Autoimmune diseases occur when the body’s immune system attacks healthy cells as a substitute of protecting them. One such autoimmune disease is systemic sclerosis (SSc), characterised by malfunctioning of the circulatory and immune systems, resulting in fibrosis (hardening and scarring of healthy tissue) of the skin and internal organs. SSc is understood to affect patients throughout their lives, thereby impairing their quality of life. Although the precise mechanisms underlying the event and progression of SSc should not clearly understood, a posh interaction of immunological, hormonal, environmental and genetic aspects is commonly implicated.

Moreover, roughly 90% of SSc patients are known to experience a phenomenon referred to as “Raynaud’s phenomenon (RP)”. That is as a result of spasms of smaller blood vessels, resulting in reduced blood flow. RP can, in turn, promote a rise within the production of molecules called reactive oxygen species (ROS). The resulting oxidative environment causes cell damage and fibrosis, further exacerbating the disease. Due to this fact, counteracting oxidative stress with antioxidant compounds is increasingly being investigated as a therapeutic strategy. Nevertheless, a single antioxidant might not be therapeutically effective in reducing oxidative stress.

For this purpose, a team of scientists from Japan, led by Professor Haruhiko Inufusa, chief scientist on the Medical Research Center. Louis Pasteur and distinguished lecturer on the Department of Antioxidant Research on the Life Sciences Research Center, Gifu University examined the effectiveness of Twendee X^® (TwX) – a dietary complement containing a mixture of eight energetic antioxidants – in reducing oxidative stress in SSc mouse models.

Explaining the rationale behind his work, published on March 6, 2024 within the journal International Journal of Molecular Sciencessays prof. Inufusa: “Research has shown that TwX reduces ROS, protects mitochondrial function, and improves cognitive function and memory. Day by day anti-oxidative stress care with this complement may contribute not only to every day health maintenance and disease prevention, but in addition to symptomatic improvement of incurable diseases corresponding to SSc.”

TwX’s eight ingredients include vitamin C, L-glutamine, niacin, L-cystine, coenzyme Q10, vitamin B2, succinic acid and fumaric acid. The combined antioxidant effects are prone to be stronger than those of either compound alone. Previous studies have shown improvements in cognitive function, memory, and motor coordination in mouse models of dementia, and reductions in affected area size, oxidative stress, and inflammation in mouse models of ischemic stroke after TwX treatment. Based on these findings, researchers conducted a study to research the consequences of TwX on a mouse model of SSc created using hypochlorous acid (HOCl).

HOCl induction led to a big increase in serum levels of advanced oxidation protein products (AOPP), mimicking SSc-like features. Further HOCl induction led to skin tissue thickening together with local and systemic inflammation, fibrosis, and vascular damage.

Notably, AOPP levels in TwX-treated mice were significantly lower than those in healthy animals. Furthermore, TwX treatment significantly reduced skin thickness, collagen protein accumulation, skin levels of hydroxyproline, a marker of oxidative stress, and skin and lung fibrosis. Moreover, TwX treatment significantly reduced α-smooth muscle actin (α-SMA), a protein that was elevated in response to HOCl induction and has been shown to activate ROS in fibrotic diseases. HOCl-induced animals treated with TwX also showed a downward trend in the degrees of inflammatory cytokines and activated immune cells involved in inflammatory responses.

Overall, these results suggest that TwX may treat SSc by regulating oxidative stress and reducing skin and lung fibrosis. Since these results were observed in a mouse model, further studies shall be needed to find out the effectiveness of TwX in humans with SSc. Nevertheless, given the advantages of TwX within the treatment of other oxidative stress-related diseases, in addition to the shortage of uncomfortable side effects, TwX holds promise as an antioxidant therapeutic agent against SSc.

Sharing final thoughts on his research, Prof. Inufusa says: “Although TwX is a dietary complement, it has undergone drug-level safety testing and might be utilized by a big selection of individuals, from children to adults. Furthermore, our findings suggest that TwX has the potential to alleviate symptoms of terminal oxidative stress diseases corresponding to SSc.”