Highlights
- •GSC is capable of decreasing oxidized DNA of RRMS patients.
- •GSC decreases inflammatory cytokines of RRMS patients.
- •GSC did not affect kidney and liver function of RRMS patients.
Abstract
Relapsing-remitting multiple sclerosis (RRMS) is the most common clinical course of
multiple sclerosis (MS), characterized by a chronic inflammatory state and elevated
levels of oxidative markers. Food supplements with potential anti-inflammatory, antioxidant
and neuroprotective effects have been tested as possible adjuvants in the treatment
of MS. In this sense, this pilot study was carried out with the aim of verifying whether
a minimum daily dose of a guarana, selenium and l-carnitine (GSC) based multi supplement, mixed in cappuccino-type coffee, administered
for 12 weeks to 28 patients with RRMS could differentially modulate oxidative blood
markers (lipoperoxidation, protein carbonylation and DNA oxidation) and inflammatory
blood markers (protein levels of cytokines IL-1β, IL-6, TNF-α, IFN-γ, IL-10, gene
expression of these cytokines, and NLRP3 and CASP-1 molecules, and C-reactive protein
levels). The results indicate that a low concentration of GSC is capable of decreasing
the plasma levels of oxidized DNA and pro-inflammatory cytokines of RRMS patients.
The results support further research into the action of GSC on clinical symptoms,
not only in patients with MS, but also with other neurological conditions.
Graphical abstract

Graphical Abstract
Keywords
Abbreviations:
Caspase-1 ((casp-1)), Enzyme-linked immunosorbent assay ((elisa)), Federal university of santa maria ((ufsm)), Glutamic oxaloacetic transaminase ((got)), Glutamic pyruvic transaminase ((gpt)), Guarana ((g)), Guarana (selenium, l-carnitine, (gsc)), Interferon gamma ((ifn-γ)), Interleukin-1 beta ((il-1β)), Interleukin-6 ((il-6)), Interleukin-10 ((il-10)), l-carnitine ((c)), Multiple sclerosis ((ms)), National Health Surveillance Agency ((ANVISA)), oxidized DNA ((oxDNA)), Pontifical Catholic University of Rio Grande do Sul ((PUCRS)), reactive oxygen species ((ROS)), real-time polymerase chain reaction ((RT-PCR)), relapsing-remitting multiple sclerosis ((RRMS)), selenium ((S))To read this article in full you will need to make a payment
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References
- Guarana improves behavior and inflammatory alterations triggered by methylmercury exposure: an in vivo fruit fly and in vitro neural cells study.Environ. Sci. Pollut. Res. Int. 2019; 26: 15069-15083https://doi.org/10.1007/s11356-019-04881-0
- Role of human macrophage polarization in inflammation during infectious diseases.Int. J. 2018; 19 (Article 1801)https://doi.org/10.3390/ijms19061801
- Effects of pyridostigmine bromide on SH-SY5Y cells: an in vitro neuroblastoma neurotoxicity model.Mutat. Res., Genet. Toxicol. Environ. Mutagen. 2017; 823: 1-10https://doi.org/10.1016/j.mrgentox.2017.08.003
- The disease-modifying therapies of relapsing-remitting multiple sclerosis and liver injury: a narrative review.CNS Drugs. 2021; 35: 861-880https://doi.org/10.1007/s40263-021-00842-9
- The protective effects of guarana extract (Paullinia cupana) on fibroblast NIH-3T3 cells exposed to sodium nitroprusside.Food Chem. Toxicol. 2013; 53: 119-125https://doi.org/10.1016/j.fct.2012.11.041
- Evaluation of antibacterial, antineoplastic, and immunomodulatory activity of Paullinia cupana seeds crude extract and ethyl-acetate fraction.Evid.-Based Complement. Altern. Med. 2016; 2016 (Article ID 1203274)https://doi.org/10.1155/2016/1203274
- Chronic caffeine treatment attenuates experimental autoimmune encephalomyelitis induced by guinea pig spinal cord homogenates in Wistar rats.Brain Res. 2010; 1309: 116-125https://doi.org/10.1016/j.brainres.2009.10.054
- Selenium analysis and speciation in dietary supplements based on next-generation selenium ingredients.Nutrients. 2018; 10 (Article 1466)https://doi.org/10.3390/nu10101466
