Treatment-naive patients with early multiple sclerosis had lower fecal levels of some beneficial gut bacteria than matched controls.
Evidence
This case-control fecal qPCR study compared 36 treatment-naive patients with first-attack MS against 36 matched healthy controls and found lower Bacteroides fragilis and Bifidobacterium spp., while Faecalibacterium prausnitzii was lower but not significantly different.
Caveat
Because this was a small observational single-time-point study of 72 people, it cannot show whether the microbiome differences cause MS or track its progression.
Simplified
Multiple sclerosis (MS) is a chronic, inflammatory disease of the central nervous system characterized by neuroinflammation, demyelination, and axonal damage. Recent evidence suggests that gut microbiota may play a critical role in MS pathogenesis by modulating immune responses and contributing to systemic inflammation. Alterations in the abundance of specific bacterial species, such as Bacteroides fragilis, Faecalibacterium prausnitzii, and Bifidobacterium spp., have been linked to immune dysregulation in MS. However, the role of gut microbiota in treatment-naïve patients at the earliest stages of MS remains underexplored. This case-control study, conducted from 2021 to 2023, included 36 treatment-naïve patients with MS (PwMS) who had experienced their first attack of symptoms and fulfilled McDonald's criteria, and 36 age- and sex-matched healthy controls. Stool samples were collected and analyzed using quantitative PCR (qPCR) to determine the relative abundance of Bacteroides fragilis, Faecalibacterium prausnitzii, and Bifidobacterium spp.. Statistical analyses compared bacterial abundance between groups while controlling for key demographic variables. The MS group included 9 males (25%) and 27 females (75%), with a mean age of 38.3 ± 9.5 years, compared to 39.8 ± 10.2 years in controls. PwMS exhibited significantly lower levels of Bacteroides fragilis (0.11 × 10⁹ vs. 0.22 × 10⁹ CFU, p < 0.05) and Bifidobacterium spp. (1.50 × 10⁹ vs. 1.65 × 10⁹ CFU, p < 0.05) compared to controls. Although Faecalibacterium prausnitzii levels were lower in PwMS (1.08 × 10⁹ vs. 1.27 × 10⁹ CFU), the difference was not statistically significant. These findings align with emerging evidence suggesting a potential role of in MS pathogenesis. The reduced abundance of beneficial bacteria, particularly B. fragilis and Bifidobacterium spp., may contribute to altered immune regulation and increased inflammation in PwMS. While these results contribute to our understanding of the gut-brain axis in MS and may inform future therapeutic approaches, further research, including larger longitudinal studies, is needed to clarify the complex relationship between gut microbiota and MS development and progression.
Key numbers
0.11 × 10⁹
Decrease in
in MS patients vs. controls
1.50 × 10⁹
Decrease in Bifidobacterium spp.
Bifidobacterium spp. in MS patients vs. controls
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