Moving past antioxidant supplementation for the dietary treatment of multiple sclerosis

Abstract

Current research has demonstrated the definitive presence of oxidative stress in multiple sclerosis (MS). This finding has led to clinical trial research which has indicated that specific antioxidants have the ability to effectively reduce markers of oxidative stress. However, few interventions testing antioxidant supplements have shown efficacy for reducing the symptom burden in the disorder. This paper quickly reviews what is currently known about oxidative stress and antioxidants in MS, explains which nutrients are critical for the creation and maintenance of the myelin sheath, describes potential negative effectors in the diet which may be contributing to oxidative stress, and how these aspects of diet, combined with current knowledge on antioxidants, may be able to be combined into a whole food dietary intervention which can be tested for efficacy in MS.

Melatonin and multiple sclerosis: antioxidant, anti-inflammatory and immunomodulator mechanism of action

“…In MS, the definitive presence of oxidative stress has been demonstrated (Holton and Kirkland 2020 ). It acts as a mediator of demyelination, axonal damage and neurodegeneration (Ramirez-Ramirez et al 2013 ; Sánchez-López et al 2018 ).…”

“…An increase in proinflammatory cytokines after lymphocyte and macrophage infiltration into the CNS augments the ROS generation, which favors inflammation still more and produces oxidative stress. The latter is a condition under which the organism’s antioxidant defenses are insufficient due to the excessive release of oxidants (Padureanu et al 2019 ) Some of its main consequences are: the large increase in lipid peroxidation products (LPO); protein carbonylation or carbonylated proteins (CP); oxidative damage to the nuclear and mitochondrial DNA, as well as disorders related to its own replication mechanisms and damage to cell tissues and walls (Senthil Kumaran et al 2008 ; Şimşek et al 2016 ; Maes et al 2019 ; Holton and Kirkland 2020 ; Morris et al 2021 ).…”

“…Reactive species are produced naturally by aerobic metabolism and processes involved in the response to pathogens (Michaličková et al 2020b ). ROS presents unpaired electrons, which makes it more reactive and with a capacity for capturing electrons from other molecules (Holton and Kirkland 2020 ). Besides, it can react with some unsaturated fatty acids present in the cell membranes, which activates the lipid peroxidation process, triggering the modification of proteins and changes in the membrane gradient, resulting in a loss of integrity and irreversible damage (Senthil Kumaran et al 2008 ).…”

Untitled

“…Some diets have been suggested to alter levels of inflammation in the body [11,12], where other diets have been suggested to repair the damaged myelin sheath that causes symptoms of the disease [10,13]. There is also some literature to supportthe use of antioxidants [14], Vitamin D [15,16] and Vitamin A supplementation for persons with MS [14].…”

Antioxidant supplements and cognition in Multiple Sclerosis: a systematic review

“…Cutuli et al investigated the impact of Omega-3 fatty acid, another substance with antioxidant effect, on cognitive function in mice and revealed the protective role of Omega-3 against cognitive decline and brain atrophy (16). Another study mentioned the fact that a diet providing a wide range of antioxidants, not a single antioxidant supplement is needed to observe significant improvement in symptoms of MS patients (17). Beydoun et al demonstrated that dietary vitamin E is correlated with the improvement in multiple domains of cognitive performance such as verbal memory, verbal fluency, and psychomotor speed.…”