Abstract
Objective: Diminished blood levels of zinc have been reported to be associated with T-cell-mediated autoimmunity, which has been implicated in multiple sclerosis (MS). We aimed to compare the distribution of serum zinc status in MS patients with that in healthy controls (HCs) and to investigate a potential correlation with clinical state, through analysis of serum zinc concentration in MS patients suffering from different disease subtypes. Methods: Serum zinc concentrations of 133 patients with relapsing (RMS) and 18 patients with the progressive form of MS (PMS), according to the McDonald criteria of 2010, were measured. Clinical status was quantified using the Expanded Disability Status Scale (EDSS). Zinc concentrations were also determined in the sera of 50 HCs, matched for age and sex at a group level. Results: MS patients showed significantly lower zinc concentrations (mean (SD)) than HCs (12.5 (2.1) µmol/L vs. 14.6 (2.3) µmol/L, p < 0.001). In contrast, we did not find any difference between RMS (12.4 (2.0) µmol/L) and PMS (13.0 (3.0) µmol/L) cases (p = 0.8). Patients receiving disease-modifying treatment showed lower mean (SD) serum zinc levels than untreated cases (12.3 (1.9) µmol/L vs. 13.5 (3.2) µmol/L, p < 0.03). Zinc levels were not related to disease duration, EDSS, annual relapse rate, or the median number of relapses. Conclusions: The data suggest that a diagnosis of MS is related to lower serum zinc concentrations than in HCs, and concentrations were lower still under disease-modifying therapy. However, zinc levels did not predict disease subtypes or disability status.
Highlights
Multiple sclerosis (MS) is a neurological, T cell-mediated autoimmune disease characterized by an imbalance of proinflammatory and anti-inflammatory factors to the detriment of the latter [1].The identification of potential nutritional supplements as treatment options is of growing interest, for patients in whom disease-modifying drugs do not hinder disease progression or when nutritional deficiencies prevail [2].Zinc is an essential trace element, which is required by a large number of enzymes, proteins, and transcription factors [3,4,5]
The observed range in zinc levels might be related to the majority of these MS studies comprising small cohorts or including patients at different disease stages, limiting the extent to which the conclusions drawn regarding serum zinc levels in MS can be extended to MS patients in general
Mean (SD) age and sex did not differ between healthy controls (HCs) (43 [14] years, 76% female) and MS patients (43 [12], 75%)
Summary
Multiple sclerosis (MS) is a neurological, T cell-mediated autoimmune disease characterized by an imbalance of proinflammatory and anti-inflammatory factors to the detriment of the latter [1].The identification of potential nutritional supplements as treatment options is of growing interest, for patients in whom disease-modifying drugs do not hinder disease progression or when nutritional deficiencies prevail [2].Zinc is an essential trace element, which is required by a large number of enzymes, proteins, and transcription factors [3,4,5]. Multiple sclerosis (MS) is a neurological, T cell-mediated autoimmune disease characterized by an imbalance of proinflammatory and anti-inflammatory factors to the detriment of the latter [1]. Abnormal lower blood levels of zinc are related to increased. It remains a matter of debate to what extent zinc deficiency could play a critical role in MS, especially as existing studies in MS patients reveal a large span of blood zinc concentrations, ranging from slightly lower to higher levels in contrast to healthy controls (HCs) [6]. The observed range in zinc levels might be related to the majority of these MS studies comprising small cohorts or including patients at different disease stages, limiting the extent to which the conclusions drawn regarding serum zinc levels in MS can be extended to MS patients in general
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