the erythrocyte membrane fatty acid levels in multiple sclerosis patients and correlate with Kurtzke Expanded Disability Status Scale.

Methods

Fatty acid composition of 31 multiple sclerosis and 30 control individuals were measured by gas chromatography.

Results

The membrane phosphatidylcholine C20:4 n – 6 concentration was lower in the multiple sclerosis patients when compared to that of the control group, P = 0.04 and it correlated inversely with the EDSS and FSS.

Conclusion

Decrease in C20:4 n – 6 in the erythrocyte membrane could be an indication of depleted plasma stores, and a reflection of disease severity.

Polyunsaturated fatty acids in the pathogenesis and treatment of multiple sclerosis

Epidemiological, biochemical, animal model and clinical trial data described in this overview strongly suggest that polyunsaturated fatty acids, particularly n-6 fatty acids, have a role in the pathogenesis and treatment of multiple sclerosis (MS). Data presented provides further evidence for a disturbance in n-6 fatty acid metabolism in MS. Disturbance of n-6 fatty acid metabolism and dysregulation of cytokines are shown to be linked and a "proof of concept clinical trial" further supports such a hypothesis. In a randomised double-blind, placebo controlled trial of a high dose and low dose selected GLA (18:3n-6)-rich oil and placebo control, the high dose had a marked clinical effect in relapsing-remitting MS, significantly decreasing the relapse rate and the progression of disease. Laboratory findings paralleled clinical changes in the placebo group in that production of mononuclear cell pro-inflammatory cytokines (TNF-alpha, IL-1beta) was increased and anti-inflammatory TGF-beta markedly decreased with loss of membrane n-6 fatty acids linoleic (18:2n-6) and arachidonic acids (20:4n-6). In contrast there were no such changes in the high dose group. The improvement in disability (Expanded Disability Status Scale) in the high dose suggests there maybe a beneficial effect on neuronal lipids and neural function in MS. Thus disturbed n-6 fatty acid metabolism in MS gives rise to loss of membrane long chain n-6 fatty acids and loss of the anti-inflammatory regulatory cytokine TGF-beta, particularly during the relapse phase, as well as loss of these important neural fatty acids for CNS structure and function and consequent long term neurological deficit in MS.

The protective effects of omega-6 fatty acids in experimental autoimmune encephalomyelitis (EAE) in relation to transforming growth factor-beta 1 (TGF-beta1) up-regulation and increased prostaglandin E2 (PGE2) production

Polyunsaturated fatty acids are known to affect the immune response and administration of the omega-6 fatty acid linoleic acid has been reported to be beneficial in multiple sclerosis (MS) and EAE. In this study we have investigated the effects of oral feeding of plant lipid rich in the omega-6 fatty acid gamma-linolenic acid from Borago officinalis on acute and relapse disease and the immune response in EAE using SJL mice. EAE was induced by an encephalitogenic peptide (92-106) of myelin oligodendrocyte glycoprotein (MOG), and mice were fed the plant lipid daily from 7 days after EAE induction to assess the effects on acute disease and from day 25 to assess the effects on disease relapse. The clinical incidence and histological manifestations of acute EAE, and the clinical relapse phase of chronic relapsing EAE (CREAE) were markedly inhibited by omega-6 fatty acid feeding. A significant increase in the production of TGF-beta1 in response to concanavalin A (Con A) at day 13 and a significant increase in TGF-beta1 and PGE2 to Con A, PPD and MOG peptide (92-106) at day 21 were detected in spleen mononuclear cells from fatty acid-fed mice. There was no difference in interferon-gamma, IL-4 and IL-2 production between the fatty acid-fed and control groups. Significantly higher TGF-beta mRNA expression was found in the spleens of omega-6 fatty acid-fed mice at day 21. There were no differences in spleen cell proliferative response to Con A, PPD and MOG peptide (92-106). Biochemical analysis of spleen cell membrane fatty acids revealed significant increases in the eicosanoid precursor fatty acids dihomo-gamma-linolenic acid and arachidonic acid in response to gamma-linolenic acid feeding, indicating rapid metabolism to longer chain omega-6 fatty acids. These results show that oral feeding of gamma-linolenic acid-rich plant lipid markedly affects the disease course of acute EAE and CREAE and is associated with an increase in cell membrane long chain omega-6 fatty acids, production of PGE2 and gene transcription and, on activation, secretion of TGF-beta1.

