Abstract
Oxidative stress has been suggested to play a key role in multiple sclerosis (MS), but clinical data on oxidative stress markers in MS patients were inconsistent. This study sought to quantitatively summarize the data of oxidative stress markers in the blood and cerebrospinal fluid (CSF) of patients with MS in the literature. We conducted a systematic search of PubMed and Web of Science and included studies if they provided data on the concentrations of oxidative stress markers in the peripheral blood and CSF of MS patients and healthy control (HC) subjects. The systematic search resulted in the inclusion of 31 studies with 2,001 MS patients and 2,212 HC subjects for meta-analysis. Random-effects meta-analysis demonstrated that patients with MS had significantly increased concentrations of blood oxidative stress markers compared with HC subjects for malondialdehyde (MDA; Hedges' g, 2.252; 95% CI, 1.080 to 3.424; p < 0.001) and lipid hydroperoxide by tert-butyl hydroperoxide-initiated chemiluminescence (CL-LOOH; Hedges' g, 0.383; 95% CI, 0.065 to 0.702; p = 0.018). In contrast, concentrations of albumin (Hedges' g, −1.036; CI, −1.679 to −0.394; p = 0.002) were significantly decreased in MS patients when compared with those in HC subjects. However, the other analyzed blood oxidative stress markers did not show significant differences between cases and controls. Furthermore, this meta-analysis showed significant association between CSF MDA and MS (Hedges' g, 3.275; 95% CI, 0.859 to 5.691; p = 0.008). Taken together, our results revealed increased blood and CSF MDA and decreased blood albumin levels in patients with MS, strengthening the clinical evidence of increased oxidative stress in MS.
Highlights
Multiple sclerosis (MS) is a disease characterized by inflammatory demyelinating lesions in the white matter of the central nervous system, which leads to the impairment of electrical signaling along an axon in the neurons (Hadzovic-Dzuvo et al, 2011)
Exclusion criteria were (1) no necessary concentration data; (2) oxidative stress markers were measured in animal models; (3) no healthy control (HC) subjects; (4) samples were overlapping with other studies; (5) in vitro data; (6) patients had serious complications; and (7) individual oxidative stress marker was assessed in
After full-text scrutiny, 97 studies were excluded because (1) no necessary concentration data (n = 44), (2) oxidative stress markers were measured in animal models (n = 8), (3) no HC subjects (n = 10), (4) samples were overlapping with other studies (n = 4), (5) in vitro data (n = 2); (6) patients had serious complications (n = 8), and (7) individual oxidative stress marker was assessed in
Summary
Multiple sclerosis (MS) is a disease characterized by inflammatory demyelinating lesions in the white matter of the central nervous system, which leads to the impairment of electrical signaling along an axon in the neurons (Hadzovic-Dzuvo et al, 2011). The most common symptoms of the disease include spasticity, chronic pain, fatigue, motor and mobility disorders, and cognitive impairment (Aboud and Schuster, 2019). Oxidative Stress in Multiple Sclerosis to understand the etiology of MS better and subsequently develop more effective drugs for the treatment of the disease. Clinical studies have shown increased oxidative stress in blood of MS patients, including dysregulated malondialdehyde (MDA) (Juybari et al, 2018), superoxide dismutase (SOD) (Tasset et al, 2012), and glutathione (GSH) (Gironi et al, 2014) levels in the patients. Some studies showed the opposite results between MS patients and controls for SOD (De Riccardis et al, 2018) and GSH (Socha et al, 2014) levels
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