Exploratory 5-year follow-up study of retinol, tocopherols, and carotenoids in multiple sclerosis.

Background: Retinol, tocopherols, and carotenoids (RTC) have physiological roles as vitamins, pro-vitamins, and antioxidants, and provide biomarkers of dietary vegetable and fruit intake. The goal was to investigate RTC in multiple sclerosis (MS).
Methods: This exploratory study included 106 people with MS (71 relapsing-remitting MS or RR-MS; and 35 progressive MS or PMS) and 31 healthy controls (HC) at baseline and 5-year follow-up (5YFU). Serum retinol, α-carotene, β-carotene, α-tocopherol, δ-tocopherol, γ-tocopherol, β-cryptoxanthin, lutein/zeaxanthin, and lycopene were measured using high performance liquid chromatography. Serum neurofilament light chain (sNfL) levels were measured using the single molecule array method. Expanded Disability Status Scale (EDSS) and low contrast letter acuity (LCLA) were used as disability measures.
Results: Retinol in MS was positively correlated with α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin, and α-tocopherol but negatively correlated with δ-tocopherol. EDSS was associated with α-tocopherol, δ-tocopherol, and lycopene. Greater retinol levels were associated with greater LCLA in RR-MS and PMS; high contrast visual acuity was not associated. Greater γ-tocopherol levels were associated with lower LCLA and high contrast visual acuity in PMS.
Conclusions: RTC exhibit distinctive associations with LCLA and EDSS in MS.
Competing Interests: Declaration of Competing Interest Ms. Nasim Nehzat and Dr. Richard Browne have nothing to disclose. Dr. Dejan Jakimovski is an Associate Editor for Clinical Neurology and Neurosurgery, and Frontiers in Cardiovascular Medicine. Bianca Weinstock-Guttman participated in speaker's bureaus and/or served as a consultant for Biogen, EMD Serono, Novartis, Genentech, Celgene/Bristol Meyers Squibb, Sanofi Genzyme, Bayer, Janssen, and Horizon. Dr. Weinstock-Guttman also received grant/research support from the agencies listed. She serves on the editorial board for BMJ Neurology, Children, CNS Drugs, MS International and Frontiers Epidemiology. Dr. Robert Zivadinov received speaker honoraria and consultant fees from Sanofi, Bristol Myers Squibb, Janssen, Mapi Pharma, CorEvitas, 415 Capital, and EMD Serono. He has received research support from Mapi-Pharma, Protembis, Bristol Myers Squibb, CorEvitas, Octave and Novartis. Dr. Murali Ramanathan received research funding from the National Multiple Sclerosis Society, Department of Defense and National Institute of Neurological Diseases and Stroke. He receives royalty from a self-published textbook.
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