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How Good Cholesterol Affects Lesions in Multiple Sclerosis

good cholesterol affects lesions in multiple sclerosis

Previous research has suggested that high cholesterol has a negative impact on the development of lesions in the brain of individuals with multiple sclerosis. Now a scientific team from the University of Buffalo has shed some light on how good cholesterol (high-density lipoprotein, or HDL cholesterol) may live up to its name for individuals who have this disease.


The purpose of the study was to investigate the association between cholesterol and apolipoproteins with blood brain barrier (BBB) permeability and inflammation of the central nervous system after the first demyelinating event. A total of 154 adults (mean age, 29.5 years) who were taking interferon beta-1a after their first demyelinating event participated in the multicenter study and were followed for four years.

The researchers collected blood and cerebrospinal fluid (CSF) samples before treatment. They also gathered serum lipid profiles and markers of BBB breakdown and CNS immune activity. Damage to the BBB provides a fertile environment for inflammation and leakage of immune cells into the brain, thus laying a foundation for MS.

The investigators found that higher levels of HDL and apolipoprotein A-1 (ApoA-I) were associated with lower CSF total protein level, CSF albumin level, albumin quotient, and CSF IgG levels. These latter factors are measured when investigating BBB integrity, and these lower levels are associated with reduced BBB damage.

Higher levels of HDL also were associated with decreased amounts of leakage of certain lymphocytes (CD80+ and CD80+CD19+) into the cerebrospinal fluid. The number of CD80+ lymphocytes is significantly higher during MS exacerbations.

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The authors concluded that higher levels of serum good cholesterol is associated with lower levels of injury to the blood brain barrier as well as less leakage of certain lymphocytes into the cerebrospinal fluid. Good cholesterol “may potentially inhibit the initiation and/or maintenance” of damage to the blood brain barrier after the first demyelinating event and thus serve “a protective role” in the injury to the BBB that precedes the formation of lesions in multiple sclerosis.

According to the study’s lead author, Murali Ramanathan, PhD, professor of pharmaceutical sciences in the University of Buffalo School of Pharmacy and Pharmaceutical Sciences, this study demonstrated for the first time how good cholesterol can be helpful against the infiltration of the blood brain barrier in individuals with multiple sclerosis. Since the breakdown of the BBB is the first step in the development of lesions in the brain in MS, this finding can prove beneficial in determining new prevention and management strategies.

Ramanathan noted that 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” as well as relevant guidance for health individuals who have genetic and other risk factors for multiple sclerosis. Basically, the study findings indicate that individuals with multiple sclerosis could benefit by keeping their good cholesterol levels in a healthy range (40 mg/dL or higher, and the higher the better).

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Fellows K et al. Protective associations of HDL with blood brain barrier injury in multiple sclerosis patients. Journal of Lipid Research 2015 Oct; 56(10): 2010-18
Multiple Sclerosis News Today. Good cholesterol helps prevent brain lesion formation in multiple sclerosis
National Institutes of Health