The impact of carnosine loading and rehabilitation therapy on muscle characteristics and exercise capacity in Multiple Sclerosis

Principle Investigator: prof. dr. Bert Op't Eijnde, Researcher: Charly Keytsman

Carnosine (β-alynyl-L-histidine) is found in high concentrations in mammalian skeletal muscle. Its physiological role is related to contractile function (Ca++ handling), to buffer muscle pH resulting from exercise–induced acidosis, to affect mitochondrial respiration and to protect against exercise-induced oxidative stress. High (or elevated) muscle carnosine content may thus be advantageous to improve muscle contractile properties and/or myocellular energy supply during exercise intervention. Because skeletal muscle carnosine synthesis is mainly determined by β-alanine availability, exogenous (dietary, 2-6g/d, 4-10w) intake of β-alanine has been successfully applied to increase muscle carnosine content (+80%, carnosine loading) in various rodent disease models and healthy volunteers. In untrained and aged subjects β-alanine supplementation has recently been shown to specifically improve maximal power output (+13-30%) in exercise types lasting 1-4min. Consequently, β-alanine is rapidly becoming a popular ergogenic substance in the (clinical) exercise/sports community.

Interestingly, we have recently found substantially reduced (~60%) skeletal muscle carnosine content in EAE (an animal MS model) rats and in MS patients (~20). Hence, carnosine treatment in MS could be a valid new approach to further improve exercise rehabilitation therapy in MS. We have already explored β-alanine and carnosine supplementation in an EAE animal experiment where preliminary data supports the beneficial impact of carnosine supplementation on muscle carnosine concentrations and the EAE disease course in these animals.

The carnosine loading potential of β-alanine supplementation in MS patients, as well as its associated (therapeutic) effects on muscle contractile functioning and cellular respiration, however, have not been investigated yet.