Data have long pointed to changes in the gut microbiome in patients with multiple sclerosis. We need an intact intestinal flora to live. It consists of a constellation of bacteria and other pathogens, e.g. yeast. Patients with MS usually have a less heterogeneous biome and those strains of pathogens that support the inflammatory process of MS, perhaps even help to trigger it, predominate. There are already results of some studies for this.
These provide information on emergence and pathophysiology MS and may identify new therapeutic targets. In fact, an altered microbiome could contribute to the development of MS, but also be a result of MS. However, little research has been conducted on how immunomodulatory therapies for MS affect the patient’s gut microbiome and metabolism. The current study deals with this.
MS treatment changes the microbiome
Scientists, including prof. Anne-Katrin Pröbstelová, winner of the Sobek Young Talent Prize 2022, and prof. Ludwig Kappos, winner of the 2017 Sobek Prize, have now been able to demonstrate that the gut bacteria in patients undergoing immunomodulation therapy changes more towards the composition of healthy people. In addition, the research team found that the presence of clinically relevant side effects during dimethyl fumarate therapy (lymphopenia) was related to the composition of the microbiome.
20 patients with relapsing-remitting MS (RRMS) and a mean age of 42 years (range 23–59) were included in the study. Certain blood metabolic values and gut micro-organisms were examined and compared before, during and 12 months after initiation of dimethyl fumarate treatment. Any previously used immunomodulators were also taken into account.
Also, microbiome-driven lymphopenia
Both V… and v Serum as in the gut, scientists have struck gold. In MS, there has been a shift towards anti-inflammatory pathogens or groups. Thus, the propensity for adverse effects such as lymphopenia (too few of certain white blood cells) with dimethyl fumarate could be related to the composition of the gut microbiome before starting treatment. Further investigation is needed to verify the findings and their more precise breakdown.
In summary, current data suggest that immunomodulatory therapies not only affect immune cells, but also have a positive effect on the gut microbiome and that the clinical side effects of therapy are modulated by gut bacteria.