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Impact of Vitamin A on Multiple Sclerosis (MS)

Phase 4
Conditions
Relapsing Remitting Multiple Sclerosis
Interventions
Dietary Supplement: vitamin A
Registration Number
NCT01417273
Lead Sponsor
Tehran University of Medical Sciences
Brief Summary

The aim of this study is the comparison between the effects of supplementation with 25000 IU preformed vitamin A (retinyl palmitate) or placebo for first 6 months and 10000 IU/day for next 6 months on disease activity and progression in patients with Multiple Sclerosis.

Detailed Description

Multiple Sclerosis (MS) is a chronic inflammatory disease where Th1 like responses from myelin-specific CD4+ T cells, as secretion of pro-inflammatory IFNγ, are believed to play a major role in the pathogenesis. The myelin-specific T cells that mediate tissue destruction in MS are believed to become activated outside the central nervous system (CNS) in lymphoid tissue and when they cross the blood brain barrier they will re-encounter their antigen. Immune deviation is the redirection of the immune response from most often Th1 like responses to Th2 like responses, even though the opposite can also occur. Vitamin A or Vitamin A-like analogs known as retinoids, are potent hormonal modifiers of type 1 or type 2 responses but a definitive description of their mechanism(s) of action is lacking. High level dietary vitamin A enhances Th2 cytokine production and IgA responses, and is likely to decrease Th1 cytokine production. Retinoic acid(RA) inhibits IL12 production in activated macrophages, and RA pretreatment of macrophages reduces IFNγ production and increases IL4 production in antigen primed CD4 T cells. Supplemental treatment with vitamin A or RA decreases IFNγ and increases IL5, IL10, and IL4 production.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Patients who have used interferon beta in last 3 months
  • Patients with 0-5 EDSS
Exclusion Criteria
  • Patients who have diseases which affect on Th1/Th2 balance such as asthma, active viral infections, and autoimmune diseases, OR

    • Patients who have allergy to vitamin A compounds, OR
    • Patients who have used vitamin supplements in last 3 months.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
vitamin A, multiple sclerosis,vitamin APatients with Multiple Sclerosis confirmed Relapsing Remitting Type who receive 25000 IU/day vitamin A for 6 months and 10000 IU/day for next 6 months
placebo/Multiple Sclerosisvitamin APatients with Multiple Sclerosis confirmed Relapsing Remitting Type who receive 1 cap of placebo/day
Primary Outcome Measures
NameTimeMethod
Expanded Disability Status Scale (EDSS)Change from baseline at 12 months

Expanded Disability Status Scale (EDSS) as a measure of activity and progression of MS disease

Multiple Sclerosis Functional Composite (MSFC)Change from baseline at 12 months

Multiple Sclerosis Functional Composite (MSFC) as a measure of activity and progression of MS disease

fatigue scoresChange from baseline at 12 months

fatigue scores on Multiple Sclerosis Fatigue Impact Scale

depression scoreChange from baseline at 12 months

depression score on Beck Depression Inventory 2

Number of active lesion in magnetic resonance imaging (MRI) number of active lesion in brain MRIChange from baseline at 12 months

Number of active lesion in magnetic resonance imaging (MRI) as a measure of activity and progression of MS disease

Secondary Outcome Measures
NameTimeMethod
number of disease relapsesChange from baseline at 12 months

To measure the effect of vitamin A supplementation on number of disease relapses

Trial Locations

Locations (1)

Tehran University of Medical Sciences,

🇮🇷

Tehran, Iran, Islamic Republic of

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