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 Table of Contents  
LETTER TO EDITOR
Year : 2020  |  Volume : 11  |  Issue : 1  |  Page : 145

Vitamin B12 deficiency and MS incidence; Which one sooner?


1 Department of Nutrition, School of Public Health; Student Research Committee; Isfahan Neuroscience Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
2 Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Nutrition, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
4 Isfahan Neuroscience Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
5 Isfahan Neuroscience Research Center, Alzahra Research Institute; Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran

Date of Submission21-Apr-2019
Date of Acceptance18-Jul-2019
Date of Web Publication10-Sep-2020

Correspondence Address:
Maedeh Moradi
Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan
Iran
Mohammad Bagher Maljaei
Department of Nutrition, School of Public Health and Student Research Committee, Iran University of Medical Sciences, Isfahan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpvm.IJPVM_135_19

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How to cite this article:
Maljaei MB, Moradi M, Nobari NT, Bahreini A, Namjoo I. Vitamin B12 deficiency and MS incidence; Which one sooner?. Int J Prev Med 2020;11:145

How to cite this URL:
Maljaei MB, Moradi M, Nobari NT, Bahreini A, Namjoo I. Vitamin B12 deficiency and MS incidence; Which one sooner?. Int J Prev Med [serial online] 2020 [cited 2020 Oct 20];11:145. Available from: https://www.ijpvmjournal.net/text.asp?2020/11/1/145/294694



Multiple sclerosis (MS) is a chronic neurological disease characterized by inflammation and development of demyelinating central nerve system which occurs mostly in young adults and is more prevalent in females. The definite etiology of MS is unknown but interacting genetic and environmental factors are considered to be involved in its pathogenesis. Among environmental factors affecting the prognosis of the disease, recent investigations have shed the light on the role of vitamin B12, folate, and homocysteine (Hcy) as possible determinants of the progressive neurodegenerative process. Cobalamine deficiency is mainly caused by insufficient dietary intake particularly in vegans and malabsorption which mostly occurs in case of pernicious anemia and gastrointestinal disorders.[1] Vitamin B12 and folate play important roles in DNA and RNA synthesis and metabolism and myelination. The neurologic manifestations of cobalamine deficiency are mainly the results of impairment in the methylation processes through which homocysteine is converted to methionine. Thus, elevated homocysteine as well as cobalamine and folate deficiencies lead to formation of defective myelin and consequently neurodegenerative deterioration in MS. Besides, it may make the MS patients more vulnerable to viral and immunological mechanisms of MS 2z). A recent meta-analysis has shown significant differences between MS patients and controls for Hcy and vitamin B12 but not folate.[2] Another study showed significantly reduced levels of vitamin B12 in the cerebrospinal fluid of MS patients.[2] As the major role of vitamin B12 in MS inflammatory and neurodegenerative symptoms as well as enhanced demand for B-vitamins for remyelination and repair is becoming increasingly clear, the concept of cobalamine supplementation has aroused great interests among investigators perusing to seek an etiology of MS.[1],[3] Since vitamin B12 is required to synthesis and maintain the myelin and is vitally important for proper immune function, its deficiency would be an important pathogenic factor in MS. It is important to note whether B12 deficiency can lead to myelin degeneration and MS incidence, or the onset of MS can lead to a B12 deficiency. Anyway, it's the fate of B12 and MS in relation to each other. Considering the burden of the disease, necessary to conduct further research to determine which one sooner? B12 deficiency or MS?

Contribution

Design of the work: M B M and M M

Drafting the work: M M, A B, M B M, and I N

Revising: M M and M B M and N T N

Final approval: M B M

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Köseoǧlu M, İpek Mİ, Çevlİk T, Özben S, Haklar G, Günal D. Effect of methylprednisolone and interferon treatment on blood Vitamin B12, folic acid and homocysteine levels in patients with multiple sclerosis. Online Türk Saǧlık Bilimleri Dergisi 2019;4:325-38.  Back to cited text no. 1
    
2.
Zhu Y, He ZY, Liu HN. Meta-analysis of the relationship between homocysteine, vitamin B12, folate, and multiple sclerosis. J Clin Neurosci 2011;18:933-8.  Back to cited text no. 2
    
3.
Sperner-Unterweger B, Kohl C, Fuchs D. Immune changes and neurotransmitters: Possible interactions in depression? Prog Neuro-psychopharmacol Biol Psychiatry 2014;48:268-76.  Back to cited text no. 3
    




 

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