Breast milk for MS patients?

    Multiple sclerosis (MS) is an inflammatory demyelinating autoimmune disease of the central nervous system. As we have discussed in class, myelin sheaths coat and protect nerve fibers, increasing resistance and reducing capacitance across the membrane and allowing action potentials to move more rapidly. MS is characterized by “myelin instability, fragmentation, and remyelination failure” which can lead to degradation of axons, trouble transmitting action potentials, and neuronal cell death (Hayes, C. E., & Ntambi, J. M., 2020). 

    MS is highly variable between patients. Common symptoms include muscle weakness, paresthesias, tremors, vision changes, lack of coordination, and unsteady gait (Sy, et al., 2020). There are symptomatic treatments available to modify the course of the disease and slow progression, however there is currently no cure. Treatments include physical therapy, muscle relaxants, corticosteroids, plasma exchange, and various oral, injectable, and infusion medications (Sy, et al., 2020). 

    A recent study published in the Journal of Biological Chemistry explored the role of a simple sugar found in breast milk, N-acetylglucosamine, in primary myelination and myelin repair (Sy, et al., 2020). Researchers found that giving oral N-acetylglucosamine to lactating mice drove primary myelination in their newborn pups (Sy, et al., 2020). In adult mice, N-acetylglucosamine drove myelin repair, preventing neuro-axonal damage. Researchers noted that low levels of N-acetylglucosamine in MS patients have been correlated with higher levels of demyelination and microstructural damage (Sy, et al., 2020).

    This led researchers to the conclusion that N-acetylglucosamine may be neuro-protective in MS patients (Sy, et al., 2020). So, do we start insisting that MS patients drink breast milk along with their morning coffee? Probably not. Interestingly, this simple sugar is sold as an over-the-counter supplement in the U.S. Although there have not been clinical trials to test the effectiveness of this N-acetylglucosamine in MS patients, it seems that adding an already-approved supplement to a treatment regimen may be a lower-risk option compared to more experimental drugs. As healthcare professionals, it is important to consider all types of treatment options for the good of the patient.

References:

Hayes, C. E., & Ntambi, J. M. (2020). Multiple Sclerosis: Lipids, Lymphocytes, and Vitamin D. Immunometabolism, 2(3), e200019. https://doi.org/10.20900/immunometab20200019

Sy M, Brandt AU, Lee SU, Newton BL, Pawling J, Golzar A, Rahman AA, Yu Z, Cooper G, Scheel M, Paul F, Dennis JW, Demetriou M. N-Acetylglucosamine drives myelination by triggering oligodendrocyte precursor cell differentiation. J Biol Chem. 2020 Sep 25:jbc.RA120.015595. doi: 10.1074/jbc.RA120.015595. Epub ahead of print. PMID: 32978254.