From ECTRIMS: New Results on Gut Bacteria and MS

The ECTRIMS meeting has been a great place to connect with researchers on what’s truly exciting in MS research. I’ve especially enjoyed hearing about an area of investigation that is moving forward quickly – from initial observations toward treatments or solutions for people with MS. From what I've heard this week, researchers who are looking at the gut microbiome and its role in the MS immune attack are doing just that. Feel free to browse the abstracts (summaries of conference presentations) here.
Drs. Yan Wang, Lloyd Kasper and colleagues from Dartmouth Medical School and Eastern Washington University built on previous work, which had shown that modulating gut bacteria during MS-like disease in mice induced specific immune cells (called Bregs – or regulatory B cells), and these Bregs reduced disease severity. At ECTRIMS, they reported that treating mice with the gut-related molecule called polysaccharide A (PSA) expanded Bregs; these cells promoted an immune response that prevented the mice from getting MS-like disease. PSA is released by specific species of gut bacteria (Bacteroides) that “colonize” the guts of almost 95% of people worldwide. Partly funded by the National MS Society, this exciting work brings us one step closer to future clinical studies to explore how PSA may help to stop the immune attack in people with MS. (Abstract 181) Members of this team also reported that PSA was effective in mice with progressive MS-like disease. (Abstract P465)

Drs. Egle Cekanaviciute, Sergio Baranzini and other collaborators in the MS Microbiome Consortium are rigorously analyzing gut bacteria to unearth clues about MS susceptibility and progression. At ECTRIMS, they reported on an analysis of bacteria in stool samples from 64 people with MS who had received treatment for MS, and 68 people without MS. Certain bacteria were increased in people with MS, and those bacteria increased immune T helper 1 (Th1) cells – major players in the MS immune attack. Meanwhile, another type of bacteria – which was reduced in people with MS – induced cells that could turn down the immune attack. (Abstract 179) If we can pinpoint certain bacteria that may drive immune system activity in MS and others that can suppress it, this research may open the door to novel therapeutic approaches based on manipulating these gut bacteria.

Young investigator Dr. Gloria Dalla Costa and colleagues from San Raffaele Hospital in Milan showed that Th17 cells, important culprits in the MS immune attack, are increased in the intestinal lining of people with MS compared with people who do not have the disease. Their next goal is to determine how manipulating gut bacteria or diet might affect the generation of these intestinal Th17 cells, and the development of MS. (Abstract 73)

The interaction between the gut and the immune attack in MS may begin quite early, says Dr. Helen Tremlett (University of British Columbia) and collaborators from the U.S. Network of Pediatric MS Centers. They examined gut bacteria and immune markers in 15 children with MS and nine children without MS. In children with MS, they found links between types of gut bacteria and specific immune markers. For example, increases in Bacteroides meant decreases in Th17 cells, which are thought to help drive attacks. (Abstract P287) Studying MS in this early stage is important to identify the first steps of gut microbiome involvement in MS. 

The microbiome is a relatively new area of research for the MS community – but I’m excited to see how far this field has come in a short amount of time. I’m eager for this progress to be propelled into treatments and solutions that will stop the disease.
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Elisabeth Mari, PhD

Dr. Elisabeth Mari is Director of Biomedical Research at the National MS Society. Her responsibilities include supporting the Society’s biomedical research grant portfolio and the International Progressive MS Alliance. An immunologist by training, she attended the University of Delaware and then earned her PhD at Imperial College London. Dr. Mari did a postdoctoral research fellowship at Thomas Jefferson University in Philadelphia. She joined the Society in 2016 and brings over 13 years of experience in biomedical research.

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  • Johan   Sep 16, 2016 10:17 AM
    Hello Dr. Mari, really enjoyed your article but probably not for the reasons you may think. You seem like a nice, young, vibrant, compassionate, likable, smart person. I was diagnosed with SPMS a few years ago. I walk with a cane, still drive and stopped working 2 years ago because of MS. I liked the article because it gave me hope.
    It gave me hope for the future, not because gut studies and mice might solve the MS riddle, but intelligent compassionate people like you are on the case (so to speak) and may come up with a workable solution to the problem that is MS. And who knows, maybe mice and gut studies will lead you to the Promised Land.
    Have fun in England, I know I would if I were you.

