Multiple Sclerosis: How Too Much Salt Can Cause Inflammation

Patients Multiple sclerosis

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New research, published in the journal Nature Immunology, now shows how a high intake of salt may cause inflammation in multiple sclerosis.

Salt on a spoon

Multiple sclerosis (MS) is an autoimmune disorder in which the body's immune system destroys the protective coating around neurons called myelin.

This neurological disease affects around 400,000 people in the United States and approximately 2.5 million adults worldwide.

Generally, women are at a higher risk of developing the condition than men.

While researchers do not yet know what causes MS, an interplay between genetic predisposition and environmental factors is likely to be key.

For instance, researchers have so far identified 233 haplotypes that underpin MS. A haplotype is a set of genetic variants that can be found on the same chromosome and that is inherited from one parent.

As for environmental factors, studies have found that vitamin D insufficiency, smoking, obesity, and a high dietary intake of salt all correlate with a higher risk of MS. Some studies have zoomed in on the effect of a high salt intake on a model of MS and found that it exacerbates brain inflammation, while others have found that it boosts the number of pro-inflammatory cells.

However, until now, the precise molecular mechanism behind this effect that salt has on MS was not known. New research finds a molecular pathway that explains how a high-salt environment might potentially trigger the autoimmune disorder.

Tomokazu Sumida, an associate research scientist in the Hafler laboratory at the Yale School of Medicine in New Haven, CT, is the first author of the new paper.

How Too Much Salt Affects Immune Cells

In their study, Sumida and colleagues analyzed regulatory T cells (Tregs) taken from people with MS. The main role of these cells is to control the immune response by regulating or suppressing other immune cells.

Tregs also "control the immune response to self and foreign particles (antigens) and help prevent autoimmune disease."

In these cells, Sumida and team found an imbalance between a type of proinflammatory cytokine called IFN-gamma and a type of anti-inflammatory cytokine called interleukin 10 (IL-10).

As the researchers explain, the scientists identified this imbalance in people with MS and "in a high-salt environment."

The researchers used RNA sequencing to analyze Tregs further, and they found that a protein called beta-catenin plays a key role in both keeping Tregs functional and regulating the two pro- and anti-inflammatory cytokines mentioned above.

The study also revealed that beta-catenin works together with a protein receptor called PTGER2 to trigger inflammation induced by a high salt intake.

The authors conclude: "Our findings suggest that the beta-catenin-PTGER2 axis serves as a bridge between environmental factors and autoimmune disease by modulating Treg function, and this axis may be involved in the pathogenesis of autoimmune disease."

Asked about the clinical implications of his findings, Sumida told Medical News Today, "Not only upregulation of [the] pro-inflammatory cytokine IFN-gamma but also downregulation of [the] anti-inflammatory cytokine IL-10 might mark dysfunctional [Tregs] in MS patients... Therefore... it would be ideal to work on [both directions]: prevent IFN-gamma and enhance IL-10, it's always important to balance pro- and anti-inflammatory arms together."

"Since this imbalance is enhanced under high salt environment, the people at risk of developing MS should consider lowering high salt intake," said Tomokazu Sumida.

He added that the PTGER2-beta-catenin axis may be of interest to cancer researchers "because these two molecules are well-studied carcinogenic factors," and it would be interesting to see if a high salt intake affects this axis in cancer, too.

"I would suggest to have [a] healthy diet with low salt content as an immunologist and also as a cardiologist," he concluded.


Have you ever experienced with salt intake and noticed any affects with MS exacerbations?

Will this affect the way you approach your diet and salt intake?

Medical News Today

Beginning of the discussion - 11/2/18

Multiple Sclerosis: How Too Much Salt Can Cause Inflammation

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Thought you may find this article and news intersting! 

Have you ever experienced with salt intake and noticed any affects with MS exacerbations?

Will this affect the way you approach your diet and salt intake?

Multiple Sclerosis: How Too Much Salt Can Cause Inflammation

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I find it interesting and frustrating. They have so many theories and yet really still no idea at all the cause. In the area of the United States where I live has one of the highest rates of anywhere in the world. 

I can tell you I always have had a natural aversion to salt. I avoid it (and on blood work my sodium levels often fall to the below “normal” area) like the plague. I also lived a very healthy lifestyle which included running, weight training, cycling etc ... I had sun exposure and always took supplements too. I’ve been tested numerous times for vitamin D and B12 deficiency .. I am tired of being called “complicated because of the multiple autoimmune diseases and tired of tests, doctors, and all their different opinions. My peripheral neuropathy is spreading like a California wildfire, and I feel worse and worse. Only one very intelligent dr finally offered an idea that made sense and that is getting a nerve biopsy ... I’ve been sick for years now and getting worse and it’s taken until a month ago for any idea that makes sense ... the same dr suggested my Vasculitis could be the cause for most of my pain .. that makes sense to mean from blood work, reading and research I’ve done myself that he is correct .. even the raging neuropathy can be from Vasculitis too ... I see so many specialists, I have actual antibodies with real diagnoses but no answers to ease pain, or slow symptoms. Especially this opioid epidemic crap (I’ve never increased my medication dosage and yet the only thing that ever helps, hydrocodone, they’ve taken away, and it’s rendered me almost non functional) .. I’ve tried other treatments including some kind of vibrating head device .. crazy.  It’s exhausting and a waste of life. Sorry for the rant ... I keep losing weight, energy, enjoyment, appetite, and frankly  losing the will to live (I’ve been down this road during “difficult” times but lately it’s just from feeling lousy) .. funny I weighed in again this morning and I’m now in the underweight area which I’ve never been in my life ... I’m praying for answers and a direction and an easing of pain somehow. 

