Evaluation of Delta-Aminolevulinic Dehydratase Activity, Oxidative Stress Biomarkers, and Vitamin D Levels in Patients with Multiple Sclerosis

Abstract

Multiple sclerosis (MS) is an autoimmune neurological disorder of unknown etiology. Oxidative stress and alterations in vitamin D levels have been implicated in the pathophysiology of MS. The aim of this study was to investigate δ-aminolevulinate dehydratase (δ-ALA-D) activity as well as the levels of vitamin D, lipid peroxidation levels, carbonyl protein content, DNA damage, superoxide dismutase (SOD) and catalase (CAT) activities, and the vitamin C, vitamin E, and non-protein thiol (NPSH) content in samples from patients with the relapsing-remitting form of MS (RRMS). The study population consisted of 29 RRMS patients and 29 healthy subjects. Twelve milliliters of blood was obtained from each individual and used for biochemical determinations. The results showed that δ-ALA-D and CAT activities were significantly increased, while SOD activity was decreased in the whole blood of RRMS patients compared to the control group (P < 0.05). In addition, we observed a significant increase in lipid peroxidation, carbonyl protein levels in serum and damaged DNA in leucocytes in RRMS patients compared with the control group (P < 0.05). Nonetheless, the levels of vitamin C, vitamin E, NPSH, and vitamin D were significantly decreased in RRMS patients in relation to the healthy individuals (P < 0.05). In conclusion, our results suggested that the increase in δ-ALA-D activity may be related to the inflammatory and immune process in MS in an attempt to maintain the cellular metabolism and reduce oxidative stress. Moreover, the alterations in the oxidant/antioxidant balance and lower vitamin D levels may contribute to the pathophysiology of MS.

New Insights into the Role of Oxidative Stress Mechanisms in the Pathophysiology and Treatment of Multiple Sclerosis

“…Consideration was given to the balance between the concentration of compounds such as lipid peroxidation levels, carbonyl protein content, DNA damage and SOD, CAT activities, vitamins C and E, and nonprotein thiol content [42]. Also, the presence of free radicals in the nervous tissue may be toxic; for example, peroxynitrite increases inflammation and in the chronic phase leads to such a high concentration that it may lead to neurodegeneration [13].…”

“…In turn, lower vitamin D levels may be responsible for the development of MS [42]. It may be related to vitamin D-binding protein (DBP) which was found to be more oxidized in both remitting and relapsing phases.…”

“…Among enzymes the most important include catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), superoxide dismutase (SOD), serum paraoxonase, arylesterase [45], and δ -aminolevulinate dehydratase ( δ -ALA-D) activity [42]. Superoxide dismutase has three isoforms that is, copper/zinc SOD (SOD-1), manganese SOD (SOD-2), and extracellular EC-SOD [13].…”

“…The following can be assessed in the serum: UA [13], nonprotein thiol groups [42, 46], and the total glutathione and reduced glutathione [47]. The lowest molecular weight antioxidants can be used.…”

Novel Approaches of Oxidative Stress Mechanisms in the Multiple Sclerosis Pathophysiology and Therapy

“…Another study stressed that changes in the oxidant and/or antioxidant balance played a role in the pathophysiology of the disease. Attention was paid to the balance between the concentration of compounds such as lipid peroxidation levels; carbonyl protein content; DNA damage and SOD; CAT activities; vitamins E and C; and nonprotein thiol content (78). Also, the presence of free radicals in the nervous tissue may be toxic; for example, peroxynitrite increases the inflammatory response, thus leading to such a high concentration in the chronic phase that it may result in neurodegeneration (9).…”