Linoleic-acid-dependent slowing of erythrocyte sedimentation in multiple sclerosis

The influence of linoleic acid upon the sedimentation of washed erythrocytes from multiple sclerosis patients and controls was investigated in the present study. Linoleic acid, especially in the concentration of 250 microM and 500 microM, caused slowing of erythrocyte sedimentation and this effect was significantly greater in multiple sclerosis than in controls. These findings with all probability reflect an unsaturated fatty acid-dependent membrane alteration in multiple sclerosis and are analogues to results obtained earlier by several authors by using cytopherometric measurements.

Red blood cell and adipose tissue fatty acids in mild inactive multiple sclerosis

The fatty acid profiles of phosphatidyl ethanolamine (PE) and phosphatidyl choline (PC) of the red blood cells of 30 patients with mild inactive multiple sclerosis (MS) and 30 healthy controls were studied by gas chromatography. The groups were well matched for factors likely to influence tissue lipid levels, including diet. The MS patients showed a significant reduction in PE eicosapentaenoic acid (p = 0.009) especially in women, and an increase in both PE dihomo-gamma-linolenic acid (p = 0.004) and PC stearic acid (p = 0.04). No reduction in linoleic acid was observed in either the PC or PE fractions of the MS subjects. A similar study of the fatty acid profile in adipose tissue in 26 MS and 35 healthy controls found no detectable eicosapentaenoic acid in either group. However, whereas docosahexaenoic acid was not detectable in any MS patient, 40% of the controls had measurable levels varying from to 0.1 to 0.3% of total estimated fatty acid (p = 0.0003). No reduction in linoleic acid in MS subjects was observed. Supplementation with oral fish body oil demonstrated that n-3 fatty acids were incorporated into red blood cells over 5 weeks and this occurred equally in MS and controls. The effects of oral supplementation on adipose tissue were studied after 1 and 2 years. Whereas many fatty acids such as linoleic acid were raised at 1 year, but did not rise subsequently, eicosapentaenoic acid and docosahexaenoic acid continued to rise through the 2-year period.(ABSTRACT TRUNCATED AT 250 WORDS)

Erythrocyte fatty acids in multiple sclerosis

Analysis of the fatty acids in the erythrocyte lipid of multiple sclerosis patients in Italy gave no indication of any difference in composition compared with that of a healthy control group. Supplementation of the diet of another group of similar patients with polyunsaturated fatty acids led to increases in the erythrocyte levels of linoleate and docosahexaenoate, with concomitant falls in oleate and elaidate. Levels of fatty acids such as lignocerate and nervonate that are found predominantly in sphingomyelin were similar in all 3 groups.

Linoleic acid levels in white blood cells, platelets, and serum of multiple sclerosis patients

We found a small but statistically significant reduction in the linoleic acid concentration of white blood cells and platelets in MS patients. The percent linoleic acid concentration (mean +/- S.D.) in the white blood cells if 24 MS patients was 8.8 +/- 1.8% as compared with 11.4 +/- 4.9 in 24 age and sex-matched controls (p less than 0.05). Platelet levels were 8.5 +/- 2.4% and 10.6 +/- 3.8% respectively (P less than 0.05). Serum linoleic acid levels were not significantly different in the two groups. The possible role of linoleic acid in the pathogenesis of MS has yet to be defined.

Natural seric anti-fatty acid antibodies in multiple sclerosis

Naturally occurring anti-oleic acid conjugate antibodies were detected in human sera using an adapted direct immunoenzymatic assay. They were present to a higher level in the sera of patients with multiple sclerosis in acute relapse compared to patients with other neurological diseases or healthy subjects and even patients with multiple sclerosis in progressive form.

Adherence of cells to myelin basic protein. I. Adherence of red and white blood cells from patients with multiple sclerosis to myelin basic protein

Red blood cells (RBC) and white blood cells (WBC) of patients with multiple sclerosis (MS) show decreased adherence to myelin basic protein (MBP) immobilized on plastic surfaces compared to the binding of cells from patients with other neurological diseases (OND), or such other autoimmune diseases as psoriasis (PS), and to that of healthy controls (HC). No similar phenomenon occurred to basic and non-basic type proteins other than MBP, for example, to histone (HIS), lysozyme (LYS) and ovalbumin (OVA). Thus, decreased adherence of RBC and WBC in MS patients to MBP appears to be a unique feature of the disease if compared with OND or PS.