  • Linda   Sep 16, 2016 11:30 AM
    There is validity to this. I was diagnosed last dec. but not knowing had symptoms for years before. Numbness and tingling in feet and hands. Two years prior had diverticulitis really bad was put on cipro symptoms went away for 6 mo or so. Hope this helps
  • Leigh michener   Sep 16, 2016 11:52 AM
    I have often wondered about the effects this may have. I was diagnosed 24years ago. I have always had a problem with going to the bathroom which got worse after two pregnancies. My diagnosis came after the second one. I have tried different pro biotic of which one really :) helped but has stopped. I did feel much better and my energy level did pick up. It can sometimes be a week until I give in and finally take something. Hopefully this could be a really fantastic thing for me. I will definitely be paying close attention to this one, and looking for volunteer availability in my area.
  • Jennifer Ray Maderl M.D.   Sep 16, 2016 12:41 PM
    Dr Mari- I am a physician with MS (Dx'd 1987) It is strange your reports. I am on Tecfidera x1 1/2 yrs, but since a nasty stomach virus in February I have noted almost a classic IBS type of system in my GI tract. I have found a low FODMAPS (I recommend you look it up if u are not familiar with it) diet really helps with this newly noted cramping and bloating I have been having. I wonder if the Feb infection changed my microbe colonies and my status. Just FYI I thought I would share. (My undergraduate was in Human Nutrition) thanks!
  • Sue   Sep 16, 2016 1:09 PM
    VERY Interested. I had colitis followed by a total colectomy. Was getting chronic pouchitis. Then got optic neuritis diagnostic for Clinical Isolated Syndrome which is suspicious with good probability to lead to MS. Because of the pouchitis I am on low dose antibiotic Cipro and Flagyl. I have not had any pouchitis or more importantly new brain or spinal lesions of MS for 5 years. I really think there is something to this gut and auto immune diseases like colitis and MS. Grateful for this study!
  • Avatar
    maria1  Sep 16, 2016 1:55 PM
    It is interesting to think about the role the gut has in maintaining well being. It has more seemed like a repository for waste elimination with no interaction with other body functions. Perhaps it, with the right microbes, is a better functioning filter to eliminate minute pests from the cells. We always thought about what we ingest as important but not as a function as what allows for better evacuation of the byproducts of living.
  • Carol   Sep 16, 2016 3:34 PM
    Very interesting reading 😀 Any research is good for people like me with MS
  • Jim K   Sep 16, 2016 4:01 PM
    I firmly believe gut bacteria holds some key in MS. I swear by a daily probiotic. Thank you for your research! I need someone to look at familial mutations of the RANBP2 gene. (ANE1) and whether this gene mutation would cause MS like symptoms. I know for sure that a mutation causes heat sensitivity and messes with nerve impulses. I am starting to think I may have this mutation and not MS. Not that there is much I could do about it though. If you could point me to someone involved in this research I would appreciate it.
  • Karen Church   Sep 16, 2016 5:17 PM
    I was diagnosed when I was 36 I am now 54. About 6 months ago I changed my diet and started taking probiotics. It helped so much then I stopped the pro biotic thinking my diet was healthy enough. I quickly went back to stomach pain bloating etc.. my stomach actually blows up like a balloon. I feel that you are definitely on the right track.
  • Mivhelle   Sep 17, 2016 5:14 AM
    Yes I think you could be on to something here. My question is: Have you seen any cases of chronic diarrhea do to this bacteria? I ask because I have MS and have had chronic diarrhea for a month or longer. And my husband has started with it also, so is the bacteria contagious? We both had stool samples tested and bloodwork and all came back negative so right now it is a mystery, so if you can shed any light on this ? Any info ?
  • Maria moreno   Sep 17, 2016 8:51 AM
    I would like to received more information
  • Denise Leath   Sep 17, 2016 12:50 PM
    Hi, Dr. Mari. What is your opinion about fecal transplantation? Also, do you think taking a probiotic is a good idea?
  • Vanessa Anaya   Sep 17, 2016 3:39 PM
    I have had an extremely active MS year. Meaning relapse after relapse. Right side paralyzed feeling for 6 months, now works but extremely weak wheelchair bound. My bowels have changed and I know I need to change what goes into my system. I can barely eat as I have no appetite for 1yr now. This is very interesting and I wonder if theres a specific diet, probiotic... You can recommend? I have to be careful with fiber.. I do have bowel control issues since this last relapse.
  • George Kochiss   Sep 17, 2016 6:16 PM
    Dr. Mari,

