Some fats found in the bloodstream of children with MS increase the risk of relapse and poorer disability

According to a recent study, changes to the levels of certain fat molecules in the bloodstream can significantly increase the risk of relapse and a poorer disability in children and adolescents with multiple sclerosis (MS).

The researchers of the study said, ‘Lipid [fat] metabolites should be further investigated as biomarkers of disease activity and severity, as findings could lead to identifying new therapeutic targets’. However, it is not clear if such changes to markers of the disease such as inflammation and neurodegeneration are the result of disease-related changes.

MS occurs as a result of the immune system mistakenly attacking the myelin sheath, a coating which protects the nerves. This triggers inflammation, and causes damage to the nerves, resulting in the onset of the condition.

The researchers for this study, from the University of California and Johns Hopkins University, focused on the products of lipid metabolism. This could have relevance as lipids are a key component of myelin and can play a role in neuroinflammation.

They took blood samples from 61 children living with either pediatric-onset MS or clinically isolated syndrome and considered at risk of MS. Each sample was examined to understand whether changes in blood lipid metabolites can impact relapses or disability.

The researchers said, ‘While relatively rare, pediatric-onset MS (POMS) can serve as a unique platform to investigate lipid’s role in the disease course.’

‘The limited exposure to environmental and other confounding factors, such as comorbidities, along with the higher relapse rates in this group may provide better insight into disease mechanisms.’

The results showed acylcarnitines and polyunsaturated fatty acids (PUFAs) are both associated with a higher relapse risk and greater disability at the study’s start. Acylcarnitines are important metabolites in cellular energy pathways, while PUFAs have been linked with neuroinflammation.

Other lipid metabolites, ceramides, sphingolipid metabolites, monoacylglycerols, and diacylglycerols, were associated with significantly worsening disability scores. Monohydroxy fatty acids were linked only with a higher risk of relapses.

However, some lipids such as phosphatidylethanolamines (PE), plasmalogens, and primary bile acids, were found to be protective and associated with a much lower risk of relapse and lower disability scores.

“These lipid metabolites may have a direct detrimental role in the inflammatory and neurodegenerative mechanisms,” the team added. “They can also be a consequence and downstream effect of the pathological changes occurring in the disease (myelin degradation and axonal injury) or be part of a compensatory, protective effort in the body.”

The researchers concluded that further studies will be needed to confirm the findings and identify potential biomarkers of disease prognosis.