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Ribeiro CM, Oliveira SR, Flauzino T, Alfieri DF, Simão ANC, Lozovoy MAB, Maes M, Reiche EMV. The effects of the MTHFR 677C>T (rs1801133) genetic variant on susceptibility and disability worsening in multiple sclerosis patients are mediated by homocysteine. Mult Scler Relat Disord 2024; 91:105883. [PMID: 39270536 DOI: 10.1016/j.msard.2024.105883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/29/2024] [Accepted: 09/07/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND Interactions between genetic and environmental variables contribute to the autoimmune inflammatory process in multiple sclerosis (MS). Elevated homocysteine levels, and vitamin D, vitamin B12, and folate deficiencies are some of the environmental factors associated with the pathogenesis of MS. Considering that the relationship between MTHFR 677C>T (rs1801133) genetic variant, homocysteine, and folate in patients with MS remains unclear and that their role were not extensively explored in the clinical course of the disease, we investigated whether this variant and plasma homocysteine and folate levels are associated with MS susceptibility, disability, disability progression, and inflammatory biomarkers. METHODS The case-control study included 163 patients with MS categorized using the Expanded Disability Status Scale (EDSS) as mild (EDSS<3) and moderate/high (EDSS≥3) disability, and 226 healthy controls (HC). Disability progression was evaluated using Multiple Sclerosis Severity Score (MSSS) and the MTHFR 677C>T variant was genotyped using real time polymerase chain reaction. The plasma levels of some inflammatory biomarkers were determined. Two new composed scores were proposed: the first, namely as inflammatory activity index (IAI), was entered as a latent vector extracted from the macrophage M1 + T helper (Th)1 + Th17 + Th2 + T regulatory (Treg) cytokines, + tumor necrosis factor (TNF)-α+ soluble TNF receptor (sTNFR)-1 + sTNFR2. The second score, namely MS-severity index was entered as a latent vector extracted from the EDSS + MSSS scores + MS diagnosis. RESULTS Patients with MS showed higher homocysteine and folate than controls (p < 0.001); homocysteine, and the M1, Th1, Th17, and Th2 Treg cytokine values were different between the three study groups and increased from HC to MS patients with mild disability and to MS patients with moderate/high disability (p < 0.0001). The levels of TNF-α and their soluble receptors sTNFR1 and sTNFR2 were higher in MS patients with EDSS≥3 than in the two other groups (EDSS<3 and HC) (p < 0.001). There was no association between the MTHFR 677 C > T genotypes and MS susceptibility, disability and disability progression (p > 0.05). Moreover, 21.8 % of the disability variance was explained by age, IAI and C-reactive protein (CRP) (all positively associated); 10.9 % of the disability progression variance was predicted by IAI and CRP (both positively) and 25-hydroxyvitamin D (negatively), whereas 54.4 % of the severity index (MS-EDSS-MSSS) was explained by the regression on age, IAI, homocysteine, folate, and CRP (all positively), and adiponectin, body mass index, and 25-hydroxyvitamin D (all negatively), female sex, and the MTHFR 677 TT genotype. In patients and controls, 16.6 % of the variance in the homocysteine was explained by the MTHFR 677 TT genotype and age (both positively), folate (negatively) and male sex. CONCLUSION The MTHFR 677C>T variant has an indirect effect on the increase in disability in patients with MS, which also depends on factors such as age, sex, ad folate status.
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Affiliation(s)
- Claudia Mara Ribeiro
- Postgraduate Program of Clinical and Laboratory Pathophysiology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Sayonara Rangel Oliveira
- Postgraduate Program of Clinical and Laboratory Pathophysiology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil; Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, State University of Londrina, Paraná, Brazil
| | - Tamires Flauzino
- Experimental Pathology Postgraduate Program, Biological Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Daniela Frizon Alfieri
- Department of Pharmaceutical Sciences, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Andrea Name Colado Simão
- Postgraduate Program of Clinical and Laboratory Pathophysiology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil; Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, State University of Londrina, Paraná, Brazil
| | - Marcell Alysson Batisti Lozovoy
- Postgraduate Program of Clinical and Laboratory Pathophysiology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil; Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, State University of Londrina, Paraná, Brazil
| | - Michael Maes
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, PR China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, PR China
| | - Edna Maria Vissoci Reiche
- Postgraduate Program of Clinical and Laboratory Pathophysiology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil; Catholic Pontifical University, School of Medicine, Campus Londrina, Londrina, Paraná, Brazil.
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Schlindwein MAM, de Moura Campos MH, Breis LC, Chara BS, Scherer CS, Caminski VAP, Matta A, Gonçalves MVM. Impacts of environmental tobacco smoke on the onset and progression of multiple sclerosis: a systematic review. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-10. [PMID: 38490261 PMCID: PMC10942830 DOI: 10.1055/s-0044-1779271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 11/17/2023] [Indexed: 03/17/2024]
Abstract
BACKGROUND Unlike cigarette smoking, environmental tobacco smoke (ETS) has not been as well described as an environmental risk for Multiple sclerosis (MS) nor as a risk factor for disease progression. OBJECTIVE We systematically reviewed the association between ETS and the risk of onset and/or progression of MS. METHODS We systematically screened MedLine/PubMed, Science Direct, LILACs, and SciELO searching for publications between January 1st, 2010, and July 5, 2021, with the following keywords: "multiple sclerosis and smoking"; "multiple sclerosis and passive smoking"; "multiple sclerosis and secondhand smoking". RESULTS Fifteen articles were included in this review, which consisted of systematic reviews with meta-analysis (N = 2), systematic reviews (N = 2), and observational studies (N = 11). Both meta-analyses reported an impact of ETS on MS onset among secondhand smokers. One of the systematic reviews selected two observational studies showing the association between ETS and MS development, and one study that did not find a significant association between ETS and the risk of MS development. The other systematic review identified selected eight articles showing a relationship between ETS and MS. Seven observational studies reported higher odds of MS onset when associated with ETS. Four observational studies did not show a relationship between ETS and MS onset or progression. CONCLUSION Most articles showed a positive association between ETS exposure and the risk of developing MS. On the other hand, an association between ETS and a higher risk for MS progression could not be established.
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Affiliation(s)
| | | | | | - Beatriz Sordi Chara
- Mayo Clinic, Department of Gastroenterology and Hepatology, Rochester, Minnesota, United States.
| | - Clara Sasse Scherer
- Universidade da Região de Joinville, Departamento de Medicina, Joinville SC, Brazil.
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Plantone D, Primiano G, Manco C, Locci S, Servidei S, De Stefano N. Vitamin D in Neurological Diseases. Int J Mol Sci 2022; 24:87. [PMID: 36613531 PMCID: PMC9820561 DOI: 10.3390/ijms24010087] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Vitamin D may have multiple effects on the nervous system and its deficiency can represent a possible risk factor for the development of many neurological diseases. Recent studies are also trying to clarify the different effects of vitamin D supplementation over the course of progressive neurological diseases. In this narrative review, we summarise vitamin D chemistry, metabolism, mechanisms of action, and the recommended daily intake. The role of vitamin D on gene transcription and the immune response is also reviewed. Finally, we discuss the scientific evidence that links low 25-hydroxyvitamin D concentrations to the onset and progression of severe neurological diseases, such as multiple sclerosis, Parkinson's disease, Alzheimer's disease, migraine, diabetic neuropathy and amyotrophic lateral sclerosis. Completed and ongoing clinical trials on vitamin D supplementation in neurological diseases are listed.
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Affiliation(s)
- Domenico Plantone
- Centre for Precision and Translational Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Guido Primiano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Carlo Manco
- Centre for Precision and Translational Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Sara Locci
- Centre for Precision and Translational Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Serenella Servidei
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Nicola De Stefano
- Centre for Precision and Translational Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
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Ali Ashrafi S, Asadi M, Shanehbandi D, Sadigh Eteghad S, Fazlollahi A, Nejadghaderi SA, Shaafi S. Association between miRNA-145 and miRNA-155 expression in peripheral blood mononuclear cells of patients with multiple sclerosis: a case-control study. BMC Neurol 2022; 22:405. [PMID: 36329419 PMCID: PMC9632146 DOI: 10.1186/s12883-022-02909-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction MicroRNAs (miR or miRNA) are short regulatory RNAs, which modulate post-transcriptional gene expression. Dysregulation of these molecules contributes to pathogenicity of autoimmune disorders, such as multiple sclerosis (MS). Aims This study was conducted to investigate changed expression pattern of miRNA-145 and miRNA-155 in MS. Methods We collected blood samples of 75 patients with relapsing-remitting MS patients and 75 healthy controls. Ficoll-Hypaque density gradient method was used to isolate peripheral blood mononuclear cells. Also, total RNA was extracted and subjected to RT-PCR analysis. We used the Mann–Whitney U test to evaluate the differences in expression levels of target miRNAs between the groups. Results We found that expression of miRNA-145 (P = 0.012) and miRNA-155 (P = 0.005) were partly reduced in patients with relapse-remitting MS in comparison with healthy controls. The miRNA-145 had an area under curve (AUC) of 0.621 (P = 0.01) and miRNA-155 levels had an AUC of 0.625 (P = 0.008). Conclusion Decreased expression of miRNA-145 and miRNA-155 contributes to development of relapse-remitting MS, while further large scale observational studies and meta-analyses are required.
