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Gut microbiome composition is associated with long-term disability worsening in multiple sclerosis

Lindsay Devolder1,2,3, Ayla Pauwels1,2,3,4,5, Ann Van Remoortel5

  • 1Laboratory of Molecular Bacteriology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Katholieke Universiteit Leuven, Leuven, Belgium.

Gut Microbes
|February 21, 2023
PubMed

Insights

The gut microbe Bacteroides 2 enterotype (Bact2) is linked to worsening disability in multiple sclerosis (MS) patients. This finding suggests Bact2 could serve as a prognostic biomarker for MS progression.

Area of Science:

  • Microbiome research
  • Neurology
  • Immunology

Background:

  • Predicting long-term outcomes in multiple sclerosis (MS) is challenging.
  • The gut microbiota is increasingly recognized for its role in MS pathogenesis.
  • Understanding gut microbial influences can aid in MS management.

Purpose of the Study:

  • To investigate the association between gut microbial composition at baseline and long-term disability worsening in MS patients.
  • To evaluate the potential of specific microbial profiles as prognostic biomarkers for MS.
  • To determine if gut microbial composition predicts disease progression over time.

Main Methods:

  • Longitudinal cohort study of 111 MS patients.
  • Collection of fecal samples and host metadata at baseline and 3 months.
  • Neurological measurements, including EDSS-Plus, performed over a median of 4.4 years.
  • Analysis of gut microbial composition, focusing on the Bacteroides 2 enterotype (Bact2).

Main Results:

  • Worsening disability (EDSS-Plus) occurred in 39/95 patients.
  • The inflammation-associated Bacteroides 2 enterotype (Bact2) was significantly more prevalent in patients with worsening disability (43.6%) compared to non-worsened patients (16.1%).
  • Bact2 association with EDSS-Plus was independent of confounders and stronger than plasma NfL levels.
  • Bact2 demonstrated relative stability over 3 months, indicating its potential as a biomarker.

Conclusions:

  • Gut microbial dysbiosis, specifically the Bacteroides 2 enterotype (Bact2), is associated with long-term disability worsening in multiple sclerosis.
  • Bact2 shows potential as a stable and reliable prognostic biomarker for MS progression.
  • These findings highlight the gut microbiome's role in MS and suggest new avenues for patient monitoring and therapeutic strategies.
Keywords:
Bacteroides 2EDSS-Plusgut microbiomelong-term disability worseningmultiple sclerosisneurofilament light chain

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