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Blood brain barrier.

HDL cholesterol has protective effect in MS patients

By ELLEN GOLDBAUM

Published October 1, 2015 This content is archived.

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Murali Ramanathan.
“This is the first time that HDL cholesterol has been found to have such a clear benefit against the breakdown of the blood-brain barrier in MS patients. ”
Murali Ramanathan, professor
School of Pharmacy and Pharmaceutical Sciences

Several studies in recent years have shown that high cholesterol is associated with an increased risk of lesions in the brains of patients with multiple sclerosis (MS). However, the impact of HDL cholesterol — high-density lipoprotein, commonly referred to as “good” cholesterol — on the disease has not been clear.

Now, an international research team led by UB scientists has found that HDL cholesterol protects the blood-brain barrier from injury in patients with MS.

“This finding is especially important because we found this protective effect very early in the disease,” explains lead author Murali Ramanathan, professor of pharmaceutical sciences, School of Pharmacy and Pharmaceutical Sciences, and professor of neurology, Jacobs School of Medicine and Biomedical Sciences.

The paper was published in August in the Journal of Lipid Research.

The role of HDL was the subject of a controlled, observational study of a group of MS patients who were followed for four years after their first MS attack.

The findings are relevant not only to new treatments for MS. They also have the potential to be used to establish future lifestyle guidelines for preventing the disease.

“This is the first time that HDL cholesterol has been found to have such a clear benefit against the breakdown of the blood-brain barrier in MS patients,” Ramanathan says. That is important, he notes, because the blood-brain barrier or “BBB” as it is known, plays a key role in the development of the brain lesions that are characteristic of MS.

“The breakdown of the BBB is the first step in the formation of brain lesions because it allows immune cells to enter the brain, form long-lasting lesions and mediate tissue injury,” Ramanathan says. He adds that many MS treatments, including interferon-beta, which UB researchers first proved was effective against MS in the 1990s, work by blocking the breakdown of the BBB.

“Cholesterol profiles can be affected by several factors, including genetics, diet, smoking and physical activity,” Ramanathan explains. “A better understanding of this key class of modifiable factors could be leveraged both as clinical advice to MS patients seeking to reduce the risk of progression and as the basis of guidance to healthy individuals with genetic and other known risk factors for MS.”

Results were gathered from 154 MS patients, 67 percent of whom were women, enrolled in a multi-center study of interferon beta–1a after their first demyelinating event. These events, in which myelin, which protects and insulates nerve fibers, breaks down, produce a range of symptoms, from dizziness and memory loss to loss of reflexes or blurred vision.

The study was conducted at Charles University in Prague, Czech Republic, by Ramanathan’s collaborators and funded by the National Multiple Sclerosis Society and the Czech Ministries of Education and Health.

UB co-authors are Kelly Fellows, School of Pharmacy and Pharmaceutical Sciences, and Richard Browne, Bianca Weinstock-Guttman and Robert Zivadinov of the Jacobs School of Medicine and Biomedical Sciences.

Co-authors at Charles University in Prague are Tomas Uher, Dana Horakova, Helena Posova, Manuela Vaneckova, Zdenek Seidl, Jan Krasensky, Michaela Tyblova and Eva Havrdova.

READER COMMENTS

I have had MS for 27 years; the very slow progressive type. My way of handling this disease is through a very healthy diet, supplements, plenty of sleep and positive thinking. My doctor, Jacqueline Chan, MD, PhD, has prescribed medicine for me but I have yet to take it. The last time my cholesterol was checked it was around 208, but my HDL was 95. I have never used any medication for MS — shots or otherwise. For the past five years, I have used a scooter as my legs will not hold me up for very long at all. My eyes are not affected and I have full use of my upper body.

 

I feel that I am truly blessed at 72 years of age.

 

Barbara Gill

The title of this article is completely wrong. There is absolutely no evidence whatsoever that HDL has protective effects on MS. The study only admits to an association between HDL levels and BBB damage. It does not show any sort of cause-effect relationship, and it could not possibly have done so.

 

There are many plausible explanations for this possible association that do not have anything to do with HDL levels being protective. It is even less likely that altering the level of HDL through any form of medication will have any beneficial effect, even though this will be the inappropriate take-away message.

 

Robert Bramel