Relapsing Remitting Multiple Sclerosis and its Relationship with the Immune System and Oxidative Stress

Background: Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of the central nervous system, characterized by progressive neurological dysfunction and recurrent multifocal exacerbations of neurological signs and symptoms. Infiltration of autoreactive lymphocytes and macrophages into the brain parenchyma produces excessive release of reactive oxygen species (ROS), reactive nitrogen species (RNS) and pro-inflammatory cytokines, which creates an elevated oxidative stress in multiple sclerosis patients. Method: A literature search was performed using the PubMed database from 2000 to July 2017. Results: Oxidative stress severely damages the oligodendrocytes and contributes to axonal degeneration. Recent clinical studies suggest the beneficial role of n-3 polyunsaturated fatty acids (PUFAs) and melatonin dietary supplementation in MS pathogenesis. Particularly, dietary supplementation with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) significantly reduces serum markers of oxidative stress and inflammation in relapsing-remitting multiple sclerosis. Melatonin also shows beneficial immunomodulatory and antioxidant effects on MS. Conclusion: Dietary intake of PUFAs and melatonin could also be considered as adjuvant treatments for that clinical course of relapsing-recurrent multiple sclerosis. Further studies focusing on the role of endocannabinoids derived from PUFA´s in MS are needed.