Fig. 1

Treatment protocol and baseline levels of serum HexNAc and cytokines. A After 4 weekly blood draws prior to starting GlcNAc supplementation, subjects were provided sachets of GlcNAc and instructed to take 2 g (one 2 g sachet), or 4 g (two 2 g sachets) three times per day after mixing the sachet contents in 6 oz. of water. Blood was drawn weekly during the 4-week treatment period, beginning 1 week after starting GlcNAc. Compliance was assessed weekly by counting the number of remaining GlcNAc sachets as well as subject statement and was found to be 100% except for one patient in the 6 g cohort. Two weeks after stopping GlcNAc, blood was drawn weekly three times. Assessments included physical and neurological exams, Expanded Disability Status Scale (EDSS), a complete blood count, and complete metabolic panel conducted or drawn at the 1st visit, prior to the start of treatment (4th visit), at completion of treatment (8th visit), and at the last visit (11th visit). B Average serum HexNAc levels measured by LC–MS/MS prior to GlcNAc treatment in the 6 g and 12 g cohort. P value by two-tailed t test. C–J Baseline IFNγ, IL-6, IL-17 and IL-10 levels as measured by sandwich ELISA separated by treatment group (C–F or baseline HexNAc levels above and below 800 nM (G–J). Only cytokine levels above the lower limit of quantification (LLOQ) were included in analysis. Each dot represents an individual subject. Error bars represent SEM. P values by two-tailed (C–F) or one-tailed (G–J) t test with Welch’s correction