Gut microbiome of multiple sclerosis patients and paired household healthy controls reveal associations with disease risk and course

Researchers identified significant differences in microbial composition between MS patients and their household controls, despite no significant difference in alpha-diversity. Specific taxa, such as Akkermansia muciniphila and various Ruthenibacterium species, were increased in untreated MS, while Faecalibacterium prausnitzii and several Blautia species were decreased. Functionally, MS patients showed an over-representation of the phytate degradation pathway, whereas pyruvate-producing pathways were notably reduced.

The study also revealed that DMTs act as significant drivers of microbial change. Different therapies, such as interferon-beta, dimethyl fumarate, and fingolimod, each induced distinct signatures in microbial taxa and metabolic output. For instance, interferon-beta was associated with increased serum propionic acid, a finding linked to the potential upregulation of short-chain fatty acid transporters. Importantly, the research suggests that disease status exerts a more profound effect on the overall gut microbiