Dietary intake and frankincense extract in multiple sclerosis

Azary S, Schreiner T, Graves J, Waldman A, Belman A, Guttman BW, Aaen G, Tillema JM, Mar S, Hart J, Ness J, Harris Y, Krupp L, Gorman M, Benson L, Rodriguez M, Chitnis T, Rose J, Barcellos LF, Lotze T, Carmichael SL, Roalstad S, Casper CT, Waubant E. Contribution of dietary intake to relapse rate in early paediatric multiple sclerosis. J Neurol Neurosurg Psychiatry. 2018 

Jan;89(1):28-33.

Abstract

OBJECTIVE:

The role of diet in multiple sclerosis (MS) course remains largely unknown. Children with MS have a higher relapse rate compared with MS in adults. Thus, studying the effect of diet on relapse rate in this age group is likely to provide more robust answers.

METHODS:

This is a multicentre study done at 11 paediatric MS centres in the USA. Patients with relapsing-remitting MS (RRMS) or clinically isolated syndrome (CIS) with disease onset before 18 years of age and duration of less than 4 years were included in this study. Dietary intake during the week before enrolment was assessed with the validated Block Kids Food Screener. The outcome of the study was time from enrolment to the next relapse. 219 patients with paediatric RRMS or CIS were enrolled. Each 10% increase in energy intake from fat increased the hazard of relapse by 56% (adjusted HR 1.56, 95% CI 1.05 to 2.31, p=0.027), and in particular each 10% increase in saturated fat tripled this hazard (adjusted HR: 3.37, 95% CI 1.34 to 8.43, p=0.009). In contrast, each additional one cup equivalent of vegetable decreased the hazard of relapse by 50% (adjusted HR: 0.50, 95% CI 0.27 to 0.91, p=0.024). These associations remained with mutual adjustment and persisted when adjusting for baseline 25(OH) vitamin D serum level. Other studied nutrients were not associated with relapse.

CONCLUSIONS:

This study suggests that in children with MS, high energy intake from fat, especially saturated fat, may increase the hazard to relapse, while vegetable intake may be independently protective.

See also:

Stürner KH, Stellmann JP, Dörr J, Paul F, Friede T, Schammler S, Reinhardt S, Gellissen S, Weissflog G, Faizy TD, Werz O, Fleischer S, Vaas LAI, Herrmann F, Pless O, Martin R, Heesen C. A standardised frankincense extract reduces disease activity in relapsing-remitting multiple sclerosis (the SABA phase IIa trial). J Neurol Neurosurg Psychiatry. 2017 Dec 16. pii: jnnp-2017-317101. doi:

10.1136/jnnp-2017-317101. [Epub ahead of print]

Abstract

OBJECTIVE:

To investigate whether oral administration of a standardised frankincense extract (SFE) is safe and reduces disease activity in patients with relapsing-remitting multiple sclerosis (RRMS).

METHODS:

We performed an investigator-initiated, bicentric phase IIa, open-label, baseline-to-treatment pilot study with an oral SFE in patients with RRMS (NCT01450124). After a 4-month baseline observation phase, patients were treated for 8 months with an option to extend treatment for up to 36 months. The primary outcome measures were the number and volume of contrast-enhancing lesions (CEL) measured in MRI during the 4-month treatment period compared with the 4-month baseline period. Eighty patients were screened at two centres, 38 patients were included in the trial, 28 completed the 8-month treatment period and 18 of these participated in the extension period.

RESULTS:

The SFE significantly reduced the median number of monthly CELs from 1.00 (IQR 0.75-3.38) to 0.50 (IQR 0.00-1.13; difference -0.625, 95% CI -1.25 to -0.50; P<0.0001) at months 5-8. We observed significantly less brain atrophy as assessed by parenchymal brain volume change (P=0.0081). Adverse events were generally mild (57.7%) or moderate (38.6%) and comprised mainly gastrointestinal symptoms and minor infections. Mechanistic studies showed a significant increase in regulatory CD4+ T cell markers and a significant decrease in interleukin-17A-producing CD8+ T cells indicating a distinct mechanism of action of the study drug.

INTERPRETATION:

The oral SFE was safe, tolerated well and exhibited beneficial effects on RRMS disease activity warranting further investigation in a controlled phase IIb or III trial.

See also: Patti F. Standardised Frankincense extract: new possible therapeutic option for patients with relapsing-remitting multiple sclerosis. J Neurol Neurosurg Psychiatry. 2017 Dec 23. pii: jnnp-2017-317380. doi: 10.1136/jnnp-2017-317380. [Epub ahead of print]

Courtesy of:  https://neurologistconnect.com/posts/5a4ce719634e8878188b456b?SKUID=6656d46c04553656b04bf4a8e0248071&mkt_tok=eyJpIjoiWm1NMFpUUmtNRGd3TVRBNCIsInQiOiJuZFFNUmU2bWFzbkFEdkxUbGxCcmw2YkxFekJtOTNQTVZyQUZ2U1A1RzFrYzVcL1NibjVMWCtibHNJSVZJbjFnaHVKWVhcLzJLR3lSTDFEZDRzZXg5Mlp4MG5LZEUwYUg5ZjVCNW9jT1NHZXc4c3ZPUklDTDhMajFGMVdEVHg5ak5OIn0%3D