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Medium-term carnosine supplementation positively affects patient-reported outcomes in multiple sclerosis

Authors:
  • Applied Bioenergetics Lab

Abstract

Multiple sclerosis (MS) is a potentially disabling autoimmune disease of the central nervous system, with a rather uncertain prognosis and no cure. Supplemental carnosine seems to be beneficial for balancing contractile function and reducing fatigue while these functions are altered in MS; however, the effects of carnosine as an element of management of MS remain unclear. PURPOSE: In this preliminary study, we evaluated the effects of medium-term carnosine administration on Multidimensional Fatigue Inventory (MFI) and Short Form Survey Instrument (SF-36) in adult patients with MS. METHODS: During 2018 (from March to November) 51 patients with MS (age 44.9 ± 8.4 years; 15 men and 36 women) were recruited and examined by a certified health care professional. All patients were allocated to an open-label treatment trial with supplemental carnosine (500mg/day) administered during the four months, with patients evaluated at baseline and at post-intervention follow-up. RESULTS: A total MFI score dropped after carnosine intervention (64.1 ± 19.1 at baseline vs. 52.5 ± 19.1 at follow-up; P < 0.05), indicating reduced self-reported fatigue for 18.1% in patients suffering from MS. This was accompanied by improved SF-36 scores for 14.5% at 4-month follow-up. CONCLUSION: Supplemental carnosine is effective in reducing fatigue in mid-age patients with MS.
Medium-Term Carnosine Supplementation Positively
Affects Patient-Reported Outcomes in Multiple Sclerosis
ABSTRACT
Multiple sclerosis (MS) is a potentially disabling autoimmune disease of the central nervous system, with a rather uncertain prognosis and no cure. Supplemental
carnosine seems to be beneficial for balancing contractile function and reducing fatigue while these functions are altered in MS; however, the effects of carnosine as an
element of management of MS remain unclear. PURPOSE: In this preliminary study, we evaluated the effects of medium-term carnosine administration on
Multidimensional Fatigue Inventory (MFIS) and Short Form Survey Instrument (SF-36)in adult patients with MS.METHODS: During 2018 (from March to November) 51
patients with MS (age 44.9 ±8.4 years; 15 men and 36 women) were recruited and examined by a certified health care professional. All patients were allocated to an
open-label treatment trial with supplemental carnosine (500mg/day) administered during the four months, with patients evaluated at baseline and at post-intervention
follow-up.RESULTS: A total MFI score dropped after carnosine intervention (64.1 ±19.1 at baseline vs.52.5 ±19.1 at follow-up;P< 0.05), indicating reduced self-
reported fatigue for 18.1% in patients suffering from MS. This was accompanied by improved SF-36 scores for 14.5% at 4-month follow up.CONCLUSION: Supplemental
carnosine is effective in reducing fatigue in mid-age patients with MS.
Figure 2. Total SF-36 score at baseline and at each follow-up visit. Values are mean ±SD.
Jasna SIMICIC, Sergej M. OSTOJIC
Applied Bioenergetics Lab, University of Novi Sad, Serbia
Figure 1. Changes in total MFI score and MFI subscales during the study.
Values are mean ±SD.
THIS STUDY WAS PARTIALLY SUPPORTED BY CARNOMED LLC, NOVI SAD 21000, SERBIA | www.carnomed.com
Background
Multiple sclerosis (MS) is a prevalent inflammatory-demyelinating disease, with
fatigue and impaired quality of life often reported among key MS pathognomonics.
Supplemental L-carnosine (dipeptide composed of beta-alanine and L-histidine)
could be effective in reducing fatigue and improving quality of life in MS patients due
to its antioxidative, anti-carbonylating, anti-glycation, neuroprotective and chelating
properties yet no human trial evaluated this hypothesis.
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Methods
In this open-label interventional preliminary study, 51 MS patients aged 20 to 65
years received oral L-carnosine formulation (500 mg per day b.i.d.) during 4 months;
most of the patients (83.0%) had relapsing-remitting MS.At baseline and at each
month follow-up visits, patients completed two questionnaires: (1) Multidimensional
Fatigue Inventory (MFI), a 20-item self-report instrument designed to measure
fatigue; and (2) Short Form Survey Instrument (SF-36), patient-reported survey of
patient health.
_______________
Results
Compliance with the intervention (determined by capsule counts at final visit) was
high (88.0 ±11,4%). Total MFI score improved from 52.5 ±19.1 at baseline to 64.1 ±
19.1 at 4-month follow-up (P< 0.05) (Figure 1). MFI subscales analysis revealed a
significant change for cognitive and physical domain after an intervention (P< 0.05).
This was accompanied by improved SF-36 scores for 14.5% at 4-month follow up
(Figure 2).
________________
Conclusion
Medium-term supplementation with L-carnosine resulted in a significant fatigue
reduction and improved health-related quality of life in men and women suffering
from MS, while a treatment protocol was well tolerated. Therefore, oral L-carnosine
may become an important adjuvant to the pharmacological therapeutics available
for the management of MS-related fatigue and quality of life.Long-term well-
sampled studies are highly warranted to confirm these preliminary results.
... Concerning MS, carnosine clinical results are relatively scarce. However, on a recent clinical level, CAR improved the levels of self-reported fatigue (p < 0.05) after four month administration of 500 mg per day [141]. 2 g daily, for two months, in three MS patients, have shown improved walking distance and normalized sympathetic and parasympathetic cardiovascular reflexes, with almost tenfold increased total antioxidant capacity [142]. ...
Article
Full-text available
Multiple Sclerosis (MS) is a degenerative disorder of the central nervous system (CNS) with complicated etiology that has not been clearly analyzed until nowadays. Apart from anti-inflammatory, immune modulatory and symptomatic treatments, which are the main tools towards MS control, antioxidant molecules may be of interest. Oxidative stress is a key condition implicated in the disease progression. Reactive species production is associated with immune cell activation in the brain as well as in the periphery, accounting for demyelinating and axonal disruptive processes. This review refers to research articles, of the last decade. It describes biological evaluation of antioxidant drugs, and molecules with pharmaceutical interest, which are not designed for MS treatment, however they seem to have potency against MS. Their antioxidant effect is accompanied, in most of the cases, by anti-inflammatory, immune-modulatory and neuroprotective properties. Compounds with such characteristics are expected to be beneficial in the treatment of MS, alone or as complementary therapy, improving some clinical and mechanistic aspects of the disease. This review also summarizes some of the pathobiological characteristics of MS, as well as the role of oxidative stress and inflammation in the progression of neurodegeneration. It presents known drugs and bioactive compounds with antioxidant, and in many cases, pleiotropic activity that have been tested for their efficacy in MS progression or the experimentally induced MS. Antioxidants may offer reduction or prevention of the disease symptoms and progression. Thus, their results may, combined with already applied treatments, be beneficial for the development of new molecules or the repurposing of drugs and supplements that are used with other indication so far. Graphical Abstract
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