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Affiliation(s)
- Sepide Ali Ashrafi
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Milad Asadi
- Department of Basic Oncology, Health Institute of Ege University, Izmir, Turkey
| | - Dariush Shanehbandi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Sadigh Eteghad
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asra Fazlollahi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Aria Nejadghaderi
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sheida Shaafi
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran.
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Nimodipine Exerts Beneficial Effects on the Rat Oligodendrocyte Cell Line OLN-93. Brain Sci 2022; 12:brainsci12040476. [PMID: 35448007 PMCID: PMC9029615 DOI: 10.3390/brainsci12040476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 02/04/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system (CNS). Therapy is currently limited to drugs that interfere with the immune system; treatment options that primarily mediate neuroprotection and prevent neurodegeneration are not available. Here, we studied the effects of nimodipine on the rat cell line OLN-93, which resembles young mature oligodendrocytes. Nimodipine is a dihydropyridine that blocks the voltage-gated L-type calcium channel family members Cav1.2 and Cav1.3. Our data show that the treatment of OLN-93 cells with nimodipine induced the upregulation of myelin genes, in particular of proteolipid protein 1 (Plp1), which was confirmed by a significantly greater expression of PLP1 in immunofluorescence analysis and the presence of myelin structures in the cytoplasm at the ultrastructural level. Whole-genome RNA sequencing additionally revealed the upregulation of genes that are involved in neuroprotection, remyelination, and antioxidation pathways. Interestingly, the observed effects were independent of Cav1.2 and Cav1.3 because OLN-93 cells do not express these channels, and there was no measurable response pattern in patch-clamp analysis. Taking into consideration previous studies that demonstrated a beneficial effect of nimodipine on microglia, our data support the notion that nimodipine is an interesting drug candidate for the treatment of MS and other demyelinating diseases.
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Effects of a Fully Humanized Type II Anti-CD20 Monoclonal Antibody on Peripheral and CNS B Cells in a Transgenic Mouse Model of Multiple Sclerosis. Int J Mol Sci 2022; 23:ijms23063172. [PMID: 35328594 PMCID: PMC8949956 DOI: 10.3390/ijms23063172] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/09/2022] [Indexed: 11/17/2022] Open
Abstract
Successful therapy with anti-CD20 monoclonal antibodies (mAbs) has reinforced the key role of B cells in the immunopathology of multiple sclerosis (MS). This study aimed to determine the effects of a novel class of anti-CD20 mAbs on vascular and extravascular central nervous system (CNS)-infiltrating B cells in experimental autoimmune encephalomyelitis (EAE), an animal model of MS. Male hCD20xhIgR3 mice and wild-type C57BL/6 (B6) mice were immunized with human myelin oligodendrocyte glycoprotein (MOG)1–125 to induce EAE. While hCD20xhIgR3 mice were injected intravenously with an anti-human CD20 mAb (5 mg/kg) (rituximab (a type I anti-CD20 mAb) or obinutuzumab (a type II anti-CD20 mAb), B6 mice received the anti-mouse CD20 antibody 18B12. Neither mAb affected clinical disease or serum antibody levels. Obinutuzumab and rituximab had an impact on splenic and CNS-infiltrated B cells with slightly differential depletion efficacy. Additionally, obinutuzumab had beneficial effects on spinal cord myelination. B cell depletion rates in the 18B12/B6 model were comparable with those observed in obinutuzumab-treated hCD20xhIgR3 mice. Our results demonstrate the usefulness of anti-CD20 mAbs for the modulation of B cell-driven peripheral immune response and CNS pathology, with type II antibodies potentially being superior to type I in the depletion of tissue-infiltrating B cells.
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Yakhdani MF, Jalili M, Salehi-Abargouei A, Mirzaei M, Rahimdel A, Ebrahimi AA. Interaction of MS prevalence, radon gas concentration, and patient nutrition: a case-control study. Sci Rep 2021; 11:17906. [PMID: 34504114 PMCID: PMC8429741 DOI: 10.1038/s41598-021-96816-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 08/06/2021] [Indexed: 02/08/2023] Open
Abstract
In general, ecological findings indicate a positive correlation between MS and the intake of certain foods. This study aimed to investigate the relationship between radon (Rn) gas concentration and nutrition of patients in food groups with MS. Demographic information, diet, and building characteristics were collected by a questionnaire. Indoors Rn gas was measured using CR-39 detectors. Three models were used in the study of food intake. The interaction analysis between MS prevalence, diet, residential building characteristics, and Rn gas content was performed using SPSS 2020. The total Rn was significantly associated with cooling devices (P = 0.021). Buildings > 20 years had higher Rn concentrations than buildings < 20 years (P = 0.038). Also, no significant relationship was found between Rn-total and MS concentrations, but the total Rn concentration was higher in people homes with MS. Case group used more processed meat than the control (P < 0.001). The case group consumed more butter than the control, which was significant in Model III (P < 0.04). Tomato consumption in the case group was significantly higher than the control (P < 0.03). According to the results there was no interaction between Rn gas concentration in any of the food groups in each cases. However, future studies with larger sample sizes will be needed prospectively.
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Affiliation(s)
- Monire Fallah Yakhdani
- Department of Environmental Health Engineering, Environmental Science and Technology Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahrokh Jalili
- Department of Environmental Health Engineering, Environmental Science and Technology Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masuod Mirzaei
- Department of Epidemiology, Centre for Healthcare Data Modeling, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abolghasem Rahimdel
- Department of Neurology, Shahid Sadoughi Hospital, Yazd University of Medical Science, Yazd, Iran
| | - Ali Asghar Ebrahimi
- Department of Environmental Health Engineering, Environmental Science and Technology Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Rumrill P, Li J, Strauser D, Roessler RT, Bishop M, Chan F, Adams C, Leslie M. Personal, health and function, and career maintenance factors as determinants of quality of life among employed people with multiple sclerosis. Work 2021; 67:81-94. [PMID: 32986637 DOI: 10.3233/wor-203254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is an intrusive disease that significantly affects labor force participation. OBJECTIVE This study examined the extent to which factors at the personal, health and function, and environmental/career maintenance levels contribute to the predictability power for quality of life among employed people with MS. METHOD Participants consisted of 523 members of nine National Multiple Sclerosis Society chapters representing 21 states and Washington, DC. These individuals were employed at the time of the survey, and they were primarily middle age (average age of 48 years) and Caucasian (74%). RESULTS The final hierarchical multiple regression model explained 54 percent of the variability in participants' quality of life scores, although none of the hypothesized personal/demographic predictors were significant. Participants who perceived better overall health and lower levels of stress, who experienced less severe cognitive and mobility-related MS symptoms, and who expressed stronger job-person matches and higher levels of job satisfaction reported higher quality of life scores than did other participants. CONCLUSIONS The findings underscore the complexity involved in predicting perceived quality of life among employed people with MS. Implications of these findings for future research and clinical practice are discussed.
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Affiliation(s)
| | - Jian Li
- Kent State University, Kent, Ohio, USA
| | | | | | | | - Fong Chan
- University of Wisconsin, Madison, Wisconsin, USA
| | - Chithra Adams
- University of Illinois, Champaign-Urbana, Illinois, USA
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Russell RD, Black LJ, Begley A. Navigating dietary advice for multiple sclerosis. Health Expect 2021; 24:853-862. [PMID: 33838061 PMCID: PMC8235876 DOI: 10.1111/hex.13226] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is an inflammatory demyelinating disease with no known cure. Numerous diets are promoted to reduce symptoms or even cure MS, despite insufficient evidence for any therapeutic diet. There are few qualitative studies exploring the experiences of people with MS in relation to diet, and no use of theory to explain the findings. PURPOSE To explore the experiences of adults with MS when navigating dietary advice, their attitudes when making dietary decisions, and their needs regarding dietary resources and education. METHODS In this qualitative study, we conducted six focus groups with people with MS (n = 33 plus one spouse without MS). Groups were audio-recorded and transcribed verbatim. Primary analysis used a general inductive approach with thematic analysis. Secondary analysis aligned themes with the constructs of the self-determination theory. RESULTS Six themes emerged: (a) confusion about where to seek dietary advice; (b) scepticism towards national dietary guidelines; (c) personalized approaches to dietary change; (d) barriers to dietary changes; (e) judging if dietary changes work; and (f) wanting dietary guidelines for MS. CONCLUSION People with MS are highly motivated to make dietary changes and improve their health. The self-determination theory explained why people with MS make dietary modifications, and the varying levels of motivation. MS-specific dietary resources and nutrition education need to incorporate ways to increase autonomous forms of motivation. Future dietary intervention studies could use the self-determination theory as a framework to improve long-term adherence to healthier diets.
