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Riboflavin Has Neuroprotective Potential: Focus on Parkinson’s Disease and Migraine

  • Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

With the huge negative impact of neurological disorders on patient’s life and society resources, the discovery of neuroprotective agents is critical and cost-effective. Neuroprotective agents can prevent and/or modify the course of neurological disorders. Despite being underestimated, riboflavin offers neuroprotective mechanisms. Significant pathogenesis-related mechanisms are shared by, but not restricted to, Parkinson’s disease (PD) and migraine headache. Those pathogenesis-related mechanisms can be tackled through riboflavin proposed neuroprotective mechanisms. In fact, it has been found that riboflavin ameliorates oxidative stress, mitochondrial dysfunction, neuroinflammation, and glutamate excitotoxicity; all of which take part in the pathogenesis of PD, migraine headache, and other neurological disorders. In addition, riboflavin-dependent enzymes have essential roles in pyridoxine activation, tryptophan-kynurenine pathway, and homocysteine metabolism. Indeed, pyridoxal phosphate, the active form of pyridoxine, has been found to have independent neuroprotective potential. Also, the produced kynurenines influence glutamate receptors and its consequent excitotoxicity. In addition, methylenetetrahydrofolate reductase requires riboflavin to ensure normal folate cycle influencing the methylation cycle and consequently homocysteine levels which have its own negative neurovascular consequences if accumulated. In conclusion, riboflavin is a potential neuroprotective agent affecting a wide range of neurological disorders exemplified by PD, a disorder of neurodegeneration, and migraine headache, a disorder of pain. In this article, we will emphasize the role of riboflavin in neuroprotection elaborating on its proposed neuroprotective mechanisms in opposite to the pathogenesis-related mechanisms involved in two common neurological disorders, PD and migraine headache, as well as, we encourage the clinical evaluation of riboflavin in PD and migraine headache patients in the future.

 

Introduction

With the huge burden of neurological diseases on patient’s life and society resources, the need of finding and having neuroprotective agents is critical and cost-effective. In fact, the advances in medical research have found up to date multiple agents having unique proposed neuroprotective mechanisms and influencing different neurologic disease processes. Riboflavin is one of those proposed neuroprotective agents; however, its neuroprotective abilities have been underestimated in comparison to other known neuroprotective agents. Our focus in this article is to shed light on riboflavin neuroprotective characteristics, encouraging more research to be done in the future in this regard.

Riboflavin, a water-soluble vitamin, is part of the B complex vitamins, known as vitamin B-2. It is characterized by its unique bright yellow coloration of urine when taken in large amounts. Riboflavin plays a role in a wide range of metabolic pathways and processes, serving as a coenzyme for a variety of flavoprotein enzyme reactions. Riboflavin active forms are flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD).

Importantly, 10–15% of global population have an inherited condition of limited riboflavin absorption and utilization; leading to a potential biochemical riboflavin deficiency worldwide (1). In fact, based on erythrocyte glutathione reductase activation coefficient test (EGRAC), 54% of British non-elderly adult population was at least having borderline riboflavin deficiency (1). Indeed, riboflavin deficiency across European countries ranges between 7 and 20% (2).

As a matter of fact, neural tissue has a higher susceptibility to oxidative stress. Oxidative stress, a term refers to the injurious results in living organisms due to an imbalance favoring oxidants over antioxidants (3), has been implicated in multiple disease processes and aging. Oxidants are the normal results of in vivo interactions between oxygen and organic molecules. Concerning the brain, it forms 2% of total body weight with high levels of fatty acids, uses 20% of total body oxygen, and has lower antioxidant activity than other tissues. This gives the neural tissue a higher susceptibility to peroxidation (4) and oxidative damage in comparison to other tissues. In fact, oxidative stress has been implicated in multiple neurodegenerative disorder pathogenesis (4).

 

https://www.frontiersin.org/articles/10.3389/fneur.2017.00333/full

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