Advances in antioxidative therapy of multiple sclerosis.

Multiple sclerosis (MS) is a chronic, multifactorial disease of the central nervous system (CNS), typified by repetitive relapses and/or progression. The conventional treatment options in MS are limited. However, recently several new drugs have been introduced. Oxidative stress is a crucial factor in MS pathogenesis by ameliorating leukocyte migration, contributing to oligodendrocyte damage and axonal injury. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) are created in CNS of MS patients mainly by activated macrophages and microglia structures responsible for demyelinisation and axons disruption. Activated microglia secretes different inflammatory and oxidative stress mediators such as cytokines (TNF and IL- 1b and IL- 6) and chemokines (macrophage inflammatory protein MIP- 1a, monocyte chemoattractant protein, MCP- 1 and interferon (IFN) inducible protein IP- 10). The inflammatory state is promoted by that. MS in chronic stages is dominated by neurogenerative processes involving axon and neuron loss probably resulting from oxidative stress and excitotoxicity. Therefore, consideration of the treatment engaging antioxidants and diet supplementation is needed. The present review describes the antioxidative system in CNS and possible antioxidative therapies in MS. Although some exogenous compounds have been proposed as such approach to MS treatment, there is a strong need for further research in this field. Such investigation is required for better understanding of the potential of protective effects of antioxidants in cellular immunology of MS neurodegeneration. Not only would that increase our knowledge about the disease mechanisms but also could help to establish new goals for innovative treatment methods and provide real therapeutic benefits in MS.