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Affiliation(s)
| | | | - Andrea Begley
- School of Population HealthCurtin UniversityPerthWAAustralia
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Abstract
Despite numerous studies on multiple sclerosis (MS) and understanding many aspects of this disease, researchers still struggle to find proper biomarkers that facilitate diagnosis; prognosis and monitoring of treatment efficacy in MS. MicroRNAs (miRNAs) are considered as endogenous, comparatively stable and small non-coding RNAs involved in various biological and pathological signaling pathways. Interestingly, miRNAs have been emerged as a potential biomarker for monitoring novel therapies in MS patients. In this review, we described the miRNAs alteration in the MS patients as well as their altered expression in patients under common MS therapies.
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Affiliation(s)
- Sahar Rostami Mansoor
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Ghasemi-Kasman
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.,Neuroscience Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Breakell T, Tacke S, Schropp V, Zetterberg H, Blennow K, Urich E, Kuerten S. Obinutuzumab-Induced B Cell Depletion Reduces Spinal Cord Pathology in a CD20 Double Transgenic Mouse Model of Multiple Sclerosis. Int J Mol Sci 2020; 21:ijms21186864. [PMID: 32962135 PMCID: PMC7559311 DOI: 10.3390/ijms21186864] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/11/2020] [Accepted: 09/16/2020] [Indexed: 11/16/2022] Open
Abstract
B cell-depleting therapies have recently proven to be clinically highly successful in the treatment of multiple sclerosis (MS). This study aimed to determine the effects of the novel type II anti-human CD20 (huCD20) monoclonal antibody (mAb) obinutuzumab (OBZ) on spinal cord degeneration in a B cell-dependent mouse model of MS. Double transgenic huCD20xHIGR3 (CD20dbtg) mice, which express human CD20, were immunised with the myelin fusion protein MP4 to induce experimental autoimmune encephalomyelitis (EAE). Both light and electron microscopy were used to assess myelination and axonal pathology in mice treated with OBZ during chronic EAE. Furthermore, the effects of the already established murine anti-CD20 antibody 18B12 were assessed in C57BL/6 wild-type (wt) mice. In both models (18B12/wt and OBZ/CD20dbtg) anti-CD20 treatment significantly diminished the extent of spinal cord pathology. While 18B12 treatment mainly reduced the extent of axonal pathology, a significant decrease in demyelination and increase in remyelination were additionally observed in OBZ-treated mice. Hence, the data suggest that OBZ could have neuroprotective effects on the CNS, setting the drug apart from the currently available type I anti-CD20 antibodies.
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MESH Headings
- Animals
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antigens, CD20/immunology
- Antigens, CD20/metabolism
- Antineoplastic Agents, Immunological/administration & dosage
- Axons/drug effects
- Axons/immunology
- Axons/pathology
- B-Lymphocytes/immunology
- B-Lymphocytes/pathology
- Chronic Disease/drug therapy
- Disease Models, Animal
- Encephalomyelitis, Autoimmune, Experimental/drug therapy
- Encephalomyelitis, Autoimmune, Experimental/immunology
- Encephalomyelitis, Autoimmune, Experimental/pathology
- Mice
- Mice, Inbred C57BL
- Mice, Transgenic
- Microscopy, Electron
- Multiple Sclerosis/drug therapy
- Multiple Sclerosis/immunology
- Multiple Sclerosis/pathology
- Multiple Sclerosis, Chronic Progressive/drug therapy
- Multiple Sclerosis, Chronic Progressive/immunology
- Multiple Sclerosis, Chronic Progressive/pathology
- Myelin Basic Protein/immunology
- Myelin Proteolipid Protein/immunology
- Neurofilament Proteins/blood
- Recombinant Fusion Proteins/immunology
- Spinal Cord/drug effects
- Spinal Cord/immunology
- Spinal Cord/pathology
- Spinal Cord/ultrastructure
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Affiliation(s)
- Thomas Breakell
- Institute of Anatomy and Cell Biology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (T.B.); (S.T.); (V.S.)
| | - Sabine Tacke
- Institute of Anatomy and Cell Biology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (T.B.); (S.T.); (V.S.)
| | - Verena Schropp
- Institute of Anatomy and Cell Biology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (T.B.); (S.T.); (V.S.)
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, 43141 Mölndal, Sweden; (H.Z.); (K.B.)
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 43180 Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
- UK Dementia Research Institute at UCL, London WC1E 6BT, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, 43141 Mölndal, Sweden; (H.Z.); (K.B.)
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 43180 Mölndal, Sweden
| | - Eduard Urich
- Roche Pharma Research and Early Development, Neuroscience, Roche Innovation Center, 4070 Basel, Switzerland;
| | - Stefanie Kuerten
- Institute of Anatomy and Cell Biology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (T.B.); (S.T.); (V.S.)
- Correspondence: ; Tel.: +49-9131-8522264
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Giustina A, Adler RA, Binkley N, Bollerslev J, Bouillon R, Dawson-Hughes B, Ebeling PR, Feldman D, Formenti AM, Lazaretti-Castro M, Marcocci C, Rizzoli R, Sempos CT, Bilezikian JP. Consensus statement from 2 nd International Conference on Controversies in Vitamin D. Rev Endocr Metab Disord 2020; 21:89-116. [PMID: 32180081 PMCID: PMC7113202 DOI: 10.1007/s11154-019-09532-w] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The 2nd International Conference on Controversies in Vitamin D was held in Monteriggioni (Siena), Italy, September 11-14, 2018. The aim of this meeting was to address ongoing controversies and timely topics in vitamin D research, to review available data related to these topics and controversies, to promote discussion to help resolve lingering issues and ultimately to suggest a research agenda to clarify areas of uncertainty. Several issues from the first conference, held in 2017, were revisited, such as assays used to determine serum 25-hydroxyvitamin D [25(OH)D] concentration, which remains a critical and controversial issue for defining vitamin D status. Definitions of vitamin D nutritional status (i.e. sufficiency, insufficiency and deficiency) were also revisited. New areas were reviewed, including vitamin D threshold values and how they should be defined in the context of specific diseases, sources of vitamin D and risk factors associated with vitamin D deficiency. Non-skeletal aspects related to vitamin D were also discussed, including the reproductive system, neurology, chronic kidney disease and falls. The therapeutic role of vitamin D and findings from recent clinical trials were also addressed. The topics were considered by 3 focus groups and divided into three main areas: 1) "Laboratory": assays and threshold values to define vitamin D status; 2) "Clinical": sources of vitamin D and risk factors and role of vitamin D in non-skeletal disease and 3) "Therapeutics": controversial issues on observational studies and recent randomized controlled trials. In this report, we present a summary of our findings.
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Affiliation(s)
- A Giustina
- Chair of Endocrinology, School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Endocrinology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - R A Adler
- McGuire Veterans Affairs Medical Center and Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - N Binkley
- Osteoporosis Clinical Research Program and Institute on Aging, University of Wisconsin-Madison, Madison, WI, USA
| | - J Bollerslev
- Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - R Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, Leuven, KU, Belgium
| | - B Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - D Feldman
- Department of Medicine, Endocrinology Division, Stanford University School of Medicine, Stanford, CA, USA
| | - A M Formenti
- Chair of Endocrinology, School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Endocrinology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Lazaretti-Castro
- Division of Endocrinology, Escola Paulista de Medicina - Universidade Federal de Sao Paulo (EPM-UNIFESP), Sao Paulo, Brazil
| | - C Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - R Rizzoli
- Divison of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - C T Sempos
- Vitamin D Standardization Program LLC, Havre de Grace, MD, USA
| | - J P Bilezikian
- Department of Medicine, Endocrinology Division, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
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Albatineh AN, Alroughani R, Al-Temaimi R. Predictors of Multiple Sclerosis Severity Score in Patients with Multiple Sclerosis. Int J MS Care 2020; 22:233-238. [PMID: 33177960 DOI: 10.7224/1537-2073.2019-054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Multiple sclerosis (MS) is a demyelinating autoimmune disorder. Several factors have been shown to associate with MS clinical severity. The influence of different lifestyle factors on MS clinical severity as assessed by the Multiple Sclerosis Severity Score (MSSS) was investigated. Methods A questionnaire was administered to 128 Kuwaiti MS patients to assess the association of smoking, nutritional supplement use, food allergy, physical activity (PA), and educational level with MSSS. A multiple linear regression model was used to test for associations. Regression model results were adjusted for sex, history of blood transfusion, age at MS onset, and marital status. Results Smoking status, passive smoking, and food allergy are not associated with MSSS. Patients with MS with a college education and graduate/professional degrees score, on average, 2.56 lower on the MSSS compared with those with less than a high school education (β= -2.22, P = .045; and β = -2.90, P = .048, respectively). Patients who perform PA score, on average, 2.32 lower on the MSSS compared with those with no PA (moderate exercise, P = .003; rigorous exercise, P = .001), and PA correlated significantly with MSSS outcomes (r2 = 0.452, P < .001). Conclusions Educational level and PA are significantly associated with reduced MSSS, and both contribute to a less severe MS clinical course. Current MS management protocols should consider lifestyle changes to improve the quality of life of patients with MS.
