A pilot study in patients with progressive multiple sclerosis (MS) found a steroid treatment of benefit by decreasing oxidative stress in the cerebrospinal fluid. The study, “One-time intrathecal triamcinolone acetonide application alters the redox potential in cerebrospinal fluid of progressive multiple sclerosis patients: a pilot study,” was published in the journal Therapeutic Advances in Neurological Disorders.
Cerebrospinal fluid (CSF) is a clear liquid that surrounds the brain and spinal cord, acting like a cushion to protect against injury. Previous studies showed that alterations in CSF composition are found in disease states. For example, CSF in healthy individuals lacks certain chemical radicals, molecules found in high levels in patients with amyotrophic lateral sclerosis (ALS). This increase may be the result of chronic neurodegenerative process.
Our body possesses mechanisms, such as antioxidant responses, to counteract the accumulation of damaging proteins that result from oxidative stress. Antioxidant responses, in fact, are an important mechanism for maintaining homeostasis and viability. Investigating these mechanisms in the cerebrospinal fluid of MS patients may give indications as to the interplay of disease progression, chronic inflammation, and response to treatment.
Researchers studied the effect of one delayed-release steroid application with triamcinolone (TCA) injection on the antioxidant system in the CSF of chronic progressive MS patients. They treated a total of 16 MS patients with 40 mg of TCA, then analyzed the antioxidant potential by measuring the number of proteins positive for an increase in copper absorption.
The research team observed that radicals were present in MS patients’ CSF, while absent in healthy controls. Moreover, they detected an increase in copper absorption, which reflects an elevated content of reduced proteins in the CSF. These results support the beneficial role of TCA by decreasing the generation of damaging reactive oxygen species, the detrimental outcomes of oxidative stress.
Although preliminary, the results seem to indicate that intrathecal steroid application alters, in a positive way, the redox potential in CSF. Future studies are warranted to investigate how TCA therapy may impact the clinical outcomes of patients with progressive MS.