Poor Gut Health May Drive Multiple Sclerosis — But a Better Diet May Ease It

Multiple Sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system. It is characterized by damage to the myelin, which is the protective sheath that surrounds nerve fibers in the brain and spinal cord. MS causes a wide range of symptoms, including muscle weakness, difficulty with coordination and balance, numbness or tingling in the limbs, chronic pain, fatigue, and difficulty with speech and vision.

Scientists from the Department of Neurology at Rutgers Robert Wood Johnson Medical School have traced a previously observed connection between the gut microbiome, made up of tiny organisms in the digestive system, and multiple sclerosis (MS).

Their research, conducted using genetically modified mice and human subjects, supports the idea that changes in diet, such as increasing fiber intake, could potentially slow the progression of MS. The team is now working to evaluate the impact of dietary interventions on MS patients.

“Unhealthy dietary habits such as low fiber and high-fat consumption may have contributed to the steep rise of MS in the US,” said Kouichi Ito, an associate professor of neurology and senior author of the study published in Frontiers in Immunology. “In nations where people still eat more fiber, MS is far less common.”

MS is a degenerative condition in which the body’s immune system attacks the protective covering of nerves in the brain, spinal cord, and eyes. According to the National Multiple Sclerosis Society, it affects nearly 1 million adults in the United States.

Several previous studies have differentiated the microbiomes of MS patients and healthy subjects, but, Ito said, they all noted different abnormalities, so it was impossible to tell what change, if any, was driving disease progression.

The Rutgers study, which was led by research associate Sudhir Kumar Yadav, used mice engineered with MS-associated genes to trace the link between alterations in the gut bacteria and an MS-like condition called experimental autoimmune encephalomyelitis (EAE).

As these mice matured — and simultaneously developed EAE and a gut inflammatory condition called colitis — the researchers observed increased recruitment of inflammatory cells (neutrophils) to the colon and production of an anti-microbial protein called lipocalin 2 (Lcn-2).

The study team then looked for evidence that the same process occurred in people with MS and found significantly elevated Lcn-2 levels in patients’ stools. This marker correlated with reduced bacterial diversity and increased levels of other markers of intestinal inflammation. Additionally, bacteria that seem to ease inflammatory bowel disease were reduced in MS patients with higher levels of fecal Lcn-2.

The study suggests that fecal Lcn-2 levels may be a sensitive marker for detecting unhealthy changes in the gut microbiome of MS patients. It also provides further evidence that high-fiber diets, which reduce gut inflammation, may help fight MS.

Rutgers is looking to test that hypothesis soon. Suhayl Dhib-Jalbut, a co-senior author of the paper who heads the medical school’s neurology department, is recruiting patients with MS for a trial that will determine how their microbiomes and immune systems are affected by a high-fiber supplement developed by Rutgers Microbiologist Liping Zhao.

Reference: “Fecal Lcn-2 level is a sensitive biological indicator for gut dysbiosis and intestinal inflammation in multiple sclerosis” by Sudhir K. Yadav, Naoko Ito, John E. Mindur, Hetal Kumar, Mysra Youssef, Shradha Suresh, Ratuja Kulkarni, Yaritza Rosario, Konstantin E. Balashov, Suhayl Dhib-Jalbut and Kouichi Ito, 21 October 2022, Frontiers in Immunology.
DOI: 10.3389/fimmu.2022.1015372