Good luck to fellow warriors in the game of life and the path to wellness. The saying about having your health being everything is so true. You can do anything you set your mind to if you’re healthy. If you’re sick God help you.  

Multiple Sclerosis: How Too Much Salt Can Cause Inflammation

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@LynndMS I cannot imagine the frustration @LynndMS‍  -  hopefully, soon through further research, etc. the medical world will understand better the cause and, thus, hopefully find a better way to manage the condition.

You are right - health is sooooo important. Those in great health do not (at no fault of their own) understand the difficulty and tolling pain / an illness can take on one person. It can be very hard for those suffering from pain or a condition to even focused on things other than that pain / condition.

If you do not mind me asking, why was your pain killer taken away if it was helping? just curious.... 

As always, thanks for your input!

I am pulling for you! I know I cannot related to your autoimmune conditions, but as someone with chronic pain, I can relate to how lacking great health can impact one's life! Pushing for you and your strength!

Multiple Sclerosis: How Too Much Salt Can Cause Inflammation

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Thank you @Lee__R‍ for well wishes. Support helps a lot ... I recently found my former pain management doc (moved to a different practice) and just received a script ... now, however, with the “opioid epidemic” that’s on the news daily who knows how long I will receive treatment. Suddenly it’s marijuana that’s the craze and I’ve tried it with disastrous results. It had a very bad effect in me. It’s funny because while I was growing up it was constantly called “the gateway drug” and now it’s being legalized everywhere. The stuff I tried was medical marijuana from CA and it was so strong it sent me to bed with paranoia until it finally wore off which took about 1/2 a day.  

So, to answer your question first I couldn’t get to my provider because of difficulty driving because of eye problems. Then she moved and no one would prescribe for me. My neurologist suggested buying hemp oil online which is dangerous because you don’t know what your getting .. he didn’t offer any specific website.  The oncologist I recently saw wasn’t s me to have a nerve biopsy to make sure the IgM spike in my blood isn’t the cause of the raging neuropathy, and yesterday I saw the head of the “operation” for that clinic who reduced me to tears saying I don’t have MS (long story but went by old clinical notes from a non board certified provider who no longer practices and she was wrong based on opinions of several other doctors) in front of 6 other doctors doing their internships ... I’m a 55 year old woman (I’ve moved a few times and that’s how I’ve gotten other opinions ... he did this without reviewing actual information and only his former colleagues notes ... in a very arrogant manner and refused to order the nerve biopsy until he did a nerve conduction study (more tests, more out of pocket costs, more delays in actual treatment)  ... I’ve had numerous neurological exams, again, by other doctors who are all in agreement that I have peripheral neuropathy, but they cannot agree on the cause. This arrogant jerk didn’t even do a neurological exam ... I was so upset all evening I cannot describe to you how bad I felt.  This same place continually misdiagnosed a friend which a “pinched nerve” for a year, when he actually had a broken bone, and it had gone on so long that it started necrosis and required hip replacement surgery by the time the correct diagnosis came.  I’m not sure what I’m going to do now but perhaps there’s a different location that can perform the biopsy so I can hopefully move on to treatment and slow this down. It’s gotten to the point of causing trouble with any regular daily functions ...  

again, I’m sorry for the rant but I’m beyond tired of this ridiculous situation ... I know you went through misdiagnosis for a long time and it caused many problems for you. I know you understand.  

Multiple Sclerosis: How Too Much Salt Can Cause Inflammation

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@LynndMS sorry to hear about your struggling.

I have been struggling with depression pretty bad lately! I wish we could find something that would just ease everything for us.

I get scared to move because of my health... what if I cant find a new doctor or they think I am crazy. our diagnoses affect all of us differently and the same.

I wish I had better words to help you. I hope your pain doctor can help you.

Multiple Sclerosis: How Too Much Salt Can Cause Inflammation

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My pain doctor thankfully I found and she did help me. Because I have not seen her in so long I was cut back yet again ... and per law I have to see her monthly. I live far away (78 miles) and I have a lot of trouble with my eyes so driving there is a problem plus I’m in an area with tons of snow (already had a blast of 9” of super heavy wet snow) and I have a non four wheel drive truck which used to be not bad in the snow but was horrible for that last blast.  I have a million appointments coming (I was seeing my ex husband who was helping me with driving but we just broke up so now I’m scared to death) and I cannot believe winter came early just like it went from very cold to very hot in the spring, so no spring or fall weather which is a hardship because either extreme causes me problems. 

I sm sorry for the rant. I hope you’re well (or as best as can be with the wretched disease) ... take care. Thank you for the message. They help a lot. 

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