Science / October 14, 2020

Possible therapy for repairing myelin in multiple sclerosis?

A simple sugar found in human breast milk and sold as an over-the-counter dietary supplement, promotes myelin repair in mouse models. It correlates with myelination levels in multiple sclerosis patients according to a new study published in JBC by scientists from University of California, Irvine and ECRC.

N-acetylglucosamine is a simple sugar that is metabolically attached to proteins at the cell surface to control cellular function. Published in the Journal of Biological Chemistry (JBC), the study also demonstrates that in mice, delivering N-acetylglucosamine orally to lactating mothers drove primary myelination in their nursing offspring.

“We found that N-acetylglucosamine activates myelin stem cells to promote primary myelination and myelin repair,” said Michael Demetriou, professor of neurology, microbiology and molecular genetics at UCI School of Medicine and leader of the study. “Our data raises the intriguing possibility that N-acetylglucosamine may be a simple therapy to promote myelin repair in multiple sclerosis patients”. Formal human studies will be required to test this theory.

Multiple sclerosis is a chronic inflammatory autoimmune disease in which immune cells attack the myelin in the brain and spinal cord. Myelin insulates the long, cable-like nerve cell branches called axons, and serves to increase the speed of electrical signal conduction between neurons. Myelination in the central nervous system also plays an important role in cognitive development during childhood.

Further clinical trials are necessary

“Interestingly, since N-acetylglucosamine is a major component of human breast milk but not baby formula, it may explain some of the cognitive function and myelination benefits realized by children fed breast milk as opposed to formula.” said Michael Sy, assistant professor of neurology at UCI School of Medicine, co-director of the regional MS program at the VA Long Beach Healthcare System, and first author of the study.

Dr. Alexander Brandt led the clinical parts of the study together with Professor Friedemann Paul from the Experimental and Clinical Research Center (ECRC), a joint institution from Charité – Universitätsmedizin Berlin and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC). Brandt says:, “The association of reduced N-acetylglucosamine serum levels with white matter changes in the brain of patients with multiple sclerosis suggests that N-acetyglucosamine deficiency may contribute to disease severity.” At the time of the study, Brandt has been the head of the Translational Neuroimaging laboratory in the Clinical Neuroimmunology group at Charité – Universitätsmedizin Berlin, which is led by Paul. Brandt has since transitioned to the UCI School of Medicine as associate professor of neurology.

Formal clinical trials are required to test the applications identified in this study and are currently being pursued by the investigators.

This study was funded in part by a Marilyn Hilton Innovator Award, the National Institutes of Health and the German Research Foundation Excellence Initiative, NeuroCure.