Antioxidative Pathways in Multiple Sclerosis

The panelists review preliminary data on the beneficial effects of antioxidants in multiple sclerosis patients.

Although Andrew D. Goodman, MD, FAAN, says there is currently no convincing evidence to support taking a certain vitamin as an antioxidant, he recognizes some clinical trial data have suggested “oxidative metabolism in nerve cells and axons has a role in why they tend to deteriorate over time in this disease process, (so) working on oxidative metabolism might have a role in protecting tissue over time.”

“We’ve done a pretty good job at preventing relapses and at preventing inflammatory lesions with all of our medicines, but what we haven’t had with such success is the prevention of disease progression and gradual accumulation of disability that happens in many people with MS,” Stephen Krieger, MD, adds. “So, I think the idea of oxidative pathways, antioxidant pathways, and others that could be truly neuroprotective irrespective of their immune modulating properties could be a hope for progressive disease.”

According to Patricia K. Coyle, MD, additional early-stage trials are examining the impact antioxidative agents might have on oxidative stress and mitochondrial injury, which are believed to factor into the neurodegenerative component underlying progressive MS.

However, Coyle notes, “we can talk about a dozen different damage mechanisms in MS … but we haven’t identified the critical damage mechanism. We really don’t know.”