The Disease Course of Multiple Sclerosis May be Modulated by the Gut Microbiome

Abstract

Multiple sclerosis is a chronic neurological and autoimmune disorder with unpredictable disease progression, often leading to physical impairment and cognitive decline. Multiple sclerosis can be categorized into three subtypes–relapsing-remitting, secondary progressive, and primary progressive–each defined by different symptom patterns and rates of progression. Individuals with multiple sclerosis often exhibit gut microbiome dysbiosis and alterations in its functional profile. However, the role of the gut microbiome in shaping disease course and progression remains poorly understood. Using data from the International Multiple Sclerosis Microbiome Study, we investigated differences between the three multiple sclerosis subtypes through the lens of the gut microbiome. While no significant differences were observed at the community level based on alpha and beta diversity metrics, unique species were identified in the individual subtypes. Notably, proinflammatory core microbes, Holdemanella porci and Segatella copri, were prevalent in primary and secondary progressive individuals, while inflammatory suppressors were observed at lower abundance in primary and relapsing-remitting subtypes. These species may contribute to the differences in metabolic pathways of the gut microbiome, particularly those involved in depleted metabolic function, which may have an influence on disease course and progression. Our findings provide additional insight into the underlying mechanisms driving the disease course of multiple sclerosis.