Changing Gut microbes with a probiotic

Its AAN this week and ProfG and many of the other Neuros are in LaLa Land to get their annual fill of all things neurology. 

What interests you this year?

As soon as the microbiome (Gut Microbe) appeared it was obvious that the scammers would be there to make money off vulnerable people.

People will asked to pay money to have their bowels cleared and the they have to eat a feacal extract to change their microbiome. Ker-ching. 

Academics would then follow do a trial and show that it doesn't really work...OK that's me just guessing. However they will do a study to see if it works and the MS Socieites spend aload of money.
Sound familiar?..CCSVI?

It is happening a trial of feacal transplant ..... Yep you get your bowels cleared and then you eat it.

Fecal Microbial Transplantation in Multiple Sclerosis: trial design. 
Ana Cristina Wing, Marcelo Kremenchutzky: 
To describe a trial design to evaluate FMT effects on MS patients. A single site, randomized, open label, controlled, crossover study. Forty patients will be randomized 1:1 into two groups. One group will receive FMT by rectal enema, while the other group will receive treatment as per standard of care (control group) for the first 6 months. Thereafter, the early intervention group will no longer receive FMT and the initially control group will receive FMT for the remaining 6 months. A 3rd group of healthy volunteers will be a reference control. Primary outcome will be peripheral blood cytokines measured by Luminex assay. As secondary outcomes blood DNA bacteria and urinalysis to evaluate gut permeability, head MRI as a safety marker and trial feasibility metrics. Results: Eight patients have already been enrolled to this study, 4 (50%) females and 4 (50%) males. Mean age of disease onset is 32 years old (22 – 40). Mean current EDSS is 4.0 (1.5 – 6.5). Patients manifested their MS symptom in average 20 years ago (7-44). All except two are currently using disease modifying therapy. Conclusions: This proof of concept, first in humans, independent pilot study will shed light on the relationships between gut bacteria and MS. We present here study design and preliminary baseline demographics, and discuss its possible impact on disease inflammation to guide future large-scale studies.

Many people have been conned to part with their hard-earned cash They no doubt give you some R & R  and fed someone elses number two's.  Canada forked out a few million to rebuff the CSSVI idea and this study is looking at changes in the microbiome

In this study from Canada you get an enema, but at the AAN, you wont get result for a few years? So do we want to know that a trial is occuring.

But in this study from Harvard, They are taking a Probiotic.

A probiotic modulates the microbiome and immunity in multiple sclerosis.
Tankou SK, Regev K, Healy BC, Tjon E, Laghi L, Cox LM, Kivisäkk P, Pierre IV, Lokhande H, Gandhi R, Cook S, Glanz B, Stankiewicz J, Weiner HL. Ann Neurol. 2018 Apr 20. doi: 10.1002/ana.25244. [Epub ahead of print]


Effect of a probiotic on the gut microbiome and peripheral immune function in healthy controls and relapsing-remitting multiple sclerosis (RRMS) patients.


MS patients (N=9) and controls (N=13) were orally administered a probiotic containing Lactobacillus, Bifidobacterium and Streptococcus twice daily for two months. Blood and stool specimens were collected at baseline, after completion of the 2-month treatment, and 3 months after discontinuation of therapy. Frozen peripheral blood mononuclear cells (PBMCs) were used for immune cell profiling. Stool samples were used for 16S rRNA profiling and metabolomics.


Probiotic administration increased the abundance of several taxa known to be depleted in MS such as Lactobacillus. We found that probiotic use decreased the abundance of taxa previously associated with dysbiosis in MS including Akkermansia and Blautia. Predictive metagenomic analysis revealed a decrease in the abundance of several KEGG (Kyoto Encyclopaedia of Genes and Genomes) pathways associated with altered gut microbiota function in MS patients such as methane metabolism following probiotic supplementation. At the immune level, probiotic administration induced an anti-inflammatory peripheral immune response characterized by decreased frequency of inflammatory monocytes, decreased mean fluorescence intensity (MFI) of CD80 on classical monocytes as well as decreased HLA-DR MFI on dendritic cells. Probiotic administration was also associated with decreased expression of MS risk allele HLA-DQA1 in controls. Probiotic induced increased in the abundance of Lactobacillus and Bifidobacterium were associated with decreased expression of MS risk allele HLA.DPB1 in controls.


Our results suggest that probiotic could have a synergistic effect with current MS therapies. 

Synergism is a word that is often overused in science. Synergiism means more than the additive effect of two things. What is the evidence for this?. Maybe the probiotic influences immunity but we need to see the effect on clinical parameters