Servei de Neurologia-Neuroimmunologia, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Centre d'Esclerosi Múltiple de Catalunya, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Universitat Autònoma de Barcelona, 08193, Bellaterra Cerdanyola del Vallès, Spain.
Neurotherapeutics. 2021 Apr;18(2):920-937. doi: 10.1007/s13311-021-01016-7. Epub 2021 Apr 7.
Gut microbiome studies in multiple sclerosis (MS) patients are unravelling some consistent but modest patterns of gut dysbiosis. Among these, a significant decrease of Clostridia cluster IV and XIVa has been reported. In the present study, we investigated the therapeutic effect of a previously selected mixture of human gut-derived 17 Clostridia strains, which belong to Clostridia clusters IV, XIVa, and XVIII, on the clinical outcome of experimental autoimmune encephalomyelitis (EAE). The observed clinical improvement was related to lower demyelination and astrocyte reactivity as well as a tendency to lower microglia reactivity/infiltrating macrophages and axonal damage in the central nervous system (CNS), and to an enhanced immunoregulatory response of regulatory T cells in the periphery. Transcriptome studies also highlighted increased antiinflammatory responses related to interferon beta in the periphery and lower immune responses in the CNS. Since Clostridia-treated mice were found to present higher levels of the immunomodulatory short-chain fatty acid (SCFA) butyrate in the serum, we studied if this clinical effect could be reproduced by butyrate administration alone. Further EAE experiments proved its preventive but slight therapeutic impact on CNS autoimmunity. Thus, this smaller therapeutic effect highlighted that the Clostridia-induced clinical effect was not exclusively related to the SCFA and could not be reproduced by butyrate administration alone. Although it is still unknown if these Clostridia strains will have the same effect on MS patients, gut dysbiosis in MS patients could be partially rebalanced by these commensal bacteria and their immunoregulatory properties could have a beneficial effect on MS clinical course.
肠道微生物组研究在多发性硬化症(MS)患者中揭示了一些一致但适度的肠道失调模式。其中,报道了梭菌属簇 IV 和 XIVa 的显著减少。在本研究中,我们研究了先前选择的混合 17 株人肠道来源的梭菌的治疗效果,这些菌株属于梭菌属簇 IV、XIVA 和 XVIII,对实验性自身免疫性脑脊髓炎(EAE)的临床结果。观察到的临床改善与较低的脱髓鞘和星形胶质细胞反应以及较低的小胶质细胞反应/浸润巨噬细胞和中枢神经系统(CNS)中的轴突损伤以及外周调节性 T 细胞的免疫调节反应增强有关。转录组研究还强调了外周干扰素β相关的抗炎反应增加和中枢神经系统免疫反应降低。由于在接受梭菌治疗的小鼠中发现血清中具有更高水平的免疫调节短链脂肪酸(SCFA)丁酸盐,因此我们研究了单独给予丁酸盐是否可以复制这种临床效果。进一步的 EAE 实验证明了其对中枢神经系统自身免疫的预防但轻微的治疗作用。因此,这种较小的治疗效果强调,梭菌诱导的临床效果并非完全与 SCFA 相关,并且不能单独通过丁酸盐给药来复制。尽管尚不清楚这些梭菌菌株是否会对 MS 患者产生相同的效果,但 MS 患者的肠道失调可以通过这些共生细菌部分重新平衡,并且它们的免疫调节特性可能对 MS 临床病程产生有益影响。