Key Points
In a recent large cohort study, the plant-based ω-3 fatty acid α-linolenic acid (ALA) was associated with a significantly lower multiple sclerosis (MS) risk, while EPA and DHA were not associated with disease risk. These results could be relevant not only for studies on disease risk, but also for disease activity, as previous trials on ω-3 fatty acids have focused on the effect of EPA and DHA. ALA may affect immune pathways relevant for MS. This study prospectively examined whether levels of ALA, measured repeatedly over 2 years, were associated with disease activity in a cohort of patients with relapsing remitting MS (RRMS). In this cohort study, higher levels of the plant-based ω-3 fatty acid ALA were associated with significantly lower odds of new T2-lesions. Higher levels of ALA were also associated with reduced odds
of new T1-GdE lesions, disability progression and new relapses during follow-up, but these effect estimates did not reach statistical significance. The findings suggest that ALA may have beneficial effects on MS disease activity. Previous studies and these findings could suggest that ALA may be relevant for both disease risk and modulation. ALA may affect pathways relevant to MS. This study found that higher ALA levels were associated with lower MRI activity in a cohort of MS patients. This suggests that the ω-3 fatty acid has beneficial effects on disease activity in MS that should be evaluated in future trials.
ABSTRACT
BACKGROUND: The plant-based ω-3 fatty acid α-linolenic acid (ALA) has been associated with lower MS risk. It is currently unknown whether ALA affects disease activity. OBJECTIVE: To investigate the association between ALA levels and disease activity. METHODS: We conducted a cohort study including 87 multiple sclerosis (MS)-patients who originally participated in a randomized trial of ω-3 fatty acids (the OFAMS study). We measured serum levels of ALA during follow-up and used random intercept logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CIs) for the association between ALA levels, new magnetic resonance imaging (MRI) lesions, Expanded Disability Status Scale (EDSS) progression and new relapses adjusting for age at inclusion, sex, and use of interferon beta-1a. RESULTS: In continuous (per 1-SD increase) multivariable-adjusted analyses, higher ALA levels were significantly associated with lower odds of new T2-lesions (OR: 0.59, 95% CI: 0.37-0.95) during follow-up. The effect estimates were similar for new T1Gd + lesions (OR: 0.73, 95% CI: 0.48-1.11), EDSS-progression (OR: 0.62, 95% CI: 0.34-1.16) and new relapses (OR: 0.49, 95% CI: 0.22-1.10), but these estimates did not reach statistical significance. Further adjustment for vitamin D and tobacco use did not materially change the results. CONCLUSION: We found that higher levels of ALA were associated with lower disease activity in MS-patients.
Link to Full Text