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Gut Bacteria and Managing MS

According to experts, friendly bacteria are vital for digestive health, easing everything from bloating to irritable bowel syndrome1, and even encouraging weight loss2.

But benevolent bugs can have a greater effect on your body than just helping you to fit in your favorite jeans. In fact, there’s mounting evidence from studies on humans and mice that the trillions of bacteria1  in your gut could hold the key to a number of inflammatory conditions including diabetes3  obesity2, cardiovascular disease4  – and, yes, even Multiple Sclerosis (MS)5.

It seems that changes in the microbiome (the technical term for the micro-organisms living in your body6) have a direct impact on the immune system and may even influence susceptibility to autoimmune conditions such as MS. This isn’t such a crazy notion, considering 70% of the body’s immune cells are located in the lymphoid tissue that lines the gut7,8,.

The evidence is certainly compelling; One study9, for example, found that people with MS had a higher number of Methanobrevibacteriaceae (a snappily named bacterium that appears to activate the immune system), but were low in other bacteria known to calm the immune system.

So how does the microbiome become disrupted? Use of antibiotics, is one cause10 – both taking them in pill form and consuming the products of animals that have been treated with them10 – but lifestyle factors can also play a role. Interestingly, differences in diet, vitamin D deficiency, smoking, and alcohol intake all have the ability to affect the microbiome and are all widely accepted risk factors for MS11.

Bacteria under the microscope

New research initiatives are helping to shed light on the role bacteria plays in autoimmune diseases all the time. For example, The National Institute of Health’s Human Microbiome Project12  aims to sequence a typical gut microbiome, providing valuable data for identifying gut flora changes in people with the disease.

Preliminary clinical trials aimed at altering the gut microbiome in people with MS are also underway, and may prove to be a promising treatment option in the future13. For example, certain probiotics were found to stimulate T helper cells14, which in turn instruct other cells to behave in specific ways and, eventually, calm the immune system and suppress autoimmune diseases15. Researchers concluded that there’s promising evidence for recommending probiotics for both the prevention and treatment of autoimmune condition like MS16.

Bacteria-friendly foods

In addition to taking probiotic supplements (you’ll need to speak to your doctor before taking these!), there are other ways to boost levels of friendly bacteria in your gut17. Fermented foods such as natural live yoghurt, miso (fermented soy) sauerkraut (pickled cabbage), kefir (a cultured milk product) and kimchi (spicy pickled cabbage) provide a broad range of good bacteria18. Although foods rich in oligosaccharides, hard-to-digest carbohydrates good bacteria feed off of can also help. These are known as “prebiotic” foods, which include onions, garlic, asparagus, leeks, artichoke, bananas, tomatoes, wheat, oats, and soy beans1.

Avoiding processed sugary foods is another way to look after your gut flora – as well as your immune system and brain. In one study by the Oregon State University19, rats who fed on a high-sugar diet, which leads to bacterial changes in the gut bacteria, showed a significant loss of “cognitive flexibility,” or the power to adapt to changing situations, an impairment in memory.

Poo transplants – Yes, really!

There are other less savory ways to replenish levels of friendly bacteria. Researchers are looking into faecal microbiota transplantation, a procedure that involves inserting a small amount of diluted stool sample from a donor into the colon of a recipient20. In theory this brings with it a healthy community of bacteria, and has already shown success in the treatment of ulcerative colitis21. Recently, though, a new study22  showed that transplanting faecal bacteria from healthy to diseased mice actually changed the expression of myelin genes and myelin content in the brains of the recipient mice. Which is kind of mind blowing when you think about it.

Yes, bacteria are tiny and icky, and we’d rather not think about them, but they hold important health benefits. In the future, dietary changes and probiotic supplements to replenish healthy gut flora may well be an integral part of MS management – and prevention. In the meantime, there’s nothing to stop you from making friends with friendly bacteria right now. Just follow your gut!

References:

