Cholesterol: A necessary evil from a multiple sclerosis perspective

Abstract

Cholesterol and lipid are essential component of nerve cells. They are found in abundant quantities in the brain, with the largest pool of free cholesterol in the myelin sheath, a crucial component taking part in electrochemical conduction along the axons. However, disruption in cholesterol homeostasis becomes detrimental, as seen in multiple sclerosis (MS) at its various stages. MS is a complex disorder that is characterized by ongoing inflammatory, demyelinating and neurodegenerative processes. With an extensive literature search and critical review, we found that emerging epidemiological and molecular evidence suggests that cholesterol might have: (i) a causal relationship with MS; (ii) a positive association with the progression in disability in MS with an increase in cholesterol level; and (iii) an important role to play as a biomarker predicting MS disease course and the therapeutic response. The present review also highlights the possible therapeutic role of cholesterol and lipids in MS.