Multiple Sclerosis and the Biome

Today has been “one of those days.”  From the minute I got up this morning, I felt overwhelmed.  There’s just too darn much for one person to do sometimes.

That overwhelmed feeling even leached into my writing this post today.  I sat here for a couple of hours staring at a blank Word doc thinking, “There are just too many things to write about for any one person!”

After a cup of coffee, a deep breath and mental reminder that I can always write again tomorrow  :- )  I’ve decided to talk a little about multiple sclerosis and the biome today.

As Scarlett O’Hara says, “Tomorrow is another day!”

Last week there was a really good online article on the topic of MS, Your Head or Your Gut?[i]  I just love its summary of the importance of the bacterial microbiome:

 “Within the gut bacterial microbiome are genes that not only promote their own survival and growth but also code for products that are indispensable for human health. Gut bacterial products can promote proper gut barrier function by ensuring normal development of the intestinal structures, are involved in the metabolism of therapeutic drugs, limit the composition and density of the gut microbiota by ensuring proper immune system development, and play crucial roles in breaking down complex dietary carbohydrates into short-chain fatty acids (SCFAs). Gut bacteria exert effects on almost every organ in the body and have been shown to affect intestinal blood vessel formation, influence lung anti-viral immunity, reduce synaptic connectivity, and regulate hepatic metabolism, among many other tasks.”

 Incredible, isn’t it?

Anyway, the article goes on to explain that multiple sclerosis is the most common neurological disease in young people, affecting at least 2.3 million people worldwide, and that it is considered a “disease of the western world.”  And there you have it:  yet another inflammatory illness that is linked to alterations in the gut biome through lack of exposure in our excessively hygienic societies.

Those with MS have been found to have lower levels of certain anti-inflammatory gut bacteria which the article explains in detail.  However, as the article states, “Simple introduction of probiotic bacteria through consumption has gained traction in recent years, but without additional intervention those introduced may not be able to successfully colonize the gut.”  That is, simply taking oral probiotics does not ensure that they will actually establish themselves.

But luckily…we have helminths!  According to research done in the last year, the presence of helminths in the gut causes major improvements in the quality of the gut bacteria.  For example, Dr. Loke’s recent work in mice demonstrated that those “…infected with intestinal worms experienced as much as a thousand-fold decrease in Bacteroides — a group of bacterial species linked by past studies to higher risk for IBD [inflammatory bowel disease]. At the same time, the number of Clostridia, a bacterial species known to counter inflammation, increased tenfold.”[ii]  Dr. Loke, a researcher at New York University, points out that while his work was specifically on IBD, this model will likely also apply to other autoimmune diseases, including MS.[iii]

This phenomena may well explain, in part, the results of one of the best in vivo studies[iv] we have to date with helminths.  12 patients with MS and helminth colonies were followed for 4 ½ years.  As compared to the controls (who did not have helminths on board), those with helminths, “…showed a significantly lower number of exacerbations, minimal variation in disability scores, as well as fewer magnetic resonance imagining changes…”

Diet is important for those with MS as well.  What you eat can greatly affect the biome, as you share your meals with all those trillions of little guys.  In fact, harkening back to my last post about sugar in young children’s diets…

Earlier this year, a paper[v] came out about MS in children that found, “… perturbations in the gut microbiome composition were observed, in parallel with predicted enrichment of metabolic pathways associated with neurodegeneration.”

The good news in all this is that there may well be something you can do about MS – work on the health of the biome now!

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[i] http://www.labnews.co.uk/features/head-gut-12-12-2016/

[ii] Deepshika Ramanan, Rowann Bowcutt, Soo Ching Lee, Mei San Tang, Zachary D. Kurtz, Yi Ding, Kenya Honda, William C. Gause, Martin J. Blaser, Richard A. Bonneau, Yvonne AL Lim, P’ng Loke, Ken Cadwell. Helminth infection promotes colonization resistance via type 2 immunity. Science, 2016 DOI: 10.1126/science.aaf3229

[iii] [iii] https://www.sciencedaily.com/releases/2016/04/160414145513.htm

[iv] Correale J, Farez M. Association between parasite infection and immune responses in multiple sclerosis. Annals of Neurology. 2007 Feb;61(2):97-108.

[v] Tremlett, H., Fadrosh, D. W., Faruqi, A. A., Zhu, F., Hart, J., Roalstad, S., Graves, J., Lynch, S., Waubant, E. and the US Network of Pediatric MS Centers (2016), Gut microbiota in early pediatric multiple sclerosis: a case−control study. Eur J Neurol, 23: 1308–1321. doi:10.1111/ene.13026