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Alharbi MA, Al-Kafaji G, Khalaf NB, Messaoudi SA, Taha S, Daif A, Bakhiet M. Four novel mutations in the mitochondrial ND4 gene of complex I in patients with multiple sclerosis. Biomed Rep 2019; 11:257-268. [PMID: 31798871 PMCID: PMC6873451 DOI: 10.3892/br.2019.1250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/16/2019] [Indexed: 12/11/2022] Open
Abstract
Multiple sclerosis (MS) is an immune-mediated neurological, inflammatory disease of the central nervous system. Recent studies have suggested that genetic variants in mitochondrial DNA (mtDNA)-encoded complexes of respiratory chain, particularly, complex I (NADH dehydrogenase), contribute to the pathogenicity of MS among different ethnicities, and targeting mitochondrial function may represent a novel approach for MS therapy. In this study, we sequenced ND genes (ND1, ND2, ND3, ND4, ND4L, ND5 and ND6) encoding subunits of complex I in 124 subjects, 60 patients with relapsing-remitting MS and 64 healthy individuals, in order to identify potential novel mutations in these patients. We found several variants in ND genes in both the patients and controls, and specific variants only in patients with MS. While the majority of these variants were synonymous, 4 variants in the ND4 gene were identified as missense mutations in patients with MS. Of these, m.11150G>A was observed in one patient, whereas m.11519A>C, m.11523A>C and m.11527C>T were observed in another patient. Functional analysis predicted the mutations, m.11519A>C, m.11523A>C and m.11150G>A, as deleterious with a direct impact on ND4 protein stability and complex I function, whereas m.11527C>T mutation had no effect on ND4 protein stability. However, the 3 mutations, m.11519A>C, m.11523A>C and m.11527C>T, which were observed in the same patient, were predicted to cause a cumulative destabilizing effect on ND4 protein, and could thus disrupt complex I function. On the whole, this study identified 4 novel mutations in the mtDNA-encoded ND4 gene in patients with MS, which could lead to complex I dysfunction, and further confirmed the implication of mtDNA mutations in the pathogenicity of MS. The identified novel mutations in patients with MS may be ethnic-related and may prove to be significant in personalized treatment.
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Affiliation(s)
- Maram Atallah Alharbi
- College of Forensic Sciences, Naif Arab University for Security Sciences, Riyadh 14812, Kingdom of Saudi Arabia
| | - Ghada Al-Kafaji
- Department of Molecular Medicine, Al-Jawhara Centre for Genetics and Inherited Disorders, College of Medicine and Medical Sciences, Arabian Gulf University, Block 329, Manama, Kingdom of Bahrain
| | - Noureddine Ben Khalaf
- Department of Life Sciences, College of Graduate Studies, Arabian Gulf University, Block 329, Manama, Kingdom of Bahrain
| | - Safia Abdulsalam Messaoudi
- College of Forensic Sciences, Naif Arab University for Security Sciences, Riyadh 14812, Kingdom of Saudi Arabia
| | - Safa Taha
- Department of Molecular Medicine, Al-Jawhara Centre for Genetics and Inherited Disorders, College of Medicine and Medical Sciences, Arabian Gulf University, Block 329, Manama, Kingdom of Bahrain
| | - Abdulqader Daif
- King Saud University Medical City, Riyadh 12372, Kingdom of Saudi Arabia
| | - Moiz Bakhiet
- Department of Molecular Medicine, Al-Jawhara Centre for Genetics and Inherited Disorders, College of Medicine and Medical Sciences, Arabian Gulf University, Block 329, Manama, Kingdom of Bahrain
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15
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Probst Y, Mowbray E, Svensen E, Thompson K. A Systematic Review of the Impact of Dietary Sodium on Autoimmunity and Inflammation Related to Multiple Sclerosis. Adv Nutr 2019; 10:902-910. [PMID: 31079157 PMCID: PMC6743836 DOI: 10.1093/advances/nmz032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/14/2019] [Accepted: 03/11/2019] [Indexed: 12/23/2022] Open
Abstract
Multiple sclerosis (MS) is an autoimmune disease of the central nervous system. Current research into potential causes, risk factors, and treatment is largely based around the immune response involved in the pathophysiology of the disease, including factors that contribute to the augmentation of this immune response. This review aimed to determine the role of sodium as a risk factor for increased autoimmunity and inflammation in relation to MS pathogenesis. This systematic review searched the Scopus, MEDLINE, and PubMed scientific databases for studies related to MS and sodium. Studies were included if they addressed sodium intake and MS but were not limited to a disease type or to a study design. Study quality was assessed through the use of the quality rating checklist of the Academy of Nutrition and Dietetics. A total of 12 studies were included in the review, including human, animal, and cellular studies. The studies related to the proinflammatory effect of sodium, the blood-brain barrier, and an effect on autoimmunity. The data presented throughout this review provide insight into the emerging evidence base for sodium intake as a risk factor for MS disease progression and potentially onset of disease. More studies are needed to determine if the influence of sodium is as a single nutrient or has a combined effect as part of an overall eating pattern. This review was registered at PROSPERO as CRD42016039174.
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Affiliation(s)
- Yasmine Probst
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Erin Mowbray
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Erika Svensen
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Keats Thompson
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
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16
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Higher fish consumption and lower risk of central nervous system demyelination. Eur J Clin Nutr 2019; 74:818-824. [PMID: 31395972 DOI: 10.1038/s41430-019-0476-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 06/25/2019] [Accepted: 07/05/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND/OBJECTIVES The evidence for diet as a risk factor for multiple sclerosis (MS) is inconclusive. We examined the associations between fish consumption and risk of a first clinical diagnosis of central nervous system demyelination (FCD), a common precursor to MS. METHODS The 2003-2006 Ausimmune Study was a case-control study examining environmental risk factors for FCD, with participants recruited from four regions of Australia and matched on age, sex, and study region. Dietary intake data were collected using a food frequency questionnaire. We used conditional logistic regression models to test associations between fish consumption (total, tinned, grilled, and fried) and risk of FCD (249 cases and 438 controls), adjusting for history of infectious mononucleosis, smoking, serum 25-hydroxyvitamin D concentrations, socio-economic status, omega-3 supplement use, dietary under-reporting, and total energy intake. RESULTS Higher total fish consumption (per 30 g/day, equivalent to two serves/week) was associated with an 18% reduced risk of FCD (AOR 0.82; 95% CI 0.70, 0.97). While we found no statistically significant associations between grilled and fried fish consumption and risk of FCD, higher tinned fish consumption (per 30 g/day) was associated with a 41% reduced risk of FCD (AOR 0.59; 95% CI 0.39, 0.89). CONCLUSIONS Tinned fish is predominantly oily, whereas grilled and fried fish are likely to be a combination of oily and white types. Oily fish is high in vitamin D and very long chain polyunsaturated omega-3 fatty acids, both of which may be beneficial in relation to MS.
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17
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Rumrill, PD, Bishop M. Multiple sclerosis: A high-incidence immune-mediated disease of the central nervous system. JOURNAL OF VOCATIONAL REHABILITATION 2019. [DOI: 10.3233/jvr-191020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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18
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Effectiveness of Vitamin D Supplementation in the Management of Multiple Sclerosis: A Systematic Review. Int J Mol Sci 2019; 20:ijms20061301. [PMID: 30875858 PMCID: PMC6471017 DOI: 10.3390/ijms20061301] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 02/25/2019] [Accepted: 03/05/2019] [Indexed: 12/11/2022] Open
Abstract
Objective: to examine the extent of effect vitamin D in Multiple Sclerosis (MS) on pathology and symptoms. Methods: A literature search was performed in November 2018 (CRD42018103615). Eligibility criteria: randomised control trials in English from 2012 to 2018; a clinical diagnosis of MS; interventions containing vitamin D supplementation (vitamin D3 or calcitriol) in disease activity compared to a control/placebo; improvement in: serum 25(OH)D, relapse rates, disability status by Expanded Disability Status Scale (EDSS) scores, cytokine profile, quality of life, mobility, T2 lesion load and new T2 or T1 Gd enhancing lesions, safety and adverse effects. Risk of bias was evaluated. Results: Ten studies were selected. The study size ranged from 40 to 94 people. All studies evaluated the use of vitamin D supplementation (ranging from 10 to 98,000 IU), comparing to a placebo or low dose vitamin D. The duration of the intervention ranged from 12 to 96 weeks. One trial found a significant effect on EDSS score, three demonstrated a significant change in serum cytokines level, one found benefits to current enhancing lesions and three studies evaluating the safety and tolerability of vitamin D reported no serious adverse events. Disease measures improved to a greater extent overall in those with lower baseline serum 25(OH)D levels. Conclusions: As shown in 3 out of 10 studies, improvement in disease measures may be more apparent in those with lower baseline vitamin D levels.
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19
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Iacopetta K, Collins-Praino LE, Buisman-Pijlman FTA, Liu J, Hutchinson AD, Hutchinson MR. Are the protective benefits of vitamin D in neurodegenerative disease dependent on route of administration? A systematic review. Nutr Neurosci 2018; 23:251-280. [PMID: 29985117 DOI: 10.1080/1028415x.2018.1493807] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: The clinical and preclinical exploration of the therapeutic properties of vitamin D have significantly increased in the past decade, owing to the growing associative evidence suggesting vitamin D is neuroprotective. However, whether depletion of vitamin D contributes to the onset of neurological disorders or is a symptom of neurological disease has yet to be defined. Much remains unclear about the causal role of vitamin D and the method of use and forms of vitamin D.Objectives: We sought to quantitatively assess if neuroprotective benefits from vitamin D in neurodegenerative diseases are dependent on route of administration: comparing the effect of endogenously sourced vitamin D from UV exposure to exogenously derived vitamin D through synthetic supplementation.Design: We systematically searched PubMed, Embase and PsycInfo databases which included both pre-clinical and clinical studies investigating vitamin D in neurodegenerative diseases. Articles were subject to strict inclusion criteria and objectively assessed for quality. Additionally, Medline data was analysed to identify trends in topic publications and linguistic characteristics of papers.Results: From a total of 231 screened articles, we identified 73 appropriate for review based on inclusion criteria: original studies that investigated vitamin D levels or levels of vitamin D supplementation in neurodegenerative diseases or investigated past/present sun exposure in disease cohorts. Results indicate there is insufficient evidence to comprehensively reflect on a potential neuroprotective role for vitamin D and if this was dependent on route of administration. The majority of current data supporting neuroprotective benefits from vitamin D are based on pre-clinical and observational studies. Solid evidence is lacking to support the current hypothesis that the beneficial effect of UV exposure results from the synthesis of vitamin D. Sun exposure, independent of vitamin D production, may be protective against multiple Sclerosis, Parkinson's disease and Alzheimer's disease. Yet, further research is required to elucidate the beneficial mechanism of actions of UV exposure. The literature of vitamin D and amyotrophic lateral sclerosis was limited, and no conclusions were drawn. Therefore, in cases where UV-derived vitamin D was hypothesized to be the beneficial mediator in the neuroprotective effects of sun exposure, we propose results are based only on associative evidence.Conclusion: On the basis of this systematic review, strong recommendations regarding therapeutic benefits of vitamin D in neurodegenerative disease cannot be made. It is unclear if vitamin D mediates a protective benefit in neurodegenerative disease or whether it is an associative marker of UV exposure, which may contribute to as of yet unidentified neuroprotective factors.
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Affiliation(s)
- Krystal Iacopetta
- Adelaide Centre for Neuroscience Research, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Lyndsey E Collins-Praino
- Adelaide Centre for Neuroscience Research, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Femke T A Buisman-Pijlman
- Adelaide Centre for Neuroscience Research, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Jiajun Liu
- Adelaide Centre for Neuroscience Research, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Amanda D Hutchinson
- School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia
| | - Mark R Hutchinson
- Adelaide Centre for Neuroscience Research, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, University of Adelaide, Adelaide, Australia
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20
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Russell RD, Black LJ, Sherriff JL, Begley A. Dietary responses to a multiple sclerosis diagnosis: a qualitative study. Eur J Clin Nutr 2018; 73:601-608. [PMID: 29941913 DOI: 10.1038/s41430-018-0252-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 06/07/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND/OBJECTIVES Multiple sclerosis (MS) is an immune-mediated disease with no known cure and insufficient evidence to support a special therapeutic diet to alter symptom management or disease progression. Several studies have reported dietary changes made by people with MS, but there has been limited investigation into experiences surrounding diet in those recently diagnosed. This study explored responses to diet after a recent diagnosis of MS in people living in Western Australia. SUBJECTS/METHODS Eleven adults with MS (mean time since diagnosis 8 months) participated in semi-structured interviews focusing on responses to diet since MS diagnosis. Interviews were transcribed, coded and analysed using grounded theory principles. RESULTS Three theme responses emerged; (1) the perceived incompatibility of lack of/or generalised dietary advice with disease seriousness at the time of diagnosis; (2) extensive personal research and information seeking with difficulty judging credibility, and (3) self-experimentation with diet to either control MS symptoms or to cure MS. CONCLUSIONS Given the seriousness of the disease, there is a perceived gap in dietary information provided at the time of diagnosis. Healthcare professionals should address concerns with alternative therapeutic diets advertised to treat or cure MS, and clearly convey the reasoning for the general healthy dietary recommendations. This would better align advice with the perceptions about the role of diet in MS, assist people with MS in need of information and minimise dietary self-experimentation. Future research should explore the importance of diet for those who have had MS for a longer period of time.
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Affiliation(s)
| | - Lucinda J Black
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Jill L Sherriff
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Andrea Begley
- School of Public Health, Curtin University, Perth, WA, Australia.
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21
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Abstract
The microbiome can be defined as the sum of the microbial and host's genome. Recent information regarding this complex organ suggests that in animal models of multiple sclerosis (MS), the composition of the gut microbiome can be altered, giving rise to both the effector and regulatory phases of central nervous system (CNS) demyelination. Experimental findings during the past decade in animal models of MS have provided clear evidence for the significant role of gut microbes in both the effector and regulatory phase of this condition. There is mounting evidence in preliminary human studies suggesting that a dysbiotic MS gut microbiome could affect disease progression. We propose considering the gut microbiome as a key organ for the regulation of tolerance mechanisms and speculate that the gut microbiome is the major environmental risk factor for CNS demyelinating disease. Accordingly, we hypothesize that intervention of the gut microbiome could result in safer novel therapeutic strategies to treat MS.
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Affiliation(s)
| | - Trevor O Kirby
- Department of Biology, Eastern Washington University, Cheney, Washington 99004
| | - Lloyd H Kasper
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire 03756
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22
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Russell RD, Lucas RM, Brennan V, Sherriff JL, Begley A, Black LJ. Reported Changes in Dietary Behavior Following a First Clinical Diagnosis of Central Nervous System Demyelination. Front Neurol 2018; 9:161. [PMID: 29615960 PMCID: PMC5870150 DOI: 10.3389/fneur.2018.00161] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 03/05/2018] [Indexed: 11/18/2022] Open
Abstract
Background/objectives Although the current evidence is insufficient to recommend a special diet for people with multiple sclerosis (MS), dietary advice for people with MS is prolific online and in the media. This study aimed to describe dietary changes made in the year following a first clinical diagnosis of central nervous system demyelination (FCD), a common precursor to MS. Subjects/methods We used follow-up data from the Ausimmune Study, a multicentre matched case-control study examining the environmental risk factors for a FCD. A total of 244 cases (60 male, 184 female) completed a 1-year follow-up interview, which included a question about dietary changes. We described the number and proportion (%) of participants who reported making dietary changes and the type of change made. We investigated independent predictors of making a dietary change using a multivariable logistic regression model. Results A total of 38% (n = 92) of participants at the 1-year follow-up reported making at least one dietary change over the last year. There were no statistically significant independent associations between any participant characteristic and odds of making a dietary change. Of those who made at least one dietary change, the most common changes were increasing fruit and/or vegetable intake (27%, n = 25) and following a low-fat diet (25%, n = 23). Conclusion A considerable proportion of the study population reported making at least one dietary change in the year following a FCD, with the majority of changes being toward a healthier diet. Further research is warranted to investigate the reasons behind any dietary changes adopted by people with a FCD or with MS, and whether making a dietary change has benefits for the progression of demyelinating diseases, e.g., to a diagnosis of MS, as well as for general health and well-being.
