Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system characterized by demyelination and axonal damage.

Despite significant advances in disease-modifying therapies, the underlying mechanisms of MS pathogenesis remain unclear. Oxidative stress is one of the key mechanisms implicated in the development and progression of MS. In this comprehensive review, we discuss the role of oxidative stress in MS pathogenesis, clinical manifestations, diagnosis, and treatment.

What is Oxidative Stress?

Oxidative stress is an imbalance between the production of reactive oxygen species (ROS) and the ability of the body to detoxify and repair the damage caused by these reactive molecules.

ROS are highly reactive molecules that can damage macromolecules such as proteins, lipids, and DNA. When ROS production is excessive, oxidative stress can result, leading to cellular damage and dysfunction.

Oxidative Stress in MS Pathogenesis

Recent studies suggest that oxidative stress plays a significant role in MS pathogenesis.

Oxidative stress can activate immune cells and induce pro-inflammatory cytokine production, leading to demyelination and axonal damage in the central nervous system. In addition, oxidative stress can impair antioxidant defenses, which can exacerbate the damage caused by ROS. Oxidative stress has also been linked to mitochondrial dysfunction, which can lead to cellular energy depletion and neurodegeneration.

Clinical Manifestations of Oxidative Stress in MS

Oxidative stress can manifest in various ways in MS patients, depending on the affected area of the central nervous system.

Inflammation and demyelination can lead to motor and sensory dysfunction, while oxidative stress-induced axonal damage can result in cognitive impairment and fatigue. Additionally, oxidative stress can contribute to MS-related depression and anxiety.

Oxidative Stress and MS Diagnosis

Oxidative stress markers can serve as diagnostic tools for MS.

Several studies have shown that MS patients have higher levels of oxidative stress biomarkers such as malondialdehyde (MDA) and 8-hydroxy-2′-deoxyguanosine (8-OHdG) than healthy controls. Measuring oxidative stress levels in MS patients can provide insights into disease severity and prognosis.

Oxidative Stress and MS Treatment

Several MS therapies aim to reduce oxidative stress levels. Antioxidants such as vitamin E and vitamin C have been shown to reduce oxidative stress and improve MS symptoms.

Additionally, disease-modifying therapies such as interferon-beta, glatiramer acetate, and dimethyl fumarate can reduce oxidative stress levels and prevent disease progression.

Conclusion

Oxidative stress is a key mechanism implicated in the development and progression of MS. It can activate immune cells, induce pro-inflammatory cytokines, and contribute to mitochondrial dysfunction and energy depletion.

Oxidative stress can manifest in various ways in MS patients and can be used as a diagnostic tool. Several therapies aim to reduce oxidative stress levels and prevent disease progression. Future research should focus on developing novel therapies that target oxidative stress pathways.