Microbiota modulation by teriflunomide therapy in people with multiple sclerosis: An observational case-control study

Laura Moles1, Ane Otaegui-Chivite1, Miriam Gorostidi-Aicua1

  • 1Biogipuzkoa Health Research Institute, Group of Neuroimmunilogy, San Sebastián, Spain; Center for Biomedical Research Network in Neurodegenerative Diseases (CIBER-CIBERNED-ISCIII), Madrid, Spain.

Insights

Multiple sclerosis (MS) gut microbiota is altered, with teriflunomide (TF) treatment impacting microbial composition. This dysbiosis correlates with MS symptoms like fatigue, anxiety, and depression.

Area of Science:

  • Neuroimmunology
  • Microbiome Research
  • Pharmacology

Background:

  • Multiple sclerosis (MS) is a chronic, immune-mediated neurological disorder.
  • Gut microbiota alterations are increasingly recognized in people with MS (pwMS).
  • Identifying specific microbial links to MS symptoms and treatment effects remains challenging.

Purpose of the Study:

  • To characterize the gut microbiota composition and function in pwMS.
  • To compare microbiota profiles across different treatment groups: teriflunomide (TF), beta interferons (IFNβ), naïve (no prior disease-modifying therapies), and healthy controls.
  • To investigate the association between gut microbiota dysbiosis and MS-related symptoms.

Main Methods:

  • Comparative analysis of gut microbiota in pwMS and healthy controls.
  • Assessment of microbiota in pwMS undergoing different disease-modifying therapies (TF, IFNβ, naïve).
  • Correlation analysis between microbial features and clinical symptoms (fatigue, anxiety, depression).

Main Results:

  • Significant alterations in gut microbiota composition and function were observed in pwMS compared to controls.
  • Teriflunomide (TF) treatment notably impacted the gut microbiota profile in pwMS.
  • Gut microbial dysbiosis was associated with increased fatigue, anxiety, and depression in pwMS.

Conclusions:

  • Gut microbiota is significantly altered in MS and influenced by disease-modifying therapies like teriflunomide.
  • Teriflunomide exerts a distinct effect on the gut microbial environment.
  • Microbiota dysbiosis in the gut is linked to key symptoms experienced by people with MS.

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