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.
Highlights
Multiple sclerosis (MS) is a complex neurodegenerative disease with a heterogeneous clinical course that is typified by repetitive relapses and/or progression
retinoic acid (RA) is able to modulate the balance between Th1/Th2, which are responsible for cellular and humoral response, and Th17/Tregs, which are responsible for inflammatory equilibrium (Th17 cells produce stimulating inflammation interleukins, such as IL-17, IL-22, and IL-23; on the other hand, Tregs produce anti-inflammatory cytokines, such as IL-10 and TGF-β, suppressing immune response) [87] as well as dendritic cells (DCs) and B cell functions, and has been found to enhance tolerance and reduce inflammatory processes [88]
Further research is needed in order to understand the potential protective effects exerted by antioxidants on the cellular immunology of MS neurodegeneration
Summary
Multiple sclerosis (MS) is a complex neurodegenerative disease with a heterogeneous clinical course that is typified by repetitive relapses and/or progression. Axonal loss is the pivotal factor responsible for the conversion from RRMS to a progressive form of the disease, progressive–relapsing MS (PRMS). This is a small percentage of patients (no more than 5%), constituting a subset of PPMS after the adoption of the new classification in 2014. The following search terms were used to locate articles specific to this study: neurodegeneration, multiple sclerosis antioxidant compounds, dietary antioxidants, antioxidant complementary therapy, and oxidative stress. Variations of these terms were used to ensure exhaustive search results.
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