The importance of glutamate in the neuro-endocrinological functions in multiple sclerosis, related to fatigue

Rev Neurol. 2018 Nov 16;67(10):387-393.
[Article in Spanish, English]

Abstract

Multiple sclerosis is an inflammatory disease, which still today affects the Northern-hemisphere population, generating a socioeconomically burden. One of the most unfavorable symptoms in this chronic disorder is fatigue. In this review, we favor and sustain a main alteration of the hypothalamus-pituitary-axis complex and its physiopathologic consequences, mostly related to glutamate and corticoid levels. We try to sustain our hypothesis in what is already reported, corroborating that the inflammatory cells release mainly glutamate, a neuro-toxic substance which leads to a demyelinating effect and as a main result fatigue as a symptom. When this hypothesis is demonstrated, we could trace therapeutic targets to stop the release of glutamate of these immunologic cells, in order to avoid fatigue in multiple sclerosis patients.

Title: Importancia del glutamato en las funciones neuroendocrinologicas en la esclerosis multiple relacionadas con la fatiga.

La esclerosis multiple es una enfermedad inflamatoria que hasta el dia de hoy afecta a la poblacion del hemisferio norte, generando una gran carga socioeconomica. Uno de los sintomas menos favorables en este fenomeno patologico cronico es la fatiga. En esta revision, sustentamos y favorecemos una alteracion principal en el complejo del eje hipotalamo-hipofiso-adrenal y sus consecuencias fisiopatologicas, relacionadas mayormente con el glutamato y los niveles de cortisol. Trataremos de sustentar nuestra hipotesis en lo que se ha notificado hasta el momento, corroborando que las celulas inflamatorias liberan mayormente glutamato, una sustancia neurotoxica que conlleva un efecto desmielinizante y como resultado principal fatiga como sintoma. Cuando esta hipotesis se demuestre, podriamos trazar dianas terapeuticas para detener la liberacion de glutamato en estas celulas inmunologicas, de manera que podamos evitar la fatiga en la esclerosis multiple.

Publication types

  • Review

MeSH terms

  • Fatigue / etiology*
  • Glutamic Acid / physiology*
  • Humans
  • Hypothalamo-Hypophyseal System / physiopathology*
  • Multiple Sclerosis / complications*
  • Multiple Sclerosis / physiopathology*
  • Pituitary-Adrenal System / physiopathology*

Substances

  • Glutamic Acid