Altered intestinal permeability in patients with relapsing-remitting multiple sclerosis: A pilot study

Area of Science:

• Gastroenterology
• Neurology
• Immunology

Background:

• Alterations in intestinal permeability (IP) are implicated in the pathophysiology of immune-mediated diseases.
• The role of IP in multiple sclerosis (MS) remains to be fully elucidated.

Purpose of the Study:

• To investigate the association between changes in intestinal permeability and multiple sclerosis (MS).

Main Methods:

• Studied 22 patients with relapsing-remitting MS (RRMS) and 18 healthy donors (HDs).
• Quantified gut dysfunction by measuring urinary lactulose (L) and mannitol (M) levels after an oral load.
• Analyzed twin pairs (one concordant, four discordant for MS).

Main Results:

• A significantly higher proportion of RRMS patients exhibited increased IP compared to HDs (73% vs. 28%; p=0.001).
• The urinary L/M ratio was significantly higher in MS patients (p=0.0284).
• Urinary mannitol concentration was lower in MS patients (p=0.022), indicating reduced intestinal absorption.

Conclusions:

• The high prevalence of IP alterations in RRMS patients supports the study hypothesis.
• Further research with larger cohorts is needed to confirm these findings and explore implications for immune disturbances and gut microbiota.
• Findings may be relevant for oral therapies in MS.