A Prospective Study of Serum Levels of Polyunsaturated Fatty Acids and Effects on Multiple Sclerosis Disease Activity and Progression
Abstract
This proposal addresses the FY18 Investigator-Initiated Research Award Focus Area "Correlates of Disease Activity and Progression in MS." Some studies suggest that diet may affect MS disease course. The example with the strongest evidence is vitamin D, which has been associated with lower conversion from a clinically isolated syndrome to MS, lower relapse rates, and development of fewer brain lesions. Identifying other dietary factors that may have a beneficial effect on early MS disease activity and progression is important as they readily lend themselves to modification via dietary changes and testing via randomized controlled clinical trials. The goal of our study is to determine whether serum levels of polyunsaturated fatty acids, or PUFAs, are beneficially associated with relapse rates, EDSS, brain lesions, cognition, and quality of life over the course of 11 years of follow-up of participants in the BENEFIT clinical trial. Using serum samples that were collected over the first two years of BENEFIT, we will measure fatty acid levels and then conduct statistical analyses to determine whether PUFAs are associated with MS outcomes. Specifically, we are asking whether higher serum concentrations of PUFAs predict (1) an increased time to conversion from CIS to clinically definite MS or McDonald MS; (2) a reduced annualized relapse rate, smaller change in EDSS, lower number of new active lesions, and slower rate of brain volume loss; and (3) reduced longer-term disease activity and progression at years 5 and 11 post-CIS, as assessed clinically and by MRI, and by higher MS functional composite and PASAT-3 scores. We will also examine whether PUFA levels predict quality of life. This project will be the most comprehensive longitudinal study on PUFAs and MS outcomes conducted to date and the first to measure multiple different fatty acids in individuals with early MS and associations with longer-term outcomes. If, at the end of this 3-year study, we find that PUFAs predict MS course as measured by clinical and imaging outcomes, individuals with MS may choose to increase their dietary intake of PUFAs and researchers would have evidence to support more rigorous clinical trials of PUFAs and MS outcomes. The results of the proposed study will apply to all patients with relapsing remitting MS, which accounts for more than 90% of all cases of MS. Before being translated into clinical practice, however, the results of the proposed study will need to be independently validated in a separate population to demonstrate the validity and generalizability of the findings. We expect that this process will take 2-3 years from the end of the proposed project.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jul 16, 2019
- Source ID
- W81XWH1910155
Entities
People
- Kassandra L Munger
Organizations
- President and Fellows of Harvard College
- United States Army