The effect of vitamin A supplementation on disease progression, cytokine levels and gene expression in multiple sclerotic patients: study protocol for a randomized controlled trial.

Multiple Sclerosis (MS) is a chronic inflammatory disease that leads to degeneration of the brain and spinal tissue. Imbalances of CD4+ T cells including Thelper1 (Th1)/Thelper2 (Th2) and Thelper17 (Th17)/Tregulatory (Treg), their secreted cytokines and gene expressions, are important aspects of in immunopathogenesis of MS. Vitamin A and its metabolites can regulate the immune system and appears to be effective in preventing progression of the autoimmune disease such as MS. Disease progression was evaluated By Magnetic Resonance Imaging (MRI), Expanded Disability States Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC) tests. Cytokine levels were measured using ELISA kits and gene expression was quantified by Real time PCR (RT-PCR) system. According to the difference between the epidemiological and clinical data on the relationship between vitamin A and immune system regulation, this study of the first time assesses Immune function as well as gene expression and progression of the disease following administration of vitamin A supplement.

Concentrations of nitric oxide metabolites in the serum of Iranian multiple sclerosis patients.

Nitric oxide is a signaling molecule that has various roles under normal conditions, notably in relation to vasodilation, neuronal function, and immune responses. Additionally, it has been implicated in some pathological states including multiple sclerosis. Multiple sclerosis is characterized by chronic inflammation and oligodendrocyte and axonal damage and ultimately death of neurons. The precise role of nitric oxide in pathogenesis is confounded by its opposing beneficial and deleterious effects. With respect to multiple sclerosis, increased nitric oxide metabolites have been well documented in the cerebrospinal fluid of patients. Reports on changes in the concentration of nitric oxide in the serum of patients have been inconsistent. Here, we report statistically significant increases in the concentrations of nitric oxide metabolites in the serum of multiple sclerosis patients not under medications from two subpopulations in Iran, supporting contentions that disease status does correlate with nitric oxide levels in this easily accessible body fluid. However, the tightness of the correlation appears to be insufficient to allow it to be used as an independent surrogate for assessment of disease status.