Summary of Multiple Sclerosis and aspirin

January 2020

Primary prevention of cardiovascular disease 

Cardiovascular disease (CVD) is a growing health burden in China and primary prevention strategies are important because over 70% of those experiencing a first Coronary Heart Disease (CHD) event in China died outside of the hospital setting1.

Primary prevention of CVD in China is a top priority, in particular lifestyle factors such as  smoking, diet, weight and increasing activity levels in order to reduce risk factors such as high blood pressure, high cholesterol and control diabetes2.

CVD risk assessment is an important way to identify those at high-risk of CVD in the Chinese population without current CVD. Specific risk assessment tools for the Chinese population have been developed based the Chinese Multi –provincial cohort study.

The 2012 China National Plan for Non-Communicable diseases [NCD] prevention and treatment3 has clear targets for CVD prevention.  As well as lifestyle interventions such as diet, exercise, low salt intake and smoking cessation the National Plan for NCD also has an ambition to limit the incidence of stroke to under 5% and decrease stroke related mortality by 5%. China’s Medium and Long Term Plan of Preventing and Controlling Chronic Diseases aims to achieve a 10% reduction in  CVD mortality rates by 2020 and 15% by 20254.  The 2016 China guidelines of dyslipidemia management and the 2017 Chinese guidelines for CVD prevention have new recommendations for risk assessment in China.

The 2016 China expert consensus advocates that for individuals with a ten year arteriosclerotic cardiovascular disease (ASCVD)5 risk of greater than or equal to 10%, aspirin should be used for the primary prevention of CVD.

New potential therapies for multiple sclerosis (MS), a chronic autoimmune disorder of the central nervous system,  can be tested on an animal model of MS;  experimental autoimmune encephalomyelitis (EAE).  Low-dose aspirin has been show to suppress EAE in mice. It is thought that aspirin has a protective effect on EAE via cAMP-response element-binding [CREB] mediated stimulation of the interleukin-11-regulatory T cell pathway.

Animal studies such as this are leading researchers to conclude that aspirin may be therapeutically important in managing MS.

For further information please see:

Pahan S and Pahan K. Mode of action of aspirin in experimenetal autoimmune encephalomyelitis. DNA Cell Biol 2019 May 28 DOI:10.1089/dna.2019.4814