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Aspirin and multiple sclerosis
Sheila Tsau1, Mitchell R Emerson2, Sharon G Lynch3
1Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA. sstsau@yahoo.com.
Insights
Aspirin may offer benefits for multiple sclerosis (MS) patients by reducing cardiovascular risks and potentially aiding remyelination. However, risks like hemorrhagic stroke and mitochondrial inhibition require careful consideration for MS patients.
Area of Science:
- Neuroscience
- Pharmacology
- Cardiovascular Medicine
Background:
- Multiple sclerosis (MS) patients exhibit increased risk for cardiovascular events like venous thromboembolism and ischemic strokes.
- Aspirin is a common medication for cardiovascular event prevention.
- The potential benefits and risks of aspirin in MS patients are not fully understood.
Purpose of the Study:
- To evaluate the potential benefits of aspirin in mitigating cardiovascular risks for multiple sclerosis patients.
- To explore aspirin's potential role in addressing MS-specific pathological mechanisms, such as inflammation and remyelination.
- To assess the risks associated with aspirin use in multiple sclerosis, including hemorrhagic stroke and mitochondrial function.
Main Methods:
- Review of existing studies on aspirin's cardiovascular effects.
- Analysis of research on aspirin's impact on inflammation and mitochondrial function.
- Examination of experimental data on aspirin's effect on oligodendrocyte precursor cells.
Main Results:
- Aspirin may reduce cardiovascular risks in MS patients, particularly in subgroups with limited mobility or antiphospholipid antibodies.
- Aspirin demonstrated potential in experimental models to promote remyelination by affecting oligodendrocyte precursors.
- Concerns exist regarding aspirin's increased risk of hemorrhagic stroke and potential inhibition of mitochondrial complex I activity, which is already impaired in MS.
Conclusions:
- Aspirin presents a complex risk-benefit profile for multiple sclerosis patients.
- Further research is warranted to determine optimal use cases and safety in specific MS populations.
- Aspirin's potential to reduce cardiovascular events and aid remyelination must be weighed against its associated risks.
Abstract:
Aspirin is widely used to lessen the risks of cardiovascular events. Some studies suggest that patients with multiple sclerosis have an increased risk for some cardiovascular events, for example, venous thromboembolism and perhaps ischemic strokes, raising the possibility that aspirin could lessen these increased risks in this population or subgroups (patients with limited mobility and/or antiphospholipid antibodies). However, aspirin causes a small increased risk of hemorrhagic stroke, which is a concern as it could potentially worsen a compromised blood-brain barrier. Aspirin has the potential to ameliorate the disease process in multiple sclerosis (for example, by limiting some components of inflammation), but aspirin also has the potential to inhibit mitochondrial complex I activity, which is already reduced in multiple sclerosis. In an experimental setting of a cerebral ischemic lesion, aspirin promoted the proliferation and/or differentiation of oligodendrocyte precursors, raising the possibility that aspirin could facilitate remyelination efforts in multiple sclerosis. Other actions by aspirin may lead to small improvements of some symptoms (for example, lessening fatigue). Here we consider potential benefits and risks of aspirin usage by patients with multiple sclerosis.
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