NEW trial information have revealed that propionic acid supplementation can considerably scale back a key biomarker of nerve harm in folks with a number of sclerosis (MS), supporting its potential as a secure and well-tolerated add-on remedy, in line with a brand new part 2b scientific trial.
Propionic acid, a microbial-derived short-chain fatty acid, has been recognised to contribute to intestinal barrier integrity, systemic immune regulation, and neuronal perform. Folks with a number of sclerosis have been proven to have decreased propionic acid ranges, and open-label information have recommended helpful results of supplementation, though randomised proof has remained restricted.
Section 2b MADAI Trial Design
Researchers performed the A number of sclerosis And DisAbility Enchancment (MADAI) trial, a randomised, double-blind, placebo-controlled, single-centre, part 2b examine evaluating propionic acid as an add-on remedy in adults with clinically steady a number of sclerosis. Between April and Might 2024, 101 adults (64% ladies; imply age 45 years) have been randomly assigned 2:1 to obtain propionic acid 500 mg twice every day or matching placebo for 90 days.
The first consequence was change in serum neurofilament gentle chain (sNfL) focus, a biomarker of neuroaxonal harm, adjusted for age, physique mass index, creatinine, and baseline sNfL. Secondary outcomes included bodily and cognitive efficiency measures and patient-reported outcomes, together with fatigue and high quality of life.
Propionic Acid Linked to Lowered Neuroaxonal Injury
Serum neurofilament gentle chain ranges fell considerably within the propionic acid group, by 17.9%, from 9.77 pg/mL to eight.02 pg/mL (p=0.000025), with no vital change within the placebo group. The adjusted imply distinction between teams at follow-up was 0.91 pg/mL (p=0.045). Reductions have been additionally noticed amongst individuals receiving moderate-to-high efficacy disease-modifying therapies (n=41, p=0.0001), together with these on anti-CD20 remedy (n=27, p=0.0005). There was a development in the direction of enchancment in motor fatigue within the propionic acid group, and no severe antagonistic occasions associated to the examine treatment occurred.
Groundwork for Bigger Trials
These findings have recommended that propionic acid supplementation is effectively tolerated and related to vital reductions in neurofilament gentle chain, indicating attenuation of neuroaxonal harm in a number of sclerosis. The authors have proposed that propionic acid might deal with an unmet want for brokers that modulate immune responses whereas selling neuroprotection, and have known as for bigger, longer-term part 3 trials to substantiate these findings.
Reference
Moser T et al. Propionic acid in a number of sclerosis: a part 2b, double-blind, randomized placebo-controlled trial. Mind. 2026;149(7):2286-94.
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