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Affiliation(s)
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia
| | - Vanessa Brennan
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Jill L Sherriff
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Andrea Begley
- School of Public Health, Curtin University, Perth, WA, Australia
| | | | - Lucinda J Black
- School of Public Health, Curtin University, Perth, WA, Australia
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23
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Mische LJ, Mowry EM. The Evidence for Dietary Interventions and Nutritional Supplements as Treatment Options in Multiple Sclerosis: a Review. Curr Treat Options Neurol 2018; 20:8. [PMID: 29549521 DOI: 10.1007/s11940-018-0494-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE OF REVIEW This review aims to critically evaluate published studies examining diets and nutritional supplements (excepting vitamin D) for the impact on prevention and prognosis of multiple sclerosis (MS). RECENT FINDINGS There is a negative relationship between the Mediterranean diet and vascular disease, and vascular co-morbidities are associated with a worse MS prognosis. Low-fat, fish-based diets, sodium-restricted diets, calorie restriction, the paleo diet, and gluten-free diets have been examined, mostly in observational studies; results are inconclusive. With regard to nutritional supplements, pilot data show a possible benefit of biotin with respect to disability worsening in people with progressive MS (PMS). The best designed randomized controlled trials (RCTs) for PUFA supplementation have not shown significant impact, but several weaker RCTs have. Many other nutritional supplements have been tested, including several anti-oxidants. While some early studies show positive results, no result has been definitive. Unfortunately, there is no strong evidence for a direct benefit of any given dietary intervention on MS risk or prognosis. However, due to its relationship with vascular co-morbidities, the Mediterranean diet has the strongest rationale for employment in PwMS. Higher-quality clinical trials are needed to ascertain the possible benefits of nutritional supplements.
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Affiliation(s)
- Leah J Mische
- Johns Hopkins School of Medicine, 733 North Broadway, Baltimore, MD, 21205, USA.
| | - Ellen M Mowry
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, 21218, USA
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24
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Skalli A, Ait Ben Haddou E, El Jaoudi R, Razine R, Mpandzou G, Tibar H, El Fahime E, Bouslam N, Alami A, Benomar A, Hajjout K, Yahyaoui M, Bouhouche A. Association of vitamin D status with multiple sclerosis in a case-control study from Morocco. Rev Neurol (Paris) 2018. [DOI: 10.1016/j.neurol.2017.06.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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25
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Vitamin D and disability in relapsing-remitting multiple sclerosis in patients with a Mexican background. Acta Neurol Belg 2018; 118:47-52. [PMID: 28975580 DOI: 10.1007/s13760-017-0834-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 09/16/2017] [Indexed: 10/18/2022]
Abstract
Previous studies of multiple sclerosis (MS) patients have reported an inverse correlation between disability, the number of relapses and vitamin D levels in mostly white patients. It is unclear if this relationship has the same behavior in individuals with Hispanic backgrounds. To determine the relationship between vitamin D serum levels and disability in a sample of Hispanics of a Mexican background with relapsing-remitting multiple sclerosis (RRMS). A cross-sectional study was conducted on 50 RRMS individuals of Mexican background. The Expanded Disability Status Scale (EDSS) score, progression index (PI) and annual relapse rate (ARR) were recorded for each patient. Vitamin D levels were assessed during the summer. Pearson's test was used to evaluate the relationship between vitamin D and EDSS, PI, ARR, and duration of disease evolution. Most patients were females (n = 29, 58%). The mean vitamin D level was 22.3 (± 6.4) ng/ml; the mean EDSS score was 2.2 (± 0.7), ARR 1.3 (± 0.5) and PI1.08 (± 0.6). No correlation was found between vitamin D levels and EDSS scores, ARR, PI or duration of disease. Moderate negative association between vitamin D levels and EDSS was found just in females (<0.0001). No correlation between vitamin D levels and disability was found in this sample of RRMS Mexicans. Longitudinal studies are needed to better understand the impact of Vitamin D in disability and multiple time points.
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26
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Azary S, Schreiner T, Graves J, Waldman A, Belman A, Guttman BW, Aaen G, Tillema JM, Mar S, Hart J, Ness J, Harris Y, Krupp L, Gorman M, Benson L, Rodriguez M, Chitnis T, Rose J, Barcellos LF, Lotze T, Carmichael SL, Roalstad S, Casper CT, Waubant E. Contribution of dietary intake to relapse rate in early paediatric multiple sclerosis. J Neurol Neurosurg Psychiatry 2018; 89:28-33. [PMID: 28993476 PMCID: PMC5732893 DOI: 10.1136/jnnp-2017-315936] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 08/09/2017] [Accepted: 08/09/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The role of diet in multiple sclerosis (MS) course remains largely unknown. Children with MS have a higher relapse rate compared with MS in adults. Thus, studying the effect of diet on relapse rate in this age group is likely to provide more robust answers. METHODS This is a multicentre study done at 11 paediatric MS centres in the USA. Patients with relapsing-remitting MS (RRMS) or clinically isolated syndrome (CIS) with disease onset before 18 years of age and duration of less than 4 years were included in this study. Dietary intake during the week before enrolment was assessed with the validated Block Kids Food Screener. The outcome of the study was time from enrolment to the next relapse. 219 patients with paediatric RRMS or CIS were enrolled. Each 10% increase in energy intake from fat increased the hazard of relapse by 56% (adjusted HR 1.56, 95% CI 1.05 to 2.31, p=0.027), and in particular each 10% increase in saturated fat tripled this hazard (adjusted HR: 3.37, 95% CI 1.34 to 8.43, p=0.009). In contrast, each additional one cup equivalent of vegetable decreased the hazard of relapse by 50% (adjusted HR: 0.50, 95% CI 0.27 to 0.91, p=0.024). These associations remained with mutual adjustment and persisted when adjusting for baseline 25(OH) vitamin D serum level. Other studied nutrients were not associated with relapse. CONCLUSIONS This study suggests that in children with MS, high energy intake from fat, especially saturated fat, may increase the hazard to relapse, while vegetable intake may be independently protective.
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Affiliation(s)
- Saeedeh Azary
- Department of Neurology, UCSF Regional Pediatric MS Center, San Francisco, California, USA
| | - Teri Schreiner
- Department of Neurology, University of Colorado, Aurora, Colorado, USA
| | - Jennifer Graves
- Department of Neurology, UCSF Regional Pediatric MS Center, San Francisco, California, USA
| | - Amy Waldman
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Anita Belman
- Department of Neurology, SUNY Stony Brook, Stony Brook, New York, USA
| | - Bianca Weinstock Guttman
- Department of Neurology, The Pediatric MS Center at the Jacobs Neurological Institute, SUNY, Buffalo, New York, USA
| | - Gregory Aaen
- Department of Child Neurology, Loma Linda University, Loma Linda, California, USA
| | | | - Soe Mar
- Division of Pediatric Neurology, Washington University, St. Louis, Missouri, USA
| | - Janace Hart
- Department of Neurology, UCSF Regional Pediatric MS Center, San Francisco, California, USA
| | - Jayne Ness
- Department of Neurology, Alabama Pediatric MS Center, Birmingham, Alabama, USA
| | - Yolanda Harris
- Department of Neurology, Alabama Pediatric MS Center, Birmingham, Alabama, USA
| | - Lauren Krupp
- Department of Neurology, New York University, New York City, New York, USA
| | - Mark Gorman
- Department of Neurology, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Leslie Benson
- Department of Neurology, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Moses Rodriguez
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Tanuja Chitnis
- Department of Neurology, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - John Rose
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - Lisa F Barcellos
- Division of Epidemiology, UC Berkeley, Berkeley, California, USA
| | - Tim Lotze
- Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
| | - Suzan L Carmichael
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Shelly Roalstad
- Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Charles T Casper
- Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Emmanuelle Waubant
- Department of Neurology, UCSF Regional Pediatric MS Center, San Francisco, California, USA
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27
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Iridoy Zulet M, Pulido Fontes L, Ayuso Blanco T, Lacruz Bescos F, Mendioroz Iriarte M. Epigenetic changes in neurology: DNA methylation in multiple sclerosis. NEUROLOGÍA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.nrleng.2015.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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28
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Vitamin D deficiency is associated with disability and disease progression in multiple sclerosis patients independently of oxidative and nitrosative stress. J Neurol Sci 2017; 381:213-219. [PMID: 28991684 DOI: 10.1016/j.jns.2017.07.046] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 07/10/2017] [Accepted: 07/29/2017] [Indexed: 12/31/2022]
Abstract
The aim of this study was to assess vitamin D status in patients with multiple sclerosis (MS) and to evaluate whether it was associated with oxidative and nitrosative stress (O&NS) markers and disability. This study included 137 patients with MS and 218 healthy controls. The markers evaluated were serum levels of 25-hydroxyvitamin D, lipid hydroperoxides, advanced oxidation protein products (AOPP), nitric oxide metabolites (NOx), and total radical-trapping antioxidant parameter TRAP/UA. Patients with 25(OH)D<20ng/mL showed higher EDSS (p=0.016), MSSS (p=0.005) and lower AOPP (p=0.046) than those with 25(OH)D≥20ng/mL. After the binary logistic regression analyses, EDSS and MSSS remained significantly associated with vitamin D deficiency. We showed that lower levels of 25(OH)D were associated with higher EDSS and MSSS independently of variables such as O&NS, age, sex, body mass index, ethnicity, MS therapy, use of interferon beta, and clinical forms of MS (odds ratio: 1.380, 95% confidence interval 1.030-1.843, p=0.031). Moreover, the study showed an association between serum levels of 25(OH)D and EDSS (r2=0.115, p=0.002), demonstrating that 25(OH)D may contribute with 11.5% of increase in EDSS. Our results suggest that vitamin D deficiency may be considered one of the predictors of the disability in MS patients, independently of their redox status and influence the progression of disability in MS.
