Becker Anouck, Abuazab Mosab, Schwiertz Andreas, Walter Silke, Faßbender Klaus C, Fousse Mathias, Unger Marcus M
Department of Neurology, Saarland University, Kirrberger Str. 100, 66421, Homburg, Germany.
Klinik für Neurologie, Gesundheitszentrum Glantal, Liebfrauenberg 32, 55590, Meisenheim, Germany.
Auto Immun Highlights. 2021 Apr 7;12(1):7. doi: 10.1186/s13317-021-00149-1.
Multiple Sclerosis (MS) is an autoimmune-mediated disease of the central nervous system. Experimental data suggest a role of intestinal microbiota and microbial products such as short-chain fatty acids (SCFAs) in the pathogenesis of MS. A recent clinical study reported beneficial effects (mediated by immunomodulatory mechanisms) after oral administration of the SCFA propionate in MS patients. Based on available evidence, we investigated whether SCFAs and the fecal inflammation marker calprotectin are altered in MS.
76 subjects (41 patients with relapsing-remitting MS and 35 age-matched controls) were investigated in this case-control study. All subjects underwent clinical assessment with established clinical scales and provided fecal samples for a quantitative analysis of fecal SCFA and fecal calprotectin concentrations. Fecal markers were compared between MS patients and controls, and were analyzed for an association with demographic as well as clinical parameters.
Median fecal calprotectin concentrations were within normal range in both groups without any group-specific differences. Fecal SCFA concentrations showed a non-significant reduction in MS patients compared to healthy subjects. Female subjects showed significantly reduced SCFA concentrations compared to male subjects.
In our cohort of MS patients, we found no evidence of an active intestinal inflammation. Yet, the vast majority of the investigated MS patients was under immunotherapy which might have affected the outcome measures. The sex-associated difference in fecal SCFA concentrations might at least partially explain female predominance in MS. Large-scale longitudinal studies including drug-naïve MS patients are required to determine the role of SCFAs in MS and to distinguish between disease-immanent effects and those caused by the therapeutic regime.
多发性硬化症（MS）是一种由自身免疫介导的中枢神经系统疾病。实验数据表明肠道微生物群和微生物产物如短链脂肪酸（SCFAs）在MS发病机制中发挥作用。最近一项临床研究报告称，MS患者口服SCFA丙酸酯后有有益效果（由免疫调节机制介导）。基于现有证据，我们研究了MS患者中SCFAs和粪便炎症标志物钙卫蛋白是否发生改变。
在这项病例对照研究中，对76名受试者（41例复发缓解型MS患者和35名年龄匹配的对照者）进行了调查。所有受试者均使用既定的临床量表进行临床评估，并提供粪便样本以定量分析粪便SCFA和粪便钙卫蛋白浓度。比较MS患者和对照者的粪便标志物，并分析其与人口统计学以及临床参数的相关性。
两组的粪便钙卫蛋白浓度中位数均在正常范围内，无任何组间特异性差异。与健康受试者相比，MS患者的粪便SCFA浓度呈非显著性降低。女性受试者的SCFA浓度显著低于男性受试者。
在我们的MS患者队列中，未发现肠道有活动性炎症的证据。然而，绝大多数接受调查的MS患者正在接受免疫治疗，这可能影响了结果指标。粪便SCFA浓度的性别差异可能至少部分解释了MS中女性占主导地位的现象。需要开展包括未接受过药物治疗的MS患者在内的大规模纵向研究，以确定SCFAs在MS中的作用，并区分疾病内在效应和治疗方案所导致的效应。