    I was encouraged to read of the progress being made on the treatment of CPMS. I was diagnosed with CPMS in 1991. Since then, I have tried several of the purported disease modifying drugs with little success. The side effect are often worse than the alleged benefits. I have used none of the Big Pharma drugs for the last 15+ years. I have learned to read the advertisements of Big Pharma and their paid spokes people with a careful eye. When I see the following words in ads, I try to add the parenthesized words into the statement, May (or may not), pending clinical trials (finish your study), in some cases have (in other cases have not), ( 20% of patents have experienced relief/improvement (80% have not) and can (maybe they can't. I try not to have a negative view of our pharmaceutical industry, but have learned to always read the fine print. Like it or not, this is a business. I have used diet, exercise, yoga, stress control, OTC drugs, and just listening to my body to manage my symptoms
  • George Kochiss   Sep 17, 2016 6:38 PM
    Dr, Mari,

    continued. Recently, I have been experiencing Pneumonia/ flu symptoms that have drastically worsened my MS symptoms. This data may be useful to your database. I will be happy to share with you. I have stayed in contact with your news and have read much of the findings.If my particular set of circumstances can help push your research forward, I will consider participating.

  • Julie furber   Sep 18, 2016 6:11 AM
    Interesting news, I would love be on a trial!
  • Joe Leighkendall   Sep 18, 2016 5:14 PM
    How do I obtain B. fragilis polysaccharide A (PSA) in my regimen of pills or probiotic I take (Vsl#3ds 950 billion), but does not have B. fragilis polysaccharide A (PSA). Can not find this in anything, or anywhere, or pill format. Please email me.
  • Linda L Halvorson   Sep 18, 2016 8:34 PM
    Thus area interests me. As friends use several diets they are finding more energy. Since one of the possible etiology show higher disease further from the equator and in areas of high fat consumption, it seems something might be there. As someone who grew up in cheese eating states of Minnesota and Wisconson, I find it interesting.
  • Diane Burns   Sep 20, 2016 10:06 AM
    I want to help! Do you know anything about gant 61. The MS conference was in spain. And the mice study was tremendous but how do we get this in addition to healing the leaky gut?
  • Ron Brannigan   Sep 29, 2016 1:21 PM
    When I was a teen, 1966-1969, I used tetracycline for acne for months. It had to kill any good gut bacteria and possibly opened the door for MS. I was diagnosed in 1997. Is this plausible? I am starting Wahl Protocol today in the hope that diet will help some of the negative affects of MS. Is that plausible?
  • Tracy   Sep 29, 2016 3:09 PM
    I've had diagnosed MS for over 16 years now. Looking back at my childhood, I remember having unaddressed food sensitivities and foot numbness in high school. At perhaps 29, I began feeling MS symptoms and became interested in health and nutrition. I was suspected of having Crohn's or IBD at that time (probably due to a high sugar diet/ low vegetable diet, among other things). Now, as I am organic, sugar-free, chemical-free, and attempting the Wahls diet, I feel a definite connection between the health of my gut and my disease. Kudos to these open-minded researchers in regards to their investigational efforts! I've long suspected a link between my diet and my symptoms...
  • Gene   Sep 29, 2016 3:56 PM
    My wife was explaining gut stuff and I did not belive her. She is working with a group developing a probiotic.
  • Dawn Oduor   Sep 29, 2016 4:33 PM
    I am very interested in hearing more about this research.
  • sln   Sep 29, 2016 5:54 PM
