Vitamin A, D and E and inflammation in multiple sclerosis

Abstract

Inflammation plays a central role in the pathology of the neurological condition relapsing-remitting multiple sclerosis (RRMS). Moreover, it is suggested that the fat-soluble vitamins A, D and E may limit the inflammation in RRMS. The aims of the thesis Vitamin A, D and E and inflammation in multiple sclerosis were to examine the potential relationship between vitamin A, D and E and systemic inflammation in an observational setting, the possible influence of vitamin D status on the anti-inflammatory effects of interferon-β therapy both systemically and in the brain, and the effects of high-dose vitamin D supplementation on systemic inflammation in the setting of a double-blinded placebo-controlled trial among patients with RRMS. To address these aims, demographic information, serum samples and clinical data were obtained from 156 patients from two independent clinical trials each lasting two years. In addition, brain magnetic resonance images were included from 88 patients from one of these trials. The results indicate that naturally increasing vitamin A, D and E levels are linked to distinct markers of systemic inflammation in RRMS. However, the effects of vitamin D appear modest compared to that of interferon-β treatment, and the interferon-β effects seem independent of the patients’ vitamin D status. Furthermore, high-dose vitamin D intervention does not appear to affect the systemic inflammation in RRMS. Overall, this implies that vitamin A, D and E can affect systemic inflammation in RRMS, but the anti-inflammatory effects of interferon-β therapy seemingly overshadow that of vitamin D and appear unaffected by the vitamin D level. Lastly, as the anti-inflammatory effects associated with rising vitamin D levels look dependent on whether the elevation is a consequence of natural variation or nutritional intake, it may be suggested that increased sun exposure promotes additional anti-inflammatory effects besides higher vitamin D production.