Integrative therapies for multiple sclerosis

Maker-Clark, Geeta; Patel, Smita

doi:10.1016/j.disamonth.2013.03.017

Cited by 10 publications

(8 citation statements)

References 54 publications

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“…5 Several reviews have examined the role of diet therapy on the management of MS symptoms and disease progression including two systematic reviews 6,7 and several scoping or short reviews. [8][9][10][11][12][13][14] Evidence for a therapeutic diet for MS is insufficient and dietary advice for PwMS is to consume a healthy diet in line with national dietary guidelines. 7 The aims of this advice is to improve the wellbeing and sense of control in PwMS.…”

Section: Introductionmentioning

confidence: 99%

Dietary responses to a multiple sclerosis diagnosis: a qualitative study

et al. 2018

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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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Section: Introductionmentioning

confidence: 99%

Dietary responses to a multiple sclerosis diagnosis: a qualitative study

et al. 2018

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“…There is little empirical evidence to support the benefits of such dietary modifications for disease activity or progression in MS. However, following a healthy diet (e.g., increasing consumption of vegetables, fruits, whole grains, legumes, nuts and seeds, and oily fish; and limiting red meat, animal products, and highly processed foods) may improve overall well-being in people with MS ( 8 , 9 ) and reduce the symptoms and co-morbidities associated with MS, such as fatigue and obesity ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Reported Changes in Dietary Behavior Following a First Clinical Diagnosis of Central Nervous System Demyelination

et al. 2018

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Background/objectivesAlthough 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/methodsWe 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.ResultsA 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).ConclusionA 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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“…But the precise pathogenesis of MS remains unknown because of its diverse performances (2,9). The current therapeutics such as natalizumab (9,10), fingolimod, (11) and immunosuppressive regimens (laquinimod, cladribine, alemtuzumab, caclizumab, and rituximab) are primarily anti-inflammatory and non-Ag-specific in nature and have severe side effects (12)(13)(14). As a result of longterm medication, most of these treatments for MS display suppression of overall immune response, which increases the risks of infection and cancer (15,16).…”

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confidence: 99%

A Tolerogenic Artificial APC Durably Ameliorates Experimental Autoimmune Encephalomyelitis by Directly and Selectively Modulating Myelin Peptide–Autoreactive CD4+ and CD8+ T Cells

Wan

Pei

Shahzad

et al. 2018

The Journal of Immunology

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In this study, a tolerogenic artificial APC (TaAPC) was developed to directly and selectively modulate myelin-autoreactive CD4 and CD8 T cells in the myelin oligodendrocyte glycoprotein (MOG) peptide-induced experimental autoimmune encephalomyelitis in C57BL/6J mice. Cell-sized polylactic-coglycolic acid microparticles were generated to cocouple target Ags (MOG/H-2D-Ig dimer, MOG/I-A multimer), regulatory molecules (anti-Fas and PD-L1-Fc), and "self-marker" CD47-Fc and encapsulate inhibitory cytokine (TGF-β1). Four infusions of the TaAPCs markedly and durably inhibited the experimental autoimmune encephalomyelitis progression and reduced the local inflammation in CNS tissue. They circulated throughout vasculature into peripheral lymphoid tissues and various organs, but not into brain, with retention of 36 h and exerted direct effects on T cells in vivo and in vitro. Two infusions of the TaAPCs depleted 65-79% of MOG-specific CD4 and 46-62% of MOG-specific CD8 T cells in peripheral blood, spleen, and CNS tissues in an Ag-specific manner and regulatory molecule-dependent fashion; induced robust T cell apoptosis; inhibited the activation and proliferation of MOG peptide-reactive T cells; reduced MOG peptide-reactive Th1, Th17, and Tc17 cells; and expanded regulatory T cells. They also inhibited IFN-γ/IL-17A secretion and elevated IL-10/TGF-β1 production in splenocytes but not in CNS tissue. More importantly, the TaAPCs treatment did not obviously suppress the overall immune function of host. To our knowledge, this study provides the first experimental evidence for the capability of TaAPCs to directly modulate autoreactive T cells by surface presentation of multiple ligands and paracrine release of cytokine, thus suggesting a novel Ag-specific immunotherapy for the T cell-mediated autoimmune diseases.

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Integrative therapies for multiple sclerosis

Cited by 10 publications

References 54 publications

Dietary responses to a multiple sclerosis diagnosis: a qualitative study

Dietary responses to a multiple sclerosis diagnosis: a qualitative study

Reported Changes in Dietary Behavior Following a First Clinical Diagnosis of Central Nervous System Demyelination

A Tolerogenic Artificial APC Durably Ameliorates Experimental Autoimmune Encephalomyelitis by Directly and Selectively Modulating Myelin Peptide–Autoreactive CD4+ and CD8+ T Cells

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