- The nutraceutical value of carnitine and its use in dietary supplements.Molecules. 2020; 25 (Article 2127)https://doi.org/10.3390/molecules25092127
- l-carnitine protects cardiac damage by reducing oxidative stress and inflammatory response via inhibition of tumor necrosis factor-alpha and interleukin-1beta against isoproterenol-induced myocardial infarction.Biomed. Pharmacother. 2021; 143 (Article 112139)https://doi.org/10.1016/j.biopha.2021.112139
- l-carnitine and acetyl-l-carnitine roles and neuroprotection in developing brain.Neurochem. Res. 2017; 42: 1661-1675https://doi.org/10.1007/s11064-017-2288-7
- Multiple sclerosis.Nat. Rev. Dis. Primers. 2018; 4 (Article 43)https://doi.org/10.1038/s41572-018-0041-4
- The cost of multiple sclerosis drugs in the US and the pharmaceutical industry: too big to fail?.Neurology. 2015; 84: 2185-2192https://doi.org/10.1212/WNL.0000000000001608
- High consumption of coffee is associated with decreased multiple sclerosis risk; results from two independent studies.J. Neurol. Neurosurg. Psychiatry. 2016; 87: 454-460https://doi.org/10.1136/jnnp-2015-312176
- A pilot cross-sectional study to investigate the biomarker potential of phosphorylated neurofilament-H and immune mediators of disability in patients with 5 year relapsing-remitting multiple sclerosis.Front. Neurol. 2019; 10 (Article 1046)https://doi.org/10.3389/fneur.2019.01046
- Prevention of experimental allergic encephalomyelitis by targeting nitric oxide and peroxynitrite: implications for the treatment of multiple sclerosis.Proc. Natl. Acad. Sci. USA. 1997; 94: 2528-2533https://doi.org/10.1073/pnas.94.6.2528
- Improved analysis of malondialdehyde in human body fluids.Free Radical Biol. Med. 1996; 20: 251-256https://doi.org/10.1016/0891-5849(95)02043-8
- Effect of chronic L-carnitine supplementation on carnitine levels, oxidative stress and apoptotic markers in peripheral organs of adult Wistar rats.Food Chem. Toxicol. 2019; 134 (Article 110851)https://doi.org/10.1016/j.fct.2019.110851
- Guaraná, a supplement rich in caffeine and catechin, modulates cytokines: evidence from human in vitro and in vivo protocols.Eur. Food Res. Technol. 2014; 239: 49-57https://doi.org/10.1007/s00217-014-2182-3
- Carbonyl assays for determination of oxidatively modified proteins.Meth. Enzymol. 1994; 233: 346-357https://doi.org/10.1016/S0076-6879(94)33040-9
- The effect of guarana (Paullinia cupana) on metabolic and inflammatory parameters in adult male mice programmed by maternal obesity.J. Nutr. 2019; 58: 765-774https://doi.org/10.1007/s00394-018-1686-1
- TNF-alpha inhibition, antioxidant effects and chemical analysis of extracts and fraction from Brazilian guarana seed powder.Food Chem. 2021; 355 (Article 129563)https://doi.org/10.1016/j.foodchem.2021.129563
- A review of various antioxidant compounds and their potential utility as complementary therapy in multiple sclerosis.Nutrients. 2019; 11 (Article 1528)https://doi.org/10.3390/nu11071528
- Uric acid: a potential biomarker of multiple sclerosis and of its disability.Clin. Chem. Lab Med. 2014; 53: 753-759https://doi.org/10.1515/cclm-2014-0744
- Uric acid in relapsing–remitting multiple sclerosis: a 2-year longitudinal study.J. Neurol. 2015; 262: 961-967https://doi.org/10.1007/s00415-015-7666-y
- Coenzyme Q10 supplementation reduces peripheral oxidative stress and inflammation in interferon-β1a-treated multiple sclerosis.Ther. Adv. Neurol. Disord. 2019; 12: 1-12https://doi.org/10.1177/1756286418819074
- A clinical and laboratory study evaluating the profile of cytokine levels in relapsing remitting and secondary progressive multiple sclerosis.J. Neuroimmunol. 2015; 278: 53-59https://doi.org/10.1016/j.jneuroim.2014.12.005
- ProspeCtive study to evaluate efficacy, safety and tOlerability of dietary supplemeNT of Curcumin (BCM95) in subjects with Active relapsing MultIple Sclerosis treated with subcutaNeous Interferon beta 1a 44 mcg TIW (CONTAIN): a randomized, controlled trial.Mult. Scler. Relat. Disord. 2021; 56103274https://doi.org/10.1016/j.msard.2021.103274
