Plasma 24-hydroxycholesterol is associated with narrower common carotid artery and greater flow velocities in relapsing multiple sclerosis

Background: Multiple sclerosis (MS) studies suggest greater cardiovascular disease burden and disturbances in the cholesterol pathways1,2 The potential impact of oxidized cholesterol molecules (oxysterols) on MS is emerging (Figure 1).3 Objective: To determine the relationship between multiple o...

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Main Authors: Dejan Jakimovski, Robert Zivadinov, Laura Pelizzari, Cynthia Dunne-Jaffe, Richard W. Browne, Niels Bergsland, Michael G. Dwyer, Bianca Weinstock-Guttman, Murali Ramanathan
Format: Article
Language:English
Published: PAGEPress Publications 2022-11-01
Series:Veins and Lymphatics
Online Access:https://pagepressjournals.org/index.php/vl/article/view/10965
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author Dejan Jakimovski
Robert Zivadinov
Laura Pelizzari
Cynthia Dunne-Jaffe
Richard W. Browne
Niels Bergsland
Michael G. Dwyer
Bianca Weinstock-Guttman
Murali Ramanathan
author_facet Dejan Jakimovski
Robert Zivadinov
Laura Pelizzari
Cynthia Dunne-Jaffe
Richard W. Browne
Niels Bergsland
Michael G. Dwyer
Bianca Weinstock-Guttman
Murali Ramanathan
author_sort Dejan Jakimovski
collection DOAJ
description Background: Multiple sclerosis (MS) studies suggest greater cardiovascular disease burden and disturbances in the cholesterol pathways1,2 The potential impact of oxidized cholesterol molecules (oxysterols) on MS is emerging (Figure 1).3 Objective: To determine the relationship between multiple oxysterol molecules and atherosclerosis burden in MS patients. Materials and methods: A total of 99 MS patients (61 relapsing-remitting MS (RRMS) and 38 progressive MS (PMS)) patients and 38 healthy controls (HCs) underwent magnetic resonance angiography (MRA) and the cross-sectional area (CSA) of the common carotid artery (CCA) was determined at three different levels before the bifurcation (C7, C6 and C5). Additionally, an echo-color Doppler ultrasound was performed and measures of blood flow velocities were derived. Blood samples acquired at the time of the imaging examinations were analyzed and 24-, 25-, 27-hydroxycholesterol (24HC, 25HC, 27HC) and 7-ketocholesterol (7KC) were quantified in ng/mL. Results: In the MS patients, higher levels of 24HC were significantly associated with smaller CCA CSA measured at all three cervical levels (r=-0.201, p=0.046; r=-0.228, p=0.023, and r=-0.215, p=0.032, for C7, C6 and C5, respectively). These associations were driven by the RRMS group only (r=-0.407, p=0.002 for C7; r=-0.414, p=0.002, for C6; and r=-0.368, p=0.006 for C5). No associations were seen in the HCs. Despite adjusting for the significant age effect (B=0.445, p=0.004), higher 24HC levels were independently associated with smaller CCA CSA (B=-0.20, p=0.045). 24HC was additionally associated with greater time-averaged and peak diastolic CCA velocities. RRMS patients treated with potent anti-inflammatory therapies had lower oxysterol levels (p=0.019). RRMS patients in the lower 24HC quartiles had significantly higher expanded disability status scale (EDSS) scores when compared to RRMS patients in the higher two 24HC quartiles (2.5 (IQR 1.9-3.1) vs 2.0 (1.5-2.5), p=0.038). Conclusions: Greater 24HC levels are associated with smaller CSA CCA and greater flow velocities in RRMS patients. The higher inflammatory activity in RRMS patients may contribute to the production of highly reactive oxysterols and worsen the atherosclerotic burden in the MS population. Potent anti-inflammatory medications can significantly decrease oxysterol levels.