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29
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Morel A, Rywaniak J, Bijak M, Miller E, Niwald M, Saluk J. Flow cytometric analysis reveals the high levels of platelet activation parameters in circulation of multiple sclerosis patients. Mol Cell Biochem 2017; 430:69-80. [PMID: 28210898 PMCID: PMC5437150 DOI: 10.1007/s11010-017-2955-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 01/28/2017] [Indexed: 12/25/2022]
Abstract
The epidemiological studies confirm an increased risk of cardiovascular disease in multiple sclerosis, especially prothrombotic events directly associated with abnormal platelet activity. The aim of our study was to investigate the level of blood platelet activation in the circulation of patients with chronic phase of multiple sclerosis (SP MS) and their reactivity in response to typical platelets’ physiological agonists. We examined 85 SP MS patients diagnosed according to the revised McDonald’s criteria and 50 healthy volunteers as a control group. The platelet activation and reactivity were assessed using flow cytometry analysis of the following: P-selectin expression (CD62P), activation of GP IIb/IIIa complex (PAC-1 binding), and formation of platelet microparticles (PMPs) and platelet aggregates (PA) in agonist-stimulated (ADP, collagen) and unstimulated whole blood samples. Furthermore, we measured the level of soluble P-selectin (sP-selectin) in plasma using ELISA method, to evaluate the in vivo level of platelet activation, both in healthy and SP MS subjects. We found a statistically significant increase in P-selectin expression, GP IIb/IIIa activation, and formation of PMPs and PA, as well as in unstimulated and agonist-stimulated (ADP, collagen) platelets in whole blood samples from patients with SP MS in comparison to the control group. We also determined the higher sP-selectin level in plasma of SP MS subjects than in the control group. Based on the obtained results, we might conclude that during the course of SP MS platelets are chronically activated and display hyperreactivity to physiological agonists, such as ADP or collagen.
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Affiliation(s)
- Agnieszka Morel
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236, Lodz, Poland.
| | - Joanna Rywaniak
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236, Lodz, Poland
| | - Michał Bijak
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236, Lodz, Poland
| | - Elżbieta Miller
- Department of Physical Medicine, Medical University of Lodz, Pl. Hallera 1, 90-647, Lodz, Poland.,Neurorehabilitation Ward, III General Hospital in Lodz, Milionowa 14, 93-113, Lodz, Poland
| | - Marta Niwald
- Department of Physical Medicine, Medical University of Lodz, Pl. Hallera 1, 90-647, Lodz, Poland.,Neurorehabilitation Ward, III General Hospital in Lodz, Milionowa 14, 93-113, Lodz, Poland
| | - Joanna Saluk
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236, Lodz, Poland
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30
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Zostawa J, Adamczyk J, Sowa P, Adamczyk-Sowa M. The influence of sodium on pathophysiology of multiple sclerosis. Neurol Sci 2017; 38:389-398. [PMID: 28078565 PMCID: PMC5331099 DOI: 10.1007/s10072-016-2802-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 12/19/2016] [Indexed: 01/06/2023]
Abstract
Multiple sclerosis (MS) is a chronic, inflammatory, autoimmune disease of the central nervous system, and is an important cause of disability in young adults. In genetically susceptible individuals, several environmental factors may play a partial role in the pathogenesis of MS. Some studies suggests that high-salt diet (>5 g/day) may contribute to the MS and other autoimmune disease development through the induction of pathogenic Th17 cells and pro-inflammatory cytokines in both humans and mice. However, the precise mechanisms of pro-inflammatory effect of sodium chloride intake are not yet explained. The purpose of this review was to discuss the present state of knowledge on the potential role of environmental and dietary factors, particularly sodium chloride on the development and course of MS.
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Affiliation(s)
- Jacek Zostawa
- Department of Neurology in Zabrze, Medical University of Silesia, ul. 3-go Maja 13-15, 41-800, Zabrze, Poland
| | - Jowita Adamczyk
- Department of Neurology in Zabrze, Medical University of Silesia, ul. 3-go Maja 13-15, 41-800, Zabrze, Poland.
| | - Paweł Sowa
- Department of Otorhinolaryngology and Oncological Laryngology, Medical University of Silesia, ul. C. Skłodowskiej 10, 41-800, Zabrze, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology in Zabrze, Medical University of Silesia, ul. 3-go Maja 13-15, 41-800, Zabrze, Poland
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31
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Nadalin S, Buretić-Tomljanović A, Lavtar P, Starčević Čizmarević N, Hodžić A, Sepčić J, Kapović M, Peterlin B, Ristić S. The lack of association between angiotensin-converting enzyme gene insertion/deletion polymorphism and nicotine dependence in multiple sclerosis. Brain Behav 2017; 7:e00600. [PMID: 28127518 PMCID: PMC5256183 DOI: 10.1002/brb3.600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/14/2016] [Accepted: 10/03/2016] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Blood-borne angiotensin II is generated from angiotensinogen via cleavage by renin and angiotensin-converting enzyme (ACE), an enzymatic cascade known as the renin-angiotensin system (RAS). Several lines of evidence indicate that ACE, beyond its classical role of mediating blood pressure regulation, might contribute to the etiology of substance addictions by influencing dopaminergic signaling. A functional insertion/deletion (I/D) polymorphism of the ACE gene was associated with risk for being a smoker among individuals with depression and with smoking severity in studies comprising patients with depression and healthy controls. Several reports have described significantly increased ACE activity in cerebrospinal fluid and serum among MS patients. Furthermore, in our previous work with MS patients from Croatian and Slovenian populations, we demonstrated that the ACE-I/D polymorphism contributes to an elevated MS risk among male patients. Here we investigated whether the ACE-I/D polymorphism might influence smoking behavior among patients with MS. PATIENTS AND METHODS Genotyping was performed in 521 patients (males/females: 139/382) using polymerase chain reaction. RESULTS We revealed no significant differences in ACE genotype and allele frequencies between smokers and nonsmokers and no significant association between the ACE-I/D polymorphism and either pack-year smoking history or number of cigarettes smoked daily (p > .05, respectively). CONCLUSION The ACE-I/D polymorphism does not contribute either to risk for nicotine dependence or to smoking severity among MS patients. In the context of reports on the ACE-I/D polymorphism and nicotine dependence among healthy controls and patients with depression, we may speculate that the mechanism by which this polymorphism influences nicotine dependence risk differs in MS compared to depression, although not compared to a healthy population. In addition to angiotensin II, other potential ACE substrates, such as substance P and neurotensin, which also influence dopaminergic neurotransmission (and are proposed to be associated with MS), may deserve study in future.
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Affiliation(s)
- Sergej Nadalin
- Department of Biology and Medical Genetics School of Medicine University of Rijeka Rijeka Croatia
| | | | - Polona Lavtar
- Clinical Institute of Medical Genetics University Medical Centre Ljubljana Slovenia
| | | | - Alenka Hodžić
- Clinical Institute of Medical Genetics University Medical Centre Ljubljana Slovenia
| | - Juraj Sepčić
- Postgraduate Studies School of Medicine University of Rijeka Rijeka Croatia
| | - Miljenko Kapović
- Department of Biology and Medical Genetics School of Medicine University of Rijeka Rijeka Croatia
| | - Borut Peterlin
- Clinical Institute of Medical Genetics University Medical Centre Ljubljana Slovenia
| | - Smiljana Ristić
- Department of Biology and Medical Genetics School of Medicine University of Rijeka Rijeka Croatia
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32
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The influence of gut-derived CD39 regulatory T cells in CNS demyelinating disease. Transl Res 2017; 179:126-138. [PMID: 27519147 PMCID: PMC5164971 DOI: 10.1016/j.trsl.2016.07.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 06/20/2016] [Accepted: 07/20/2016] [Indexed: 02/07/2023]
Abstract
There is considerable interest in trying to understand the importance of the gut microbiome in human diseases. The association between dysbiosis, an altered microbial composition, as related to human disease is being explored in the context of different autoimmune conditions, including multiple sclerosis (MS). Recent studies suggest that MS affects the composition of the gut microbiota by altering the relative abundances of specific bacteria and archaea species. Remarkably, some of the bacterial species shown reduced in the gut of MS patients are known to promote immunosuppressive regulatory T cells (Tregs). In MS, the function of a phenotype of Tregs that express CD39, an ectoenzyme involved in the catabolism of adenosine triphosphate as immunomodulatory cells, appears to be reduced. In this review, we discuss the involvement of the gut microbiota in the regulation of experimental models of central nervous system inflammatory demyelination and review the evidence that link the gut microbiome with MS. Further, we hypothesize that the gut microbiome is an essential organ for the control of tolerance in MS patients and a potential source for safer novel therapeutics.
