Simple sugar compound improves function in multiple sclerosis patients, a UCI study shows

The dietary supplement N-acetylglucosamine reduced inflammation and neurodegeneration markers in trial participants

"Future studies demonstrating that N-acetylglucosamine can restore neuro-
logical function in MS patients would be a game changer," said UCI
physician-scientist Dr. Michael Demetriou. Photo by Steve Zylius/UCI

Irvine, Calif. — UCI researchers have found that N-acetylglucosamine, a simple sugar compound, reduced multiple markers of inflammation and neurodegeneration in clinical trial participants with multiple sclerosis (MS).

In addition, the dietary supplement improved neurological function in 30% of study participants, they report in a new paper published in the Journal of Neuroinflammation.

The lead investigator of the open-label, dose-escalation study is UCI Health neurologist Michael Demetriou, MD, PhD, who leads the Multiple Sclerosis and Neuroimmunology division for the UCI School of Medicine's Department of Neurology. The study's first author is UCI Health MS specialist Michael Y. Sy, MD, PhD, and the second author is Department of Neurology project scientist and clinical coordinator Barbara Newton, MD. If validated in future, blinded clinical trials, N-acetylglucosamine could be a "game changer" in treatment for MS, Demetriou said.

MS, a chronic and potentially disabling autoimmune disorder of the central nervous system, affects more than 1.8 million people, according to the World Health Organization. While there are treatments to prevent relapses and improve quality of life, there is no cure.

Current MS therapies do not treat active chronic neuroinflammation in the brain and the associated failure to repair the loss of the myelin sheath that covers and protects axons, the electrical wires of the brain. Over time, this leads to permanent nerve cell damage and a slow, progressive loss of neurological function in patients.

“Our previous studies in mice and humans implicated N-acetylglucosamine in suppressing brain inflammation, promoting the re-growth of the myelin sheath and slowing brain degeneration,” said Demetriou, professor of Neurology and Microbiology & Molecular Genetics at the UCI School of Medicine.

The new paper, titled “N-acetylglucosamine inhibits inflammation and neurodegeneration markers in multiple sclerosis: a mechanistic trial,” describes the results of the first clinical trial to directly investigate these potential activities of N-acetylglucosamine in MS patients. The unblinded trial was developed and conducted in the Demetriou Lab at the UCI School of Medicine and the UCI Institute of Clinical and Translational Science.

Researchers found that N-acetylglucosamine was safe and reduced inflammation and neurodegeneration markers in trial participants who already were receiving glatiramer acetate, an FDA-approved immunomodulatory therapy for MS that is known to impact these pathways outside the brain.

“We also observed a sustained reduction in neurological disability in 30% of the patients, an activity which has not been observed with current FDA-approved therapies,” said Sy, an associate professor and director of the Department of Neurology's neuroimmunology fellowship program. “Current treatments at best can slow progression, not improve function.”

The trial data suggest that N-acetylglucosamine reduced untreated chronic-active neuroinflammation and/or promoted myelin repair. However, the researchers stress that future blinded studies with additional parameters are essential to validate N-acetylglucosamine’s potential to suppress residual chronic-active brain inflammation, repair damaged myelin sheaths, reduce neurodegeneration and improve neurological function in MS patients.

“Future studies demonstrating that N-acetylglucosamine can restore neurological function in MS patients would be a game changer and provide something that no other current therapy can do,”  Demetriou said.

About the UCI School of Medicine

Each year, the UCI School of Medicine educates more than 400 medical students and nearly 150 PhD and MS students. More than 700 residents and fellows are trained at the UCI Medical Center and affiliated institutions. Multiple MD, PhD and MS degrees are offered. Students are encouraged to pursue an expansive range of interests and options. For medical students, there are numerous concurrent dual degree programs, including an MD/MBA, MD/MPH, or an MD/MS degree through one of three mission-based programs: the Health Education to Advance Leaders in Integrative Medicine (HEAL-IM), the Program in Medical Education for Leadership Education to Advance Diversity-African, Black and Caribbean (PRIME LEAD-ABC), and the Program in Medical Education for the Latino Community (PRIME-LC). The UCI School of Medicine is accredited by the Liaison Committee on Medical Accreditation and ranks among the top 50 nationwide for research. For more information, visit medschool.uci.edu.

About UCI Health

UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system in Orange County. Patients can access UCI Health at primary and specialty care offices across Orange County and at its main campus, UCI Medical Center in Orange, Calif. The 459-bed acute care hospital, listed among America’s Best Hospitals by U.S. News & World Report for 23 consecutive years, provides tertiary and quaternary care, ambulatory and specialty medical clinics, behavioral health and rehabilitation services. UCI Medical Center is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. Follow us on Facebook, Instagram, LinkedIn and Twitter.