(Links are included to abstracts on the AAN site - access is free.)Walk down any grocery aisle and you’ll find products marketed as antioxidants. Antioxidants block the action of “free radicals,” which are normal by-products of bodily processes that may cause tissue injury in MS. A poster presentation by Dr. Rebecca Spain and colleagues from Oregon Health & Science University reported promising results from a clinical trial of lipoic acid, an antioxidant supplement, in 51 people with secondary progressive MS. The group conducted a 2 year, double-blind, randomized controlled trial of 1200 mg daily lipoic acid compared to inactive placebo. The first outcome they studied was reduction in brain atrophy (shrinkage). They also evaluated secondary outcomes such as atrophy of spinal cord and brain substructures, changes in neurological exam, walking, cognition, fatigue, and quality of life. Their most significant finding was that after two years, those taking lipoic acid showed less brain atrophy than those taking placebo. Overall, treatment was safe and tolerable, with stomach upset being the most pronounced issue reported by those taking lipoic acid. This is wonderful news, and I hope it bears out in further, larger studies. (Abstract P1.373) Fatty acids, like omega-3, are always a hot topic in discussions of diet research for any disease, and MS is no different. Dr. Aiden Haghikia and a team from Ruhr University in Germany found that a fatty acid called propionic acid improved mice that had MS-like disease by increasing a type of immune cell called regulatory T cells or “Treg” cells. As their name suggests, these cells work to regulate and dampen the immune response. They did preliminary tests of this oral fatty acid in 60 people with MS and 30 controls without MS. They found that Tregs increased in both groups, and reduced levels of cells considered inflammatory (Th17). The investigators say that other results, which will soon be published, show that the effect on Tregs was even stronger in people with MS. The team reports no side effects. It will be important to see if larger studies prove it to be a safe and effective. (Abstract P1.374) Recent lab reports have suggested that dietary salt might speed the development of the immune attack in mice with MS-like disease. Dr. Marianna Cortese (University of Bergen, Norway) and researchers at Harvard assessed the intake of salt and other minerals in the Nurses’ Health Study group (involving more than 150,000 female nurses in the U.S. followed over time). None of the minerals, including salt, seem to alter the risk of developing MS. If salt is a factor in MS, it’s good to have studies such as this one help us to fine tune if, when, and how it makes a difference. (Abstract S37.001) Research into impacts of gut bacteria (a critical part of maintaining ‘balance’ in the immune system) presents the exciting possibility that probiotic strategies may ultimately be developed to treat MS. Dr. Stephanie Tankou and another Harvard team investigated a probiotic product VSL#3 in 15 people with MS, people without MS, as well as mice with MS-like disease. The investigators were looking at the ability of VSL#3 to push immune cells in a less inflammatory direction. Treatment was well tolerated in people with MS, and they reported finding some signs from blood cells suggesting a reduction of inflammatory signals, but most did not reach statistical significance. Treated mice had less severe disease. We need more research to know if this can work, and work safely. We know that gut bacteria are important in MS. This study tells us something about how they may be working to balance the immune system. (Abstract P5.320) It’s great to see such variety in studies on diet and MS. We have more to say on diet and nutrition now than ever before. I’m hopeful that work like this will lead to practical solutions for stopping disease activity and restoring function to people with MS.