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Resveratrol

This information is a shortened version of a post entitled "MicroRNA - Regulators of Genetic Expression"  - written by Dr Erica Peirson and shared on her website Peirson Center for Children.

Resveratrol is a compound found in high concentration in grape skin and Japanese knotweed. It is categorized as an antioxidant and an anti-inflammatory. It has not been studied specifically in the Down syndrome model.  It has, however, been studied for it's impact on Alzheimer's disease, which is found in 100% of patients with Down syndrome as early as 40 years old (Rafii 2014).  Teng Ma, et al discuss the latest research supporting resveratrol for it's neuroprotective effects and it's therapeutic potential in Alzheimer's disease. They concluded that, "For the antioxidative and anti-inflammatory functions, resveratrol truly represents the beneficial effects on AD." (Teng Ma 2014).

Dosage is important and clinical trials to determine safe and effective doses are just now coming out.  In October of 2015 it was reported that doses as high as 1,000 mg twice a day in adults resulted in less of a decline in Aβ40 than in those who were taking placebo (Turner 2015).  A decline in Aβ40 indicates progression of the disease (Honig 2014). It was generally well-tolerated at these very high doses despite some reports of nausea, diarrhea and weight loss.  Levels of resveratrol were also tested in the cerebral spinal fluid (CSF) of patients taking it and it was found to be present, indicating it's ability to cross the blood brain barrier.  In 2011 doses as high as 5 g/day in adults was reported to safe and "reasonably" well-tolerated (Patel 2011).  Mukherjee, et al state in their review, "Thus, at lower dose, resveratrol can be very useful in maintaining the human health whereas at higher dose, resveratrol has pro-apoptotic actions on healthy cells, but can kill tumor cells." (Mukherjee 2010). Many compounds, natural and synthetic have different effects at low doses versus higher doses.

An example of the sheer number of doses of resveratrol that are being tested can be seen in Singh's review of resveratrol's effect on the brain after stroke.  More than twelve different doses were reported as having been tested, ranging from 1 mg/kg to 100 mg/kg (Singh 2013). Dr. Jill Crandall states in her report in 2013, "Doses used in animal (5–500 mg/kg/day) and human studies (5–5,000 mg/day) have varied widely, and not enough is known about the dose-response relationship." (Crandall 2013).

Many parents who use resveratrol are using 0.5-2 mg/kg per day, but this dose has not been tested to be effective at reducing miR-155 nor has it been proven to be effective at impacting cognitive impairment in Down syndrome.  

So where does that leave us?  Many parents are using a lot of supplements in very young children with Down syndrome and safety is of utmost importance.  I do support parents and caregivers using resveratrol in their loved ones with Down syndrome, however, I can't make a recommendation about dosage that has been proven to be effective in studies or in clinical trials. 

 

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