Multiple sclerosis treatment improves intestinal flora

According to researchers at the University of Basel and the University Hospital of Basel, drugs used to treat multiple sclerosis also have a beneficial effect
on the composition of the intestinal flora.
Conversely, the intestinal flora also plays a role
in the side effects that arise during drug treatment.

Few previous studies have examined the effects of MS treatment on the gut microbiota and its composition in
terms of efficacy and side effects.
A team of researchers from the University of Basel and the University Hospital Basel studied 20 patients with multiple sclerosis who were treated with dimethyl fumarate
.
The research team, led by Professor Anne-Katrin Prbstel, senior physician in neurology and head of the research team, and Prof.
Adrian Egli, who recently moved to the University of Zurich, published their findings
in the journal Gut Microbiome.

The brand name of this drug is Tecfidera, which reduces the number of
multiple sclerosis episodes by interfering with the metabolic processes of certain immune cells.
However, this therapy also has side effects, including hot flashes and gastrointestinal discomfort, and in some cases lymphopenia, a lack of B cells and T cells
in the blood.
This can lead to serious complications
.

More "good" bacteria

In their study, the researchers examined stool and blood samples
from subjects before and during treatment.
Their focus is on the composition
of the gut microbiota.
Prbstel and her team also measured the number of lymphocytes in the blood to determine which patients had a side effect of lymphopenia
.

After just three months of treatment, the team was already able to identify changes in the gut microbiome: "We were able to show that the gut bacteria of patients treated with the drug began to become more like the composition of healthy individuals," explains Prbstel
.
Treatment with dimethyl fumarate reduces the proportion of pro-inflammatory bacteria associated with MS and supports the growth
of "good" bacteria.

In addition, the researchers were able to make a link between the composition of the gut microbiome and the development of lymphopenia: the presence of the bacteria Akkermansia muciniophila, combined with the deficiency of Copri Prevotia, presented risk factors
for this side effect.
Therefore, the authors suspect that COPRI may have a protective effect
against lymphopenia.

Interaction of treatment with intestinal flora

"Our data suggest that immunomodulatory therapies not only affect immune cells, but also positively affect the gut microbiota
," Prbstel explains.
The link between gut bacteria and clinical side effects of treatment may eventually lead to early identification of patients at risk of
developing lymphopenia.
Microbiologist Egli continues: "In the future, this relatively new field of microbiology may help us better understand the effects and side effects of many drugs on gut bacteria and personalize treatments
accordingly.
"

"So far, what we've done is just a pilot study with a relatively small
number of participants," she warns.
Larger studies are needed to confirm the results and explore the potential to support MS treatment through the gut microbiota and predict side effects
in advance.

The research team from the Research Centre for Neurology, Biomedical, Clinical Research and Clinical Neuroimmunology at the University Hospital Basel and the University Hospital Basel received research funding
from the Propatient Foundation at the University Hospital Basel, the Goldschmidt-Jacobson Foundation, Biogen, the National Multiple Sclerosis Society and the Swiss National Science Foundation.