The symptoms of multiple sclerosis (MS), a chronic neurological autoimmune disease in which the immune system eats away the protective covering surrounding the central and peripheral nervous systems, 1 can be debilitating. The symptoms vary with each person and can range from mood swings to vision loss to tremors. As these symptoms change, so do the methods of treatment. While there is no cure for MS, research has shown that some symptoms can be managed through a well-balanced diet.

Scientists and researchers have made advances in MS treatment that are leading to better understanding the relationship between MS and nutrition. While investigation into the relationship is relatively new, there have been significant breakthroughs in the connection between gut bacteria–or gut microbiome–and immune response in people with MS.

The gut microbiome has a beneficial, symbiotic relationship with our bodies. It aids metabolic processes, immune and brain functions, and emotional behavior.5 Most importantly, the healthy function of the gut microbiota has been shown to reduce inflammation in the body, which is associated with MS symptoms. The human gut microbiome has a complex composition that varies from person to person, making it hard to pinpoint an ideal blueprint balance for a healthy gut. However, microbial imbalance, also known as dysbiosis, has been shown to contribute a number of health conditions. Dysbiosis has been associated with autoimmune diseases, which makes it a critical area of study for mitigating the symptoms of MS.5 Research from German scientists suggests hat the presence of microbialim balances in the gut of people with MS heightens MS symptoms. In a 14-day trial from Ruhr- Universität Bochum, investigators observed a decrease in proprionic acid–a short-chain fatty acid–among the study subjects with MS, which they believe was associated with changes in the composition of gut microbiome.1 After the researchers added proprionic acid supplements to the study subject’s MS medication regimen, they observed increases in immune cells called Tregs, which can decrease inflammation. The researchers also reviewed the records of 97 people with MS who had taken proprionic acid supplements for at least one year and found evidence of “reduced relapses and disability progression, compared to the 57 patients with MS who did not take proprionic acid supplementation.”2

The origin of MS remains unclear. However, studies have found genetic and environmental factors associated with the disease, which investigators are exploring in their search for innovative and effective treatments for the condition. This new evidence of a connection between MS and gut microbiota should serve to expand areas of potential research.

KEY TERMS

Myelin: the protective coating around nerve fibers in the central nervous system; is a primary target of the immune attack in MS

Gut microbiome: the totality of microorganisms, bacteria, viruses, protozoa, and fungi, and their collective genetic material present in the gastrointestinal tract4

Dysbiosis: a state of gut microbial imbalance in the gastrointestinal (GI) tract6

Proprionic acid: a short-chain fatty acid molecule produced by gut bacteria1

Inflammation: a defense mechanism in the body where the immune system recognizes damaged cells, irritants, and pathogens

REFERENCES

1. Researchers Show that a Molecule Produced by Gut Bacteria May Help To Regulate Immune Response in MS. March 18, 2020. https://www.nationalmssociety. org/About-the-Society/News/Researchers-Show-that- a-Molecule-Produced-by-Gut-B. March 23, 2020.
2. Duscha A, Gisevius B, Hirschberg S. Propionic acid shapes the multiple sclerosis disease course by an immunomodulatory mechanism. Cell. 2020;180(6):1067–1080.
3. Nowack, D. Food for Thought: MS and Nutrition.
   July 2016. https://www.nationalmssociety.org/ NationalMSSociety/media/MSNationalFiles/Brochures/ Brochure-Food-for-Thought%e2%80%94MS-and- Nutrition_1503.pdf. March 24, 2020.
4. MS Society site. Diet and Nutrition. Updated August 2016. March 23, 2020.
5. Kirby TO, Ochoa-Repáraz J. The gut microbiome in multiple sclerosis: a potential therapeutic avenue. Med Sci (Basel). 2018;6(3):69.
6. Tasnim N, Abulizi N, Pither J, Et al. Linking the gut microbial ecosystem with the environment: does gut health depend on where we live? Front Microbial. 2017;8:1935
7. Jewell T. What Causes Dysbiosis and How Is It Treated? November 2, 2018. https://www.healthline.com/ health/digestive-health/dysbiosis. April 4, 2020. NHR