Plasma non-esterifi ed fatty acids in patients with multiple sclerosis

Objective: The purpose of this study was to investigate the levels of non-esterifi ed fatty acids in plasma from patients with multiple sclerosis and further to correlate these fi ndings with the neurological profi le as measured by the Kurtzke Expanded Disability Status Scale. Methods: Plasma non-esterifi ed fatty acids and esterifi ed fatty acids from 30 control subjects and 31 patients with multiple sclerosis were measured by gas chromatography. Results: Non-esterifi ed fatty acids C18:2n-6, C20:4n-6, C16:1n-7, C18:1n-7, C18:1n-9, C14:0, C16:0 and C18:0 were signifi cantly increased in plasma from patients with multiple sclerosis, P ≤ 0.01, while esterifi ed fatty acid C18:2n-6 was decreased, P = 0.003. Fatty acid PC C16:1n-7 and non-esterifi ed fatty acids C16:1n-7, C18:1n-7 and C18:1n-9 showed positive and fatty acids C18:1n-9, C20:0, C22:0 and C24:0 showed inverse correlations with the Functional System Scores. Conclusions: We have identifi ed increased monounsaturated non-esterifi ed fatty acids in plasma from patients with multiple sclerosis as indicative of a worse disease outcome. Further, the decrease in fatty acid C18:2n-6, with increases in non-esterifi ed fatty acids C18:2n-6 and C20:4n-6, suggested a role for these eicosanoid precursor fatty acids in the infl ammatory condition experienced by these patients. Neurology Asia 2011; 16(3) : 217 – 222 Address correspondence to: Tandi Matsha (PhD), Biomedical Technology, Faculty of Health and Wellness Science, Cape Peninsula University of Technology, P O Box 1906, Bellville, 7530 Cape Town, South Africa. Telephone number: + 27 21 959 6366, Fax number: +27 21 959 6760, E-mail address: matshat@ cput.ac. za INTRODUCTION Fatty acid metabolic abnormalities have been reported in brain tissue, plasma and peripheral blood cells in patients with multiple sclerosis (MS). However, reports on polyunsaturated fatty acid abnormalities in plasma/serum from patients with MS are inconsistent. Cherayil reported reduced C18:2n-6 and C20:4n-6, Holman et al. and Cunnane et al. found the n-3 fatty acids decreased, while Cumings et al. did not fi nd any signifi cant abnormalities in the blood fatty acid profi le from patients with multiple sclerosis. Abnormalities in non-esterifi ed fatty acid (NEFA) concentrations have also been reported in brain tissue from these patients. No information is available on NEFA concentrations in plasma from these patients. Plasma fatty acids may be esterifi ed in the form of neutral triglycerides and phospholipids, or nonesterifi ed (NEFAs). Fatty acids may be saturated or monoand polyunsaturated. Polyunsaturated fatty acids are metabolized respectively from the essential parent fatty acids, C18:2n-6 (Linoleic acid) and C18:3n-3 (Alpha-linolenic acid), which cannot be synthesized in the body and which must be ingested from food. In contrast, the body can synthesize both saturated and monounsaturated fatty acids from carbohydrates, if suffi cient dietary fat is unavailable. Furthermore, when essential fatty acids are unavailable, they will be replaced by the nonessential fatty acids, saturated and monounsaturated fatty acids, and in patients with MS, the subnormal concentrations of polyunsaturated fatty acids were reported to be compensated for by an increase in saturated and monounsaturated fatty acids in plasma. Non-esterified fatty acids may influence immune cell functions such as chemotaxis, phagocytosis and bactericidal ability. However, NEFAs are toxic to surrounding cells and increased NEFAs in plasma have been implicated in a number of diseases, such as sudden cardiac death, insulin resistance, atherosclerosis and Neurology Asia September 2011 218 hypertension. The concentration and possible effects of NEFAs in plasma from patients with MS are not well documented; therefore the aim of this study was to determine the levels of NEFAs in plasma from patients with multiple sclerosis and to correlate with these with disease outcome as measured by the Kurtzke Expanded Disability Status Scale (EDSS). Both the patients and control subjects were specifi cally screened to exclude the use of interferon, cortisone and/or fatty acid supplements. “Blood sampling was done early each day after an overnight fast to minimize the possible effects of diurnal variation on the plasma fatty acid profi le. ”