# The Potential of Twendee X® as a Safe Antioxidant Treatment for Systemic Sclerosis

## TL;DR

This study explores Twendee X® as a safe antioxidant treatment for systemic sclerosis, showing it reduces fibrosis and oxidative stress in a mouse model.

## Contribution

The novel contribution is demonstrating Twendee X®'s efficacy in reducing SSc-related fibrosis and autoimmunity in an oxidative stress-induced mouse model.

## Key findings

- Twendee X® significantly reduced lung and skin fibrosis in HOCl-induced SSc mice.
- Twendee X® decreased serum AOPP levels and suppressed Col-1 gene expression and B cell activation.

## Abstract

Systemic sclerosis (SSc) is an autoimmune disease characterized by systemic skin hardening, which combines Raynaud’s phenomenon and other vascular disorders, skin and internal organ fibrosis, immune disorders, and a variety of other abnormalities. Symptoms vary widely among individuals, and personalized treatment is sought for each patient. Since there is no fundamental cure for SSc, it is designated as an intractable disease with patients receiving government subsidies for medical expenses in Japan. Oxidative stress (OS) has been reported to play an important role in the cause and symptoms of SSc. HOCl-induced SSc mouse models are known to exhibit skin and visceral fibrosis, vascular damage, and autoimmune-like symptoms observed in human SSc. The antioxidant combination Twendee X® (TwX) is a dietary supplement consisting of vitamins, amino acids, and CoQ10. TwX has been proven to prevent dementia in humans with mild cognitive impairment and significantly improve cognitive impairment in an Alzheimer’s disease mouse model by regulating OS through a strong antioxidant capacity that cannot be achieved with a single antioxidant ingredient. We evaluated the effectiveness of TwX on various symptoms of HOCl-induced SSc mice. TwX-treated HOCl-induced SSc mice showed significantly reduced lung and skin fibrosis compared to untreated HOCl-induced SSc mice. TwX also significantly reduced highly oxidized protein products (AOPP) in serum and suppressed Col-1 gene expression and activation of B cells involved in autoimmunity. These findings suggest that TwX has the potential to be a new antioxidant treatment for SSc without side effects.