A number of studies have previously suggested a negative effect of high cholesterol levels on the development of brain lesions in patients with multiple sclerosis (MS), however, little is known about the effect of HDL (high-density lipoprotein) cholesterol, or “good” cholesterol, on MS. A team of scientists from the University of Buffalo recently found that good cholesterol has protective properties for the blood-brain barrier. The study, titled, “Protective Associations of HDL with Blood Brain Barrier Injury in Multiple Sclerosis Patients” was published earlier in August in the Journal of Lipid Research.

“This finding is especially important because we found this protective effect very early in the disease,” said the study’s lead author Murali Ramanathan, PhD, who is a professor of pharmaceutical sciences in the UB School of Pharmacy and Pharmaceutical Sciences, and professor of neurology in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo.

To better understand the impact of HDL on MS, the team followed a group of patients for 4 years following their first experience of an attack of MS symptoms. The results offer a number of implications, not only in treatment discovery and development, but also in the drafting of future guidelines for MS prevention and management.

“This is the first time that HDL cholesterol has been found to have such a clear benefit against the breakdown of the blood-brain barrier in MS patients,” said Dr. Ramanathan. Understanding what can best preserve the blood-brain barrier is crucial as its integrity is a major factor in the development of brain lesions in MS. “The breakdown of the BBB [blood-brain barrier] is the first step in the formation of brain lesions because it allows immune cells to enter the brain, form long-lasting lesions and mediate tissue injury,” added Dr. Ramanathan, also referencing to some of the first MS treatments in the 1990s, which worked by protecting the blood-brain barrier.

“Cholesterol profiles can be affected by several factors including genetics, diet, smoking and physical activity,” explained Dr. Ramanathan. “A better understanding of this key class of modifiable factors could be leveraged both as clinical advice to MS patients seeking to reduce the risk of progression and as the basis of guidance to healthy individuals with genetic and other known risk factors for MS.”

Kelly Fellows, the study’s first author, will present data on this topic at the 31st Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Barcelona, Spain. The poster is entitled “High HDL levels suppress blood brain barrier injury following the first demyelinating event” (P#847, Poster Session 2, October 9).