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Published on: October 18, 2019
Is Clostridium perfringens epsilon toxin associated with multiple sclerosis?
Richard W Titball1, Nicholas Lewis2, Richard Nicholas3
1Department of Biosciences, University of Exeter, Exeter, UK.
Clostridium perfringens epsilon toxin may contribute to multiple sclerosis (MS) in humans. Studies found higher levels of the toxin and related antibodies in MS patients, suggesting a potential link to the disease.
Area of Science:
- Neuroimmunology
- Microbiology
- Toxicology
Background:
- Clostridium perfringens epsilon toxin is a known cause of enterotoxaemia in livestock.
- Emerging research suggests a potential role for this toxin in human multiple sclerosis (MS).
Purpose of the Study:
- To investigate the association between Clostridium perfringens epsilon toxin and multiple sclerosis in humans.
- To explore the mechanism by which epsilon toxin might contribute to MS pathogenesis.
Main Methods:
- Comparing the prevalence and levels of C. perfringens strains producing epsilon toxin in the gut microbiota of MS patients versus healthy controls.
- Analyzing serum antibody levels against epsilon toxin in MS patients and controls.
- Investigating the interaction of epsilon toxin with the myelin and lymphocyte (MAL) protein receptor.
- Evaluating the effects of epsilon toxin in the experimental autoimmune encephalomyelitis (EAE) model of MS.
Main Results:
- C. perfringens strains producing epsilon toxin were found significantly more often and at higher levels in the gut of MS patients compared to controls.
- MS patients showed a significantly higher prevalence of antibodies against epsilon toxin in their sera.
- Epsilon toxin targets the MAL receptor, leading to damage of the blood-brain barrier and brain cells expressing MAL.
- In the EAE model, epsilon toxin facilitated immune cell infiltration into the central nervous system, inducing an MS-like condition.
Conclusions:
- The findings provide evidence supporting a role for Clostridium perfringens epsilon toxin in the pathogenesis of multiple sclerosis.
- While suggestive, these studies do not yet meet Koch's postulates to definitively prove a causal relationship.
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