Mycobacterium avium subsp. paratuberculosis and multiple sclerosis in Sardinian patients: epidemiology and clinical...

Area of Science:

• Neuroimmunology
• Infectious Diseases
• Autoimmunity

Background:

• Mycobacterium avium subspecies paratuberculosis (MAP) has been recently identified as a potential factor associated with multiple sclerosis (MS).
• Initial observations in Sardinia suggested a link between MAP and MS in this specific population.

Purpose of the Study:

• To confirm the association between MAP and MS in the Sardinian population.
• To investigate the potential role of MAP in the clinical manifestations and immunological features of MS.

Main Methods:

• A case-control study involving 436 MS patients and 264 healthy controls (HCs).
• Detection of MAP DNA and MAP2694 antibodies using IS900-specific PCR and ELISA.
• Analysis of clinical data including disease course, disability (EDSS), and presence of oligoclonal bands (OBs).

Main Results:

• Significantly higher prevalence of MAP DNA and MAP2694 antibodies in MS patients compared to HCs (p < 10⁻¹¹ and p < 10⁻²³ respectively).
• Reduced frequency of oligoclonal bands (OBs) in MAP-positive MS patients (OR = 0.52; p = 0.02).
• MAP positivity correlated with steroid use (MAPDNA, OR = 2.65; p = 0.02) and MS treatments (MAP2694 antibodies, OR = 2.26; p = 0.01).

Conclusions:

• The study confirms a significant association between MAP and MS in Sardinia.
• The findings suggest MAP may act as a peripheral trigger in MS autoimmunity, indicated by lower OB frequency.
• MAP detection may be influenced by MS therapies, including steroids. Further research in other populations is recommended.