Expert Review of Clinical Immunology February 2013, Vol. 9, No. 2, Pages 113-115 , DOI 10.1586/eci.12.105
Massimo Filippi*, Paolo Preziosa and Maria A Rocca
Evaluation of: Løken-Amsrud KI, Myhr KM, Bakke SJ et al. Retinol levels are associated with magnetic resonance imaging outcomes in multiple sclerosis. Mult. Scler. doi:10.1177/1352458512457843 (2012) (Epub ahead of print).
A combination of genetic and environmental factors probably plays a role in determining an increased susceptibility to multiple sclerosis (MS). Among these factors, vitamin D and A metabolites are likely to play a role given their immunomodulatory properties. Decreased serum vitamin D levels have been associated with clinical and MRI activity of MS. Løken-Amsrud et al. evaluated the association of retinol concentration with clinical and MRI measures of disease activity in MS patients over a 2-year period. Serum retinol levels correlated with MRI metrics of disease activity, but not with clinical findings. Following IFN-β-1a treatment, the association with MRI metrics was lost. These results support a role of vitamin A metabolites in influencing disease activity in MS.
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- An increase of 1 µmol/l of serum retinol reduced the risk of developing new Gd-enhancing lesions by 49%, new T2 lesions by 42% and active lesions (a combination of the former two) by 46%;
- MRI outcomes were associated with retinol levels prior to initiation of IFN-β-1a treatment, but not after;
- All these findings were not influenced by vitamin D and ω-3 fatty acid levels or by HLA-DRB51*15genotype, which has been shown to interact with environmental risk factors for MS