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Nutritional status and antioxidant capacity in Multiple Sclerosis
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A Esclerose Múltipla é uma doença neurológica que afecta o sistema nervoso central, onde linfócitos auto-reactivos promovem um processo de inflamação com proliferação de linfócitos T. Esses linfócitos activam também a microglia, que conduz a lesões na mielina, desacelerando o fluxo de impulsos elétricos para determinada região do corpo, consoante o local onde ocorre a desmielinização. Por esta razão, os sintomas sentidos pelos doentes portadores de Esclerose Múltipla, são muito diferentes entre si, dificultando o processo de diagnóstico. À luz do conhecimento actual, a susceptibilidade genética, os factores ambientais – como a exposição ao fumo do tabaco, a baixa exposição à luz solar e, consequentemente, os níveis baixos de vitamina D – e a dieta serão determinantes para a etiologia.
A existência de uma maior incidência de Esclerose Múltipla em países industrializados, onde as dietas são mais calóricas, com um maior consumo de produtos processados, ricos em açúcar e, simultaneamente, menos nutritivas, pobres em vitaminas e minerais, tem suscitado interesse em diversos grupos de investigação. Recentemente, também se tem estudado como as opções alimentares afectam a flora intestinal e como esta alteração se relaciona com a inflamação observada nas fases iniciais da Esclerose Múltipla. Nesse sentido, a dieta do indivíduo terá um papel fundamental, podendo as escolhas alimentares mais saudáveis diminuir a inflamação.
Os doentes de Esclerose Múltipla apresentam valores inferiores de alguns nutrientes, comparativamente com indivíduos saudáveis, como os níveis de vitamina D, entre outras e alguns minerais essenciais. Quando a dieta é ajustada de forma a corrigir essas diferenças, os doentes mostram melhorias na evolução da doença. O mesmo acontece com a toma de suplementos vitamínicos, nomeadamente vitamina D. Atualmente, os medicamentos disponíveis apenas conseguem atrasar a progressão da doença. No entanto, apesar dos benefícios associados à alteração da dieta, o doente não é aconselhado pelo médico, que o segue, relativamente à importância dessas alterações. Os doentes de Esclerose Múltipla são indivíduos que se mostram bastante disponíveis em alterar os seus hábitos alimentares e estilo de vida, no entanto, muitas vezes, fazem-no sem aconselhamento ou recorrendo a medicinas alternativas.
Multiple Sclerosis is a neurological disease that affects the central nervous system, in which self-reactive lymphocytes promote an inflammatory process, leading to the proliferation of T lymphocytes. They also activate microglia, which leads to lesions in myelin, slowing the flow of electrical impulses to certain regions of the body, depending on the place where demyelination occurs. Hence, the symptoms experienced by patients with Multiple Sclerosis are very different, making the diagnosis process difficult. For what is currently known, genetic susceptibility, environmental factors – such as exposure to tobacco smoke, low exposure to sunlight and, consequently, low levels of vitamin D – and diet are determining factors for the etiology. The higher incidence of Multiple Sclerosis in industrialized countries, where diets are more caloric, with a greater consumption of processed products, rich in sugar and, simultaneously, less nutritious, poor in vitamins and minerals, has raised interest in different investigation groups. Recently, it has also been studied how food choices affect the intestinal flora and how these changes may be related to the inflammatory status that is observed in the initial stages of Multiple Sclerosis. Taking that into account, the individual's diet will play a fundamental role, and healthier food choices could reduce inflammation. Multiple Sclerosis patients have lower levels of some nutritional factors compared to healthy individuals, such as vitamin D levels, among other vitamins, and some essential minerals. When the diet is adjusted to correct these differences, patients show improvements managing the progression of the disease. The same happens with taking vitamin supplements, namely vitamin D. Despite those benefits, upon diagnosis, Multiple Sclerosis patients are not advised about the importance of changes in diet, even if the medications currently available only delay the progression of the disease. Multiple Sclerosis patients are very willing to change their eating habits and lifestyle. However, most of them do it without any clinical counseling or by selecting alternative medicines.
Multiple Sclerosis is a neurological disease that affects the central nervous system, in which self-reactive lymphocytes promote an inflammatory process, leading to the proliferation of T lymphocytes. They also activate microglia, which leads to lesions in myelin, slowing the flow of electrical impulses to certain regions of the body, depending on the place where demyelination occurs. Hence, the symptoms experienced by patients with Multiple Sclerosis are very different, making the diagnosis process difficult. For what is currently known, genetic susceptibility, environmental factors – such as exposure to tobacco smoke, low exposure to sunlight and, consequently, low levels of vitamin D – and diet are determining factors for the etiology. The higher incidence of Multiple Sclerosis in industrialized countries, where diets are more caloric, with a greater consumption of processed products, rich in sugar and, simultaneously, less nutritious, poor in vitamins and minerals, has raised interest in different investigation groups. Recently, it has also been studied how food choices affect the intestinal flora and how these changes may be related to the inflammatory status that is observed in the initial stages of Multiple Sclerosis. Taking that into account, the individual's diet will play a fundamental role, and healthier food choices could reduce inflammation. Multiple Sclerosis patients have lower levels of some nutritional factors compared to healthy individuals, such as vitamin D levels, among other vitamins, and some essential minerals. When the diet is adjusted to correct these differences, patients show improvements managing the progression of the disease. The same happens with taking vitamin supplements, namely vitamin D. Despite those benefits, upon diagnosis, Multiple Sclerosis patients are not advised about the importance of changes in diet, even if the medications currently available only delay the progression of the disease. Multiple Sclerosis patients are very willing to change their eating habits and lifestyle. However, most of them do it without any clinical counseling or by selecting alternative medicines.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2023, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Multiple Sclerosis Inflammation Oxidative stress Nutrition Antioxidants Mestrado Integrado - 2023