The treatment of multiple sclerosis with inosine

OBJECTIVE: The objective of this study is to evaluate the safety and tolerability of inosine in patients with relapsing-remitting multiple sclerosis (RRMS). The secondary objectives are to assess the effects of inosine administration on serum urate (UA) levels, the progression of neurologic disability, the cumulative number of new, active lesions on magnetic resonance imaging (MRI), and changes in serum levels for markers of inflammation. DESIGN: Oral administration of inosine was used to raise serum levels of the natural peroxynitrite scavenger UA in 16 patients with RRMS during a 1-year randomized, double-blind trial. OUTCOME MEASURES: The endpoints studied were relapse rate, disability assessed by the Kurtzke Expanded Disability Status Scale (EDSS), MRI, and analysis of serum levels of nitrotyrosine, and oxidative and pro-inflammatory makers. RESULTS: Increased serum UA levels correlated with a significant decrease in the number of gadolinium-enhanced lesions and improved EDSS. A number of MRI intensity-based parameters were altered by inosine treatment, in certain cases correlating with changes in serum UA levels. In a patient with low serum UA and high lesion activity, raising UA levels by inosine treatment decreased serum nitrotyrosine while increasing the ratio of Th2 to Th1 cytokines in circulating cells. The only side-effect correlated with inosine treatment was kidney stone formation in 4/16 subjects. CONCLUSIONS: These data suggest that the use of inosine to raise serum UA levels may have benefits for at least some MS patients. The effect of this treatment is likely to be a consequence of inactivation of peroxynitrite-dependent free radicals. Close monitoring of serum UA levels as well as other measures are required to avoid the potential development of kidney stones.

Markowitz, Clyde E.
Spitsin, Sergei
Zimmerman, Vanessa
Jacobs, Dina
Udupa, Jayaram K.
Hooper, D. Craig
Koprowski, Hilary
Item Type: 
Journal Article
Publication Title: 
Journal of Alternative and Complementary Medicine (New York, N.Y.)
Journal Abbreviation: 
J Altern Complement Med
Publication Date: 
Jun 2009
Publication Year: 
Library Catalog: 
NCBI Published Medical (?)
PMID: 19425822 PMCID: PMC3189001

Turabian/Chicago Citation

Clyde E. Markowitz, Sergei Spitsin, Vanessa Zimmerman, Dina Jacobs, Jayaram K. Udupa, D. Craig Hooper and Hilary Koprowski. Jun 2009. "The treatment of multiple sclerosis with inosine." Journal of Alternative and Complementary Medicine (New York, N.Y.) 15: 6: 619-625. 10.1089/acm.2008.0513.

Wikipedia Citation

<ref> {{Cite journal | doi = 10.1089/acm.2008.0513 | issn = 1557-7708 | volume = 15 | pages = 619-625 | last = Markowitz | first = Clyde E. | coauthors = Spitsin, Sergei, Zimmerman, Vanessa, Jacobs, Dina, Udupa, Jayaram K., Hooper, D. Craig, Koprowski, Hilary | title = The treatment of multiple sclerosis with inosine | journal = Journal of Alternative and Complementary Medicine (New York, N.Y.) | date = Jun 2009 | pmid = | pmc = }} </ref>