  1. Use of probiotics in gastrointestinal disorders: what to recommend? Elizabeth C. Verna, Susan Lucak. Therap Adv Gastroenterol. 2010 Sep; 3(5): 307–319. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002586/
  2. Role of probiotics in obesity management. Prados-Bo A1, Gómez-Martínez S, Nova E, Marcos A. Nutr Hosp. 2015 Feb 7;31 Suppl 1:10-8. http://www.ncbi.nlm.nih.gov/pubmed/25659049
  3. Oral probiotic administration induces interleukin-10 production and prevents spontaneous autoimmune diabetes in the non-obese diabetic mouse. F. Calcinaro, S. Dionisi, M. Marinaro, P. et al. Diabetologia. August 2005, Volume 48, Issue 8, pp 1565-1575 http://link.springer.com/article/10.1007/s00125-005-1831-2
  4. Potential of probiotics in controlling cardiovascular diseases. Rajiv Saini, Santosh Saini, and Sugandha Sharma. J Cardiovasc Dis Res. 2010 Oct-Dec; 1(4): 213–214. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3023901/
  5. The role of microbiome in central nervous system disorders. Wang Y, Kasper LH. Brain Behav Immun. 2014 May;38:1-12. http://www.ncbi.nlm.nih.gov/pubmed/24370461
  6. Ursell LK, Metcalf JL, Parfrey LW, Knight R. Defining the Human Microbiome. Nutrition reviews. 2012;70(Suppl 1):S38-S44. doi:10.1111/j.1753-4887.2012.00493.x. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426293/
  7. The role of microbiome in central nervous system disorders. Wang Y, Kasper LH. Brain Behav Immun. 2014 May;38:1-12. http://www.ncbi.nlm.nih.gov/pubmed/24370461
  8. Allergy and the gastrointestinal system. G Vighi, F Marcucci, L Sensi, G Di Cara, and F Frati. Clin Exp Immunol. 2008 Sep; 153(Suppl 1): 3–6. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515351/
  9. Increased Archaea Species and Changes with Therapy in Gut Microbiome of Multiple Sclerosis Subjects (S24.001). Sushrut Jhangi, Roopali Gandhi, Bonnie Glanz, Sandra Cook, Parham Nejad, Doyle Ward, Ning Li, Georg Gerber, Lynn Bry and Howard Weiner. Neurology April 8, 2014 vol. 82 no. 10 Supplement S24.001 http://www.neurology.org/content/82/10_Supplement/S24.001.short
  10. Antibiotics and the Human Gut Microbiome: Dysbioses and Accumulation of Resistances M. P. Francino. Front Microbiol. 2015; 6: 1543. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709861/
  11. The gut microbiome in multiple sclerosis. Curr Treat Options Neurol. 2015 Apr;17(4):344. doi: 10.1007/s11940-015-0344-7. http://www.ncbi.nlm.nih.gov/pubmed/?term=The+gut+microbiome+in+multiple+sclerosis+Mielcarz+DW1%2C+Kasper+LH
  12. Role of the gut microbiota in health and chronic gastrointestinal disease: understanding a hidden metabolic organ. Caitriona M. Guinane and Paul D. Therap Adv Gastroenterol. 2013 Jul; 6(4): 295–308.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3667473/
  13. The gut microbiome in multiple sclerosis. Mielcarz DW, Kasper LH. Curr Treat Options Neurol. 2015 Apr;17(4):344. doi: 10.1007/s11940-015-0344-7. http://www.ncbi.nlm.nih.gov/pubmed/25843302
  14. Any role for probiotics in the therapy or prevention of autoimmune diseases? Up-to-date review. Özdemir Ö1. J Complement Integr Med. 2013 Aug 6;10. http://www.ncbi.nlm.nih.gov/pubmed/23921494
  15. Berger A. Th1 and Th2 responses: what are they? BMJ : British Medical Journal. 2000;321(7258):424. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC27457/
  16. Liu Y, Alookaran J, Rhoads J. Probiotics in Autoimmune and Inflammatory Disorders. Nutrients. 2018 Oct; 10(10): 1537. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213508/
  17. University Of Maryland Medical Center. Multiple Sclerosis. http://umm.edu/health/medical/altmed/condition/multiple-sclerosis
  18. Inclusion of Fermented Foods in Food Guides around the World. Stephanie N. Chilton, Jeremy P. Burton, and Gregor Reid. Nutrients. 2015 Jan; 7(1): 390–404. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303846/
  19. Website “Oregon State University - News and Research Communications” – Fat, sugar cause bacterial changes that may relate to loss of cognitive function. Last accessed: 31.05.16 http://oregonstate.edu/ua/ncs/archives/2015/jun/fat-sugar-cause-bacterial-changes-may-relate-loss-cognitive-function
  20. Rohlke F, Stollman N. Fecal microbiota transplantation in relapsing Clostridium difficile infection. Therapeutic Advances in Gastroenterology. 2012;5(6):403-420. doi:10.1177/1756283X12453637. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491681/
  21. Kruis W, Frič P, Pokrotnieks J, et al. Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut. 2004;53(11):1617-1623. doi:10.1136/gut.2003.037747. http://gut.bmj.com/content/53/11/1617.full
  22. Microbiota-driven transcriptional changes in prefrontal cortex override genetic differences in social behavior. Mar Gacias Sevasti Gaspari Patricia Mae-Santos Sabrina Tamburini Monica Andrade Fan Zang Nan Shen Vladimir Tolstikov Michael A Kiebish Jeffrey L Dupree Venetia Zachariou Jose C Clemente Patrizia Casaccia. eLife 2016;10.7554/eLife.13442. https://elifesciences.org/content/5/e13442v1
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