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spelling doaj.art-c95b5dcabb08419fb3fb6a14aff1a1e92022-12-22T03:43:29ZengPAGEPress PublicationsVeins and Lymphatics2279-74832022-11-0111110.4081/vl.2022.10965Plasma 24-hydroxycholesterol is associated with narrower common carotid artery and greater flow velocities in relapsing multiple sclerosisDejan Jakimovski0Robert Zivadinov1Laura Pelizzari2Cynthia Dunne-Jaffe3Richard W. Browne4Niels Bergsland5Michael G. Dwyer6Bianca Weinstock-Guttman7Murali Ramanathan8Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, BuffaloCenter for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, BuffaloIRCCS, Fondazione Don Carlo Gnocchi, MilanDepartment of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, BuffaloDepartment of Biotechnical and Clinical Laboratory Sciences, State University of New York, BuffaloIRCCS, Fondazione Don Carlo Gnocchi, Milan,Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, BuffaloDepartment of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, BuffaloDepartment of Pharmaceutical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo Background: Multiple sclerosis (MS) studies suggest greater cardiovascular disease burden and disturbances in the cholesterol pathways1,2 The potential impact of oxidized cholesterol molecules (oxysterols) on MS is emerging (Figure 1).3 Objective: To determine the relationship between multiple oxysterol molecules and atherosclerosis burden in MS patients. Materials and methods: A total of 99 MS patients (61 relapsing-remitting MS (RRMS) and 38 progressive MS (PMS)) patients and 38 healthy controls (HCs) underwent magnetic resonance angiography (MRA) and the cross-sectional area (CSA) of the common carotid artery (CCA) was determined at three different levels before the bifurcation (C7, C6 and C5). Additionally, an echo-color Doppler ultrasound was performed and measures of blood flow velocities were derived. Blood samples acquired at the time of the imaging examinations were analyzed and 24-, 25-, 27-hydroxycholesterol (24HC, 25HC, 27HC) and 7-ketocholesterol (7KC) were quantified in ng/mL. Results: In the MS patients, higher levels of 24HC were significantly associated with smaller CCA CSA measured at all three cervical levels (r=-0.201, p=0.046; r=-0.228, p=0.023, and r=-0.215, p=0.032, for C7, C6 and C5, respectively). These associations were driven by the RRMS group only (r=-0.407, p=0.002 for C7; r=-0.414, p=0.002, for C6; and r=-0.368, p=0.006 for C5). No associations were seen in the HCs. Despite adjusting for the significant age effect (B=0.445, p=0.004), higher 24HC levels were independently associated with smaller CCA CSA (B=-0.20, p=0.045). 24HC was additionally associated with greater time-averaged and peak diastolic CCA velocities. RRMS patients treated with potent anti-inflammatory therapies had lower oxysterol levels (p=0.019). RRMS patients in the lower 24HC quartiles had significantly higher expanded disability status scale (EDSS) scores when compared to RRMS patients in the higher two 24HC quartiles (2.5 (IQR 1.9-3.1) vs 2.0 (1.5-2.5), p=0.038). Conclusions: Greater 24HC levels are associated with smaller CSA CCA and greater flow velocities in RRMS patients. The higher inflammatory activity in RRMS patients may contribute to the production of highly reactive oxysterols and worsen the atherosclerotic burden in the MS population. Potent anti-inflammatory medications can significantly decrease oxysterol levels. https://pagepressjournals.org/index.php/vl/article/view/10965
spellingShingle Dejan Jakimovski
Robert Zivadinov
Laura Pelizzari
Cynthia Dunne-Jaffe
Richard W. Browne
Niels Bergsland
Michael G. Dwyer
Bianca Weinstock-Guttman
Murali Ramanathan
Plasma 24-hydroxycholesterol is associated with narrower common carotid artery and greater flow velocities in relapsing multiple sclerosis
Veins and Lymphatics
title Plasma 24-hydroxycholesterol is associated with narrower common carotid artery and greater flow velocities in relapsing multiple sclerosis
title_full Plasma 24-hydroxycholesterol is associated with narrower common carotid artery and greater flow velocities in relapsing multiple sclerosis
title_fullStr Plasma 24-hydroxycholesterol is associated with narrower common carotid artery and greater flow velocities in relapsing multiple sclerosis
title_full_unstemmed Plasma 24-hydroxycholesterol is associated with narrower common carotid artery and greater flow velocities in relapsing multiple sclerosis
title_short Plasma 24-hydroxycholesterol is associated with narrower common carotid artery and greater flow velocities in relapsing multiple sclerosis
title_sort plasma 24 hydroxycholesterol is associated with narrower common carotid artery and greater flow velocities in relapsing multiple sclerosis
url https://pagepressjournals.org/index.php/vl/article/view/10965
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