- l-carnitine supplementation as a potential antioxidant therapy for inherited neurometabolic disorders.Gene. 2014; 533: 469-476https://doi.org/10.1016/j.gene.2013.10.017
- Cerebrospinal fluid detection of interleukin-1beta in phase of remission predicts disease progression in multiple sclerosis.J. Neuroinflam. 2014; (Article 32)https://doi.org/10.1186/1742-2094-11-32
- Lipotoxicity-associated inflammation is prevented by guarana (Paullinia cupana) in a model of hyperlipidemia.Drug. Chem. Toxicol. 2021; 44: 524-532https://doi.org/10.1080/01480545.2019.1624767
- Selenium and autoimmune diseases: a review article.Curr. Rheumatol. Rev. 2019; 15: 123-134https://doi.org/10.2174/1573397114666181016112342
- Phytochemicals as modulators of M1-M2 macrophages in inflammation.Oncotarget. 2018; 9: 17937-17950https://doi.org/10.18632/oncotarget.24788
- Micro-RNA-96 and interleukin-10 are independent biomarkers for multiple sclerosis activity.J. Neurol. Sci. 2019; 403: 92-96https://doi.org/10.1016/j.jns.2019.06.022
- Safety indicators of a novel multi supplement based on guarana, selenium,and l-carnitine: evidence from human and red earthworm immune cells.Food Chem. Toxicol. 2021; 150 (Article 112066)https://doi.org/10.1016/j.fct.2021.112066
- Serum uric acid levels in multiple sclerosis patients correlate with activity of disease and blood-brain barrier dysfunction.Eur. J. Neurol. 2002; 9: 221-226https://doi.org/10.1046/j.1468-1331.2002.00384
- Circulating levels of interleukin-17A, tumor necrosis factor-alpha, interleukin-18, interleukin-10, and cognitive performance of patients with relapsing-remitting multiple sclerosis.Neurol. Res. 2018; 40: 153-159https://doi.org/10.1080/01616412.2017.1420522
- A1 adenosine receptor upregulation and activation attenuates neuroinflammation and demyelination in a model of multiple sclerosis.J. Neurosci. 2004; 24: 1521-1529https://doi.org/10.1523/JNEUROSCI.4271-03.2004
- Neuroprotective effects of guarana (Paullinia cupana Mart.) against vincristine in vitro exposure.J. Prev. Alzheimers Dis. 2018; 5: 65-70https://doi.org/10.14283/jpad.2017.45
- Rising prevalence of multiple sclerosis worldwide: insights from the Atlas of MS, third edition.Mult. Scler. 2020; 26: 1816-1821https://doi.org/10.1177/1352458520970841
- Supplementation of micronutrient selenium in metabolic diseases: its role as an antioxidant.Oxid. Med. Cell Longev. 2017; 2017 (Article ID 7478523)https://doi.org/10.1155/2017/7478523
- Bioavailability of catechins from guaraná (Paullinia cupana) and its effect on antioxidant enzymes and other oxidative stress markers in healthy human subjects.Food Funct. 2016; 7: 2970-2978https://doi.org/10.1039/c6fo00513f
- Mechanism and adverse effects of multiple sclerosis drugs: a review article.Int. J. Physiol. Pathophysiol. Pharmacol. 2019; 11 (PMID: 31523357; PMCID: PMC6737429): 95-104
- Mechanism and adverse effects of multiple sclerosis drugs: a review article.Int. J. Physiol. Pathophysiol. Pharmacol. 2019; 11 (PMID: 31523358; PMCID: PMC6737425): 105-114
- Guarana (Paullinia cupana Mart.) protects against amyloid-beta toxicity in Caenorhabditis elegans through heat shock protein response activation.Nutr. Neurosci. 2020; 23: 444-454https://doi.org/10.1080/1028415X.2018.1517473
- l-carnitine regulated Nrf2/Keap1 activation in vitro and in vivo and protected oxidized fish oil-induced inflammation response by inhibiting the NF-κB signaling pathway in Rhynchocypris lagowski Dybowski.Fish Shellfish Immunol. 2019; 93: 1100-1110https://doi.org/10.1016/j.fsi.2019.08.041
Article info
Publication history
Published online: January 13, 2023
Accepted:
January 12,
2023
Received in revised form:
December 22,
2022
Received:
August 24,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.