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33
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Perricone C, Versini M, Ben-Ami D, Gertel S, Watad A, Segel MJ, Ceccarelli F, Conti F, Cantarini L, Bogdanos DP, Antonelli A, Amital H, Valesini G, Shoenfeld Y. Smoke and autoimmunity: The fire behind the disease. Autoimmun Rev 2016; 15:354-74. [DOI: 10.1016/j.autrev.2016.01.001] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 12/31/2015] [Indexed: 12/14/2022]
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34
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Durhan G, Diker S, Has AC, Karakaya J, Tuncer Kurne A, Oguz KK. Influence of cigarette smoking on white matter in patients with clinically isolated syndrome as detected by diffusion tensor imaging. Diagn Interv Radiol 2016; 22:291-6. [PMID: 27015443 DOI: 10.5152/dir.2015.15415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Cigarette smoking has been associated with increased occurrence of multiple sclerosis (MS), as well as clinical disability and disease progression in MS. We aimed to assess the effects of smoking on the white matter (WM) in patients with clinically isolated syndrome (CIS) using diffusion tensor imaging. METHODS Smoker patients with CIS (n=16), smoker healthy controls (n=13), nonsmoker patients with CIS (n=17) and nonsmoker healthy controls (n=14) were included. Thirteen regions-of-interest including nonenhancing T1 hypointense lesion and perilesional WM, and 11 normal-appearing white matter (NAWM) regions were drawn on color-coded fractional anisotropy (FA) maps. Lesion load was determined in terms of number and volume of WM hyperintensities. RESULTS A tendency towards greater lesion load was found in smoker patients. T1 hypointense lesions and perilesional WM had reduced FA and increased mean diffusivity to a similar degree in smoker and nonsmoker CIS patients. Compared with healthy smokers, smoker CIS patients had more extensive NAWM changes shown by increased mean diffusivity. There was no relationship between diffusion metrics and clinical disability scores, duration of the disease and degree of smoking exposure. CONCLUSION Smoker patients showed a tendency towards having greater number of WM lesions and displayed significantly more extensive NAWM abnormalities.
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Affiliation(s)
- Gamze Durhan
- Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey.
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35
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Lucas RM, Byrne SN, Correale J, Ilschner S, Hart PH. Ultraviolet radiation, vitamin D and multiple sclerosis. Neurodegener Dis Manag 2015; 5:413-24. [PMID: 26477548 DOI: 10.2217/nmt.15.33] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
There is compelling epidemiological evidence that the risk of developing multiple sclerosis is increased in association with low levels of sun exposure, possibly because this is associated with low vitamin D status. Recent work highlights both vitamin D and non-vitamin D effects on cellular immunity that suggests that higher levels of sun exposure and/or vitamin D status are beneficial for both MS risk and in ameliorating disease progression. Here we review this recent evidence, focusing on regulatory cells, dendritic cells, and chemokines and cytokines released from the skin following exposure to ultraviolet radiation.
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Affiliation(s)
- Robyn M Lucas
- National Centre for Epidemiology & Population Health, Research School of Population Health, The Australian National University, Canberra, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Scott N Byrne
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Jorge Correale
- Department of Neurology, Raul Carrea Institute for Neurological Research, FLENI, Buenos Aires, Argentina
| | | | - Prue H Hart
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
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36
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Iridoy Zulet M, Pulido Fontes L, Ayuso Blanco T, Lacruz Bescos F, Mendioroz Iriarte M. Epigenetic changes in neurology: DNA methylation in multiple sclerosis. Neurologia 2015; 32:463-468. [PMID: 25976949 DOI: 10.1016/j.nrl.2015.03.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 02/19/2015] [Accepted: 03/05/2015] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Epigenetics is defined as the study of the mechanisms that regulate gene expression without altering the underlying DNA sequence. The best known is DNA methylation. Multiple Sclerosis (MS) is a disease with no entirely known etiology, in which it is stated that the involvement of environmental factors on people with a genetic predisposition, may be key to the development of the disease. It is at this intersection between genetic predisposition and environmental factors where DNA methylation may play a pathogenic role. DEVELOPMENT A literature review of the effects of environmental risk factors for the development of MS can have on the different epigenetic mechanisms as well as the implication that such changes have on the development of the disease. CONCLUSION Knowledge of epigenetic modifications involved in the pathogenesis of MS, opens a new avenue of research for identification of potential biomarkers, as well as finding new therapeutic targets.
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Affiliation(s)
- M Iridoy Zulet
- Servicio de Neurología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - L Pulido Fontes
- Servicio de Neurología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España; Navarrabiomed-Fundación Miguel Servet, Pamplona, Navarra, España
| | - T Ayuso Blanco
- Servicio de Neurología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - F Lacruz Bescos
- Servicio de Neurología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - M Mendioroz Iriarte
- Servicio de Neurología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España; Navarrabiomed-Fundación Miguel Servet, Pamplona, Navarra, España.
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37
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Meems LMG, de Borst MH, Postma DS, Vonk JM, Kremer HPH, Schuttelaar MLA, Rosmalen JGM, Weersma RK, Wolffenbuttel BHR, Scholtens S, Stolk RP, Kema IP, Navis G, Khan MAF, van der Harst P, de Boer RA. Low levels of vitamin D are associated with multimorbidity: results from the LifeLines Cohort Study. Ann Med 2015; 47:474-81. [PMID: 26340085 DOI: 10.3109/07853890.2015.1073347] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The prevalence of multimorbidity (≥ 1 disease within an individual) is rapidly increasing. So far, studies on the relationship between vitamin D and morbidity are mainly focusing on effects on single disease domains only, while vitamin D biology is associated with several diseases throughout the human body. METHODS We studied 8,726 participants from the LifeLines Cohort Study (a cross-sectional, population-based cohort study) and used the self-developed composite morbidity score to study the association between vitamin D levels and multimorbidity. RESULTS Study participants (mean age 45 ± 13 years, 73% females) had a mean plasma vitamin D level of 59 ± 22 nmol/L. In participants aged between 50 and 60 years, 58% had ≥ 2 affected disease domains, while morbidity score increased with age (70-80 years: 82% morbidity score > 1; > 80 years: 89% morbidity score > 1). Each incremental reduction by 1 standard deviation (SD) of vitamin D level was associated with an 8% higher morbidity score (full model OR 0.92, 95% CI 0.88-0.97, P = 0.001). Participants with vitamin D levels < 25 nmol/L were at highest risk for increasing morbidity prevalence (versus > 80 nmol/L, OR 1.34, 95% CI 1.07-1.67, P = 0.01). CONCLUSIONS Low levels of vitamin D are associated with higher prevalence of multimorbidity, especially in participants with vitamin D levels < 25 nmol/L. Collectively, our results favor a general, rather than an organ-specific, approach when assessing the impact of vitamin D deficiency.
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Affiliation(s)
- Laura M G Meems
- a Department of Cardiology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Martin H de Borst
- b Department of Internal Medicine , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Dirkje S Postma
- c Department of Pulmonology , Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Judith M Vonk
- c Department of Pulmonology , Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Hubertus P H Kremer
- d Department of Neurology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Marie-Louise A Schuttelaar
- e Department of Dermatology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Judith G M Rosmalen
- b Department of Internal Medicine , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.,f Department of Psychiatry , Department of Internal Medicine, University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Rinse K Weersma
- g Department of Gastroenterology and Hepatology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Bruce H R Wolffenbuttel
- h Department of Endocrinology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Salome Scholtens
- i Department of LifeLines Cohort Study & Biobank , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Ronald P Stolk
- i Department of LifeLines Cohort Study & Biobank , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Ido P Kema
- j Department of Laboratory Medicine , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Gerjan Navis
- b Department of Internal Medicine , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Mohsin A F Khan
- a Department of Cardiology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Pim van der Harst
- a Department of Cardiology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
| | - Rudolf A de Boer
- a Department of Cardiology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands
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