ResearchSpeak & ClinicSpeak the gut microbiome and MS

Are you considering a faecal transplant? Don't! Stop and think. #ClinicSpeak #ResearchSpeak #MSBlog #MSResearch

"Chicken or Egg? The number of articles dedicated to the human microbiome is increasing exponentially. The microbes that live in our guts are being linked to almost every disease state including MS."

"The review below is very timely and looks at the evidence supporting a role of the gut microbiome in the pathogenesis of multiple sclerosis. As this topic is so important I will invite Ellen Mowry to do a guest post for the blog on this issue and the role of diet in managing MS."

"We already have a well describe association between gut parasites and a low incidence of MS, which has led to trials of worm therapy in MS. The latter is a true experiment and is testing whether or not infection with a parasitic worm reduces MS disease activity. More recently it has been suggested that changes in the gut micobiome are an important risk factor for developing MS. Some have hypothesised that altering our gut microbiomes, using antibiotics followed by probiotics and/or faecal transplant from 'healthy donors' may lead to better control of MS disease activity. Before accepting this as fact you have to realise that developing MS may in itself change the microbiome and not the other way around; in statistical speak we call this reverse causation. Therefore a lot more research needs to be done on the microbiome before anyone can claim causation. The animal studies help, but they are what they are, just animal studies! I say this because one of my patients has already asked me what I think about faecal transplantation as a treatment for MS? This patient was considering travelling to Brisbane, Australia, to undergo the procedure in a private clinic. My comment was that unless the faecal transplantation was being done as part of a well-controlled randomised study with ethics approval they should not be having this procedure. Similarly, if it is proper research they should not have to pay to participate in the study. We are very concerned about 'faecal transplantation' becoming the next CCSVI with clinics offering an unproven therapy at great cost to desperate MSers and their families."

Glenn & Mowry. Emerging Concepts on the Gut Microbiome and Multiple Sclerosis. J Interferon Cytokine Res. 2016 May 4.

Microbiota of the human body perform fundamental tasks that contribute to normal development, health, and homeostasis and are intimately associated with numerous organ systems, including the gut. Microbes begin gut inhabitance immediately following birth and promote proper gut epithelial construction and function, metabolism and nutrition, and immune system development. Inappropriate immune recognition of self-tissue can lead to autoimmune disease, including conditions such as multiple sclerosis (MS), in which the immune system recognizes and attacks central nervous system tissue. Preclinical studies have demonstrated a requirement of gut microbiota for neuroinflammatory autoimmune disease in animal models, and a growing number of clinical investigations are finding associations between MS status and the composition of the gut microbiota. In this review, we examine current undertakings into better understanding the role of gut bacteria and their phages in MS development, review associations of the gut microbiota makeup and MS, and discuss potential mechanisms by which the gut microbiota may be manipulated for therapeutic benefit.

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