title: Cholesterol and markers of cholesterol turnover in multiple sclerosis: relationship with disease outcomes.
abstract: Multiple sclerosis (MS) is a chronic central nervous system disease that is associated with progressive loss of myelin and subsequent axonal degeneration. Cholesterol is an essential component of mammalian cellular and myelin membranes. In this systematic review, we examined the relationship between levels of cholesterol and markers of cholesterol turnover in circulation and/or cerebrospinal fluid (CSF) and disease outcomes in adults with clinically isolated syndrome (CIS) or confirmed MS. Studies suggest that elevated levels of circulating low density lipoprotein cholesterol (LDL), total cholesterol, and particularly, apolipoprotein B and oxidized LDL are associated with adverse clinical and MRI outcomes in MS. These relationships were observed as early as CIS. The studies also suggest that oxysterols, cholesterol precursors, and apolipoprotein E may be markers of specific disease processes in MS, but more research is required to elucidate these processes and relationships. Taken together, the data indicate that cholesterol and markers of cholesterol turnover have potential to be used clinically as biomarkers of disease activity and may even be implicated in the pathogenesis of MS.
authors: Department of Clinical Neurosciences, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
authors: Simon
authors: S
authors: Zhornitsky
authors: Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
authors: Kyla A
authors: KA
authors: McKay
authors: Department of Clinical Neurosciences, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
authors: Luanne M
authors: LM
authors: Metz
authors: Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
authors: Charlotte E
authors: CE
authors: Teunissen
authors: Department of Neuroscience, Centre de recherche du CHU de Québec - Université Laval, Québec, Canada; Department of Molecular Medicine, Faculty of Medicine, Université Laval, Québec, Canada. Electronic address: manu.rangachari@crchudequebec.ulaval.ca.
authors: Manu
authors: M
authors: Rangachari
mesh_terms: D001053:Apolipoproteins / Q000097:blood* / Q000134:cerebrospinal fluid*; D001055:Apolipoproteins B / Q000097:blood / Q000134:cerebrospinal fluid; D015415:Biomarkers / Q000097:blood / Q000134:cerebrospinal fluid; D002784:Cholesterol / Q000097:blood* / Q000134:cerebrospinal fluid*; D008078:Cholesterol, LDL / Q000097:blood / Q000134:cerebrospinal fluid; D006801:Humans; D009103:Multiple Sclerosis / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000473:pathology
chemical_list: D001053:Apolipoproteins; D001055:Apolipoproteins B; D015415:Biomarkers; D008078:Cholesterol, LDL; D002784:Cholesterol
keywords: 24-hydroxycholesterol; ApoA; ApoB; ApoD; ApoE; Apolipoprotein; Biomarker; Cholesterol; Clinically isolated syndrome; HDL; LDL; Lipoprotein; Multiple sclerosis; Oxysterol