A Review of Various Antioxidant Compounds and their Potential Utility as Complementary Therapy in Multiple Sclerosis

Abstract

Multiple sclerosis (MS) is a complex disease of the central nervous system (CNS). The etiology of this multifactorial disease has not been clearly defined. Conventional medical treatment of MS has progressed, but is still based on symptomatic treatment. One of the key factors in the pathogenesis of MS is oxidative stress, enhancing inflammation and neurodegeneration. In MS, both reactive oxygen and nitrogen species are formed in the CNS mainly by activated macrophages and microglia structures, which can lead to demyelination and axon disruption. The course of MS is associated with the secretion of many inflammatory and oxidative stress mediators, including cytokines (IL-1b, IL-6, IL-17, TNF-α, INF-γ) and chemokines (MIP-1a, MCP-1, IP10). The early stage of MS (RRMS) lasts about 10 years, and is dominated by inflammatory processes, whereas the chronic stage is associated with neurodegenerative axon and neuron loss. Since oxidative damage has been known to be involved in inflammatory and autoimmune-mediated processes, antioxidant therapy could contribute to the reduction or even prevention of the progression of MS. Further research is needed in order to establish new aims for novel treatment and provide possible benefits to MS patients. The present review examines the roles of oxidative stress and non-pharmacological anti-oxidative therapies in MS.

Inflammation and Oxidative Stress in Multiple Sclerosis: Consequences for Therapy Development

“…Even though the mechanism of action of DMF in MS treatment is not well understood, it has been confirmed as a safe antioxidant treatment for MS. In this line, many antioxidant dietary compounds can exert similar functions and boost the beneficial effects of DMFs if used as complementary therapies [144].…”

“…Antioxidant complementary therapies and their relevance for MS. Complementary antioxidant therapies for MS were reviewed in detail in[144].…”

The Association Between Shift Work and Immunological Biomarkers in Nurses

“…MCP-1 is a chemo-attractant and one of the key cytokines that regulate migration and infiltration of monocytes and macrophages into different tissues around the body. It is believed to play a role in the development of atherosclerosis and probably also in autoimmune disease (22,23). Our finding with regard to MCP-1 using a within-subject study design is novel.…”

New Insights in the Mechanisms of Impaired Redox Signaling and its Interplay With Inflammation and Immunity in Multiple Sclerosis

“…This has given hope that attenuation of OS by antioxidant supplementation can be employed in therapy of MS. However, contrary to promising basic research and preclinical results, the results of clinical trials are still controversial (Adamczyk and Adamczyk-Sowa 2016, Miller et al 2019, Saso and Firuzi 2014. Currently, a number of clinical trials are on way and hopefully more information will be available when these are completed.…”

“…Currently, there is one drug approved by EMA for the treatment of RR MS, which activates Nrf2: it is dimethyl fumarate (DMF; trade name: Tecfidera). Up to date, there have been multiple preclinical studies and also several clinical trials evaluating potential of other Nrf2 activators in the treatment of MS. Noteworthy, these molecules also display anti-inflammatory effects through other mechanisms in addition to Nrf2 activation, such as SIRT1 activation, NF-κB, c-Jun N-terminal kinase (p-JNK), protein kinase RNA-like endoplasmic reticulum kinase (p-ERK), and phospho-p38 members of the mitogen-activated protein kinase (MAPK) pathway attenuation (Adamczyk and Adamczyk-Sowa 2016, Miller et al 2019, Saso et al 2014. Based on preclinical studies, compounds which seem to have therapeutic potential are: sulforaphane, curcumin, melatonin, resveratrol, several flavonoids, such as quercetin, EGCG, naringenin (Long et al 2018, Mohajeri et al 2015, Li et al 2013, Fonseca-Kelly et al 2012, Muthian et al 2004, Semnani et al 2017.…”