    My sister has Crohns and I have SPMS. She went to a dr's appt a couple of months ago.The dr. told her to buy different brands of probiotics. He said they all affect bacteria differently. So, I started taking one brand in the morning and another in the evening. Amazing results. No more nausea or vomiting. No more constipation. My favorite, no more abdominal pain. I am not a dr or even in the health system. I will try just about anything that will help with this horrific disease.
  • Marge   Sep 30, 2016 5:39 PM
    I know there's a connection between a leaky gut and MS. I developed MS symptoms about a year after I was diagnosed with ulcerative colitis. Since then I've been diagnosed with SPMS. Over the last year, my UC flared up and my MS has also gotten worse, affecting my walking and balance. At present I've been taking Entyvio infusions for UC and I'm no longer on steroids. As a result, I am feeling better with both of my autoimmune diseases. Since I'm sensitive to gluten and lactose, I avoid eating foods that have gluten and dairy. I'm eating more fish, and lots of fruits and vegetables. Please keep me updated on future studies and related information. Thank you.
  • Marianne Chase   Sep 30, 2016 8:14 PM
    This is huge!!!! My doctor has been pushing probiotics down my throat for years. If it can be narrowed down to what probable bacteria is most effective in getting the immune system closer to normal, even if it just affects the guts, I'm signing up! I have chronic intestinal issues. They make me so tired and are so uncomfortable. Thank you to everyone involved in researching this!
  • Judith   Oct 3, 2016 11:14 AM
    Wow. I am currently having digestive issues caused by Metformin, so was relieved to see this article to help verify my sanity. I was diagnosed when 28 (1977), am now 67, and have suffered with digestive issues the entire time. My MS was RandR until 3 years ago, but is now secondary progressive. I also have sensitivity to meds (cannot take Cipro, Novocaine, and now Metformin etc.), have had white cell count of 18,000 (or more) whenever I do have gut issues, etc. and no doc has ever been able to pinpoint the problem. Thanks for the very informative article and relevant research.
  • Mary Conran Smith   Oct 8, 2016 10:35 PM
    Great info!!! I've been trying to get answers why my bowels and stomach are totally off balance. This week they want to see if the Probiotics will slow down diahreea & lack of appetite. I have a Urostemy. Feb 2016 I collapsed falling out of my wheel chair and hitting my head on the slate floor. I was
    Unconscious and rushed to St. Francis Hospital in Hartford, Ct.After
    Many tests the blood work came back that I had a severe UTI that caused
    The infection to go septic. I was told I had a high fever, terrible nerve pain
    Nausea and hallucinations. After days on IV CIPRO & so many other drugs I started to come out of it!
    Unfortunately the mess made my stomach bleed. So I had no appetite
    For weeks. At the Rehab Facility the
    Doctor started me on Probiotics.
    I really didn't see much of a change for a few months! My stomach and diarrhea slowed down! But now it's acting up again!? Could it be that I was taken off the Probiotics for a month? I am very frustrated and my caregivers are burning out! Any suggestions would be appreciated!
    Thank you! HOPE... Mary
  • Janet aleman   Oct 10, 2016 8:36 PM
    I am very interested in this subject. I do believe the bacteria in the gut of MS patients is different and controlling the severity of symptoms and progression
  • tamnmark4ever  Oct 12, 2016 7:50 AM
    We have read quite a bit about the gut bacteria andhow it affects MS. We are now on the Dr. Terry Wahls diet. We just started this 2 weeks ago. I have read several testimonies about how the paleo diet has helped people with MS but it takes a year before major results will begin to happen. We will see if that helps! Fingers crossed.