Highlights of the 29th Congress of the European Committee for Treatment and Research in MS (ECTRIMS), Copenhagen, DK, October 2-5, 2013 – A Yale University study presented earlier this year suggested that dietary sodium chloride levels may drive autoimmune diseases by induced pathogenic Th17 cells, based on results from mouse and human cell cultures (Kleinewietfeld et al. Nature 2013;496:518-522). In high-salt conditions, Th17 cells increased production of inflammatory cytokines such as TNF-alpha and IL-2.
The relationship between dietary sodium and MS disease activity has been investigated in a two-year study of 70 RRMS patients (Farez et al. ECTRIMS 2013; abstract 119). Sodium intake was estimated from urine samples. Clinical and radiological assessments were performed every 3-6 months.
Sodium intake was correlated with relapse rates in multivariate analysis. The relapse rate was 3.95 times higher in patients with high sodium intake and 2.75 times higher in patients with medium sodium intake versus low sodium intake (p=0.001 for trend).
Patients with high sodium intake also had a 3.4-fold increased risk of a new MRI lesion. On average, patients in the high-sodium group had eight more T2 lesions compared to patients with low sodium intake. These results suggest that dietary sodium may influence inflammatory activity in MS.
Guest Reviewer: Dr. Paul S. Giacomini, Associate Director, MS Clinic, Montreal Neurological Hospital and Institute, Assistant Professor, Department of Neurology and Neurosurgery, McGill University, Montréal, Québec.