Red cell and hemorheological changes in multiple sclerosis

Blood rheology in multiple sclerosis (MS) was investigated in 15 subjects with varying degrees of locomotor difficulties who were members of the local MS Society. Control data were obtained from blood samples from 25 male and 25 female normal blood donors. Whole blood viscosity was measured and blood filterability was assessed. Six MS females provided blood samples for scanning electron microscopy. Erythrocyte membrane fatty acids and phospholipids were assayed. Whole blood viscosity in MS females was higher than controls at 3 of 4 shear rates (p less than 0.001) but in MS males blood viscosity was higher only at shear rate of 1.0 s-1 (p less than 0.05). MS erythrocyte filtration rates were significantly lower than controls (p less than 0.001). Leucocyte counts in MS were greater than controls both in males (p less than 0.01) and females (p less than 0.001). MS erythrocyte morphology was greatly different from controls (p less than 0.0001) and erythrocyte membranes contained less sphingomyelin than controls (p less than 0.01) but more phosphatidylinositol plus phosphatidylserine (p less than 0.02). We conclude that, because our findings indicate an identifiable and potentially correctable abnormality, it is possible to envisage an inhibition of the progressive nature of MS, with the hope of a better prognosis for patients.

Response to platelet-activating factor of platelets from patients with multiple sclerosis

The response of Multiple Sclerosis (MS) and control platelets to different concentrations of platelet-activating factor was studied. At concentrations in the range 10(-7) to 10(-5)M, it was found that the MS platelets tended to aggregate fully at lower concentrations than was the case with control platelets. At a concentration of 10(-6)M, it was found that in 19 cases the MS platelets gave a full aggregation response whilst 4 cases showed biphasic but full aggregation, whereas at this concentration the control platelets showed full aggregation in only 2 cases, biphasic but less complete aggregation in 5 cases and reversible aggregation in 16 cases. In crossover studies, it could be shown that MS platelets resuspended in control platelet-poor plasma still showed enhanced aggregability and that the response of control platelets was unaffected by resuspension in MS platelet-poor plasma. Differences were also seen in susceptibility of platelets of MS and control subjects to inhibition by indomethacin, bromophenacyl bromide (a phospholipase inhibitor) and verapamil (a Ca2+ antagonist). It is suggested that the hyperaggregability of the MS platelets could reside in the platelets themselves, and may be associated with enhanced phospholipase activity.

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.

Sialic acid and fatty acid concentrations in lymphocytes, red blood cells and plasma from patients with multiple sclerosis

Lipids and constituents of lipids were isolated from peripheral blood lymphocytes (PBL), red blood cells (RBC), plasma and sera from 51 patients with multiple sclerosis (MS) and 51 controls, matched for age, sex and race. The amount of sialic acid released by incubation of intact PBL from MS patients was significantly lower (P less than 0.02) than that of the sialic acid from control lymphocytes. The amounts of sialic acid released by neuraminidase from intact RBC, on the other hand, did not differ significantly between the MS group and the control group. The concentrations of ganglioside sialic acid in PBL from MS and control groups did not vary significantly. Similarly the concentration of ganglioside sialic acid in RBC from MS patients was not significantly different from that in the controls. Analyses of the fatty acids isolated after alkaline methanolysis of the lipids from the PBL of MS patients and controls showed a small but significant decrease (P less than 0.01) in the relative percentage of linoleic acid in patients with MS. Determination of the ester-linked fatty acids in RBC lipids from patients with MS showed a significant decrease (P less than 0.001) in the relative percentage of linoleic acid and an increase (P less than 0.01) in palmitic plus palmitoleic acids compared to control values. The fatty acid composition of the plasma neutral lipids plus free fatty acids showed a very significant decrease (P much less than 0.001) in the relative percentage of linoleic acid, a small decrease (P less than 0.05) in arachidonic acid and significant increases in palmitic (P less than 0.001) and oleic acids (P less than 0.001) in MS, compared to controls. These results are suggestive of possible differences in metabolism of lipids between patients with MS and controls.

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.

Simplified E-UFA test for multiple sclerosis (MS): some sources of "false" results

A simple modification of the Erythrocyte-Unsaturated Fatty Acid (E-UFA) Test for Multiple Sclerosis is described, whereby well washed erythrocytes (RBC) are allowed to stand in Hanks medium 199, for about 21 days at 4 degrees C. The control-experimental difference in electrophoretic mobility of RBC rises to nearly 20%. Precautions in interpretation and wider implications of the SE-UFA test, recently uncovered, are briefly indicated.