Bitarafan Sama, Mohammadpour Zinat, Jafarirad Sima, Harirchian Mohammad-Hossein, Yekaninejad Mir Saeed, Saboor-Yaraghi Ali Akbar
Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Liver Transplantation Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Clin Neurol Neurosurg. 2019 Feb;177:101-105. doi: 10.1016/j.clineuro.2019.01.003. Epub 2019 Jan 7.
Multiple sclerosis (MS) is an inflammatory and autoimmune disease associated with the imbalance of cytokines secreted from CD4 T cells. Studies have shown that vitamin A and its active derivatives are able to modulate the immune system in MS patients. The aim of the present study was to investigate the effect of supplementation of retinyl palmitate (RP), the dietary form of vitamin A, on pro- and anti-inflammatory cytokines in the plasma and supernatants of cultured peripheral blood mononuclear cells (PBMCs) of MS patients.
Thirty-six relapsing-remitting MS patients were enrolled in this double-blind randomized clinical trial. Participants received one capsule of 25,000 IU RP or a placebo per day for six months. Blood samples were taken before and after intervention. After intervention, the PBMCs were isolated and cultured. The levels of pro- and anti-inflammatory cytokines in the plasma and supernatant of cells stimulated with myelin oligodendrocyte glycoprotein, phytohemagglutinin or vehicle (media) were determined. The sample t-test and Mann Whitney U test were used to compare data between groups.
The changes in pro-inflammatory cytokine levels (IL-1β, TNF-α, IFN- γ, IL-2, IL-6, and IL-17) in the serum and supernatant of MS patients were not significant (p > 0.05). There were also no significant changes in the levels of anti-inflammatory cytokines (IL-10, IL-13, IL-4, and TGF-β) (p > 0.05).
Unexpectedly, this study found no significant changes in cytokine levels after six months of RP supplementation in MS patients. The results of other studies by our team have shown significant changes in the gene expression of the cytokines in response to RP supplements. Therefore, we recommend that periodic follow-up of RP supplementation may be needed to reveal changes in the level of the cytokines in the plasma and PBMCs and to clarify the real effect of RP on the immune factor levels in the serum of MS patients.
多发性硬化症（MS）是一种与CD4 T细胞分泌的细胞因子失衡相关的炎症性自身免疫疾病。研究表明，维生素A及其活性衍生物能够调节MS患者的免疫系统。本研究的目的是探讨补充维生素A的膳食形式棕榈酸视黄酯（RP）对MS患者外周血单个核细胞（PBMC）培养上清液和血浆中促炎和抗炎细胞因子的影响。
36例复发缓解型MS患者纳入本双盲随机临床试验。参与者每天服用一粒25,000 IU的RP胶囊或安慰剂，持续六个月。在干预前后采集血样。干预后，分离并培养PBMC。测定用髓鞘少突胶质细胞糖蛋白、植物血凝素或载体（培养基）刺激的细胞的血浆和上清液中促炎和抗炎细胞因子的水平。采用样本t检验和Mann Whitney U检验比较组间数据。
MS患者血清和上清液中促炎细胞因子水平（IL-1β、TNF-α、IFN-γ、IL-2、IL-6和IL-17）的变化不显著（p>0.05）。抗炎细胞因子（IL-10、IL-13、IL-4和TGF-β）水平也无显著变化（p>0.05）。
出乎意料的是，本研究发现MS患者补充RP六个月后细胞因子水平无显著变化。我们团队的其他研究结果表明，补充RP后细胞因子的基因表达有显著变化。因此，我们建议可能需要对RP补充进行定期随访，以揭示血浆和PBMC中细胞因子水平的变化，并阐明RP对MS患者血清中免疫因子水平的实际影响。
