Exploratory 5-year follow-up study of retinol, tocopherols, and carotenoids in multiple sclerosis

Background: Retinol, tocopherols, and carotenoids (RTC) have physiological roles as vitamins, pro-vitamins, and antioxidants, and provide biomarkers of dietary vegetable and fruit intake. The goal was to investigate RTC in multiple sclerosis (MS).Methods: This exploratory study included 106 people with MS (71 relapsing-remitting MS or RR-MS; and 35 progressive MS or PMS) and 31 healthy controls (HC) at baseline and 5-year follow-up (5YFU). Serum retinol, alpha-carotene, 0-carotene, alpha-tocopherol, 8-tocopherol, gamma-tocopherol, 0-cryptoxanthin, lutein/zeaxanthin, and lycopene were measured using high performance liquid chromatography. Serum neurofilament light chain (sNfL) levels were measured using the single molecule array method. Expanded Disability Status Scale (EDSS) and low contrast letter acuity (LCLA) were used as disability measures.Results: Retinol in MS was positively correlated with alpha-carotene, 0-carotene, 0-cryptoxanthin, lutein/zeaxanthin, and alpha-tocopherol but negatively correlated with 8-tocopherol. EDSS was associated with alpha-tocopherol, 8-tocopherol, and lycopene. Greater retinol levels were associated with greater LCLA in RR-MS and PMS; high contrast visual acuity was not associated. Greater gamma-tocopherol levels were associated with lower LCLA and high contrast visual acuity in PMS.Conclusions: RTC exhibit distinctive associations with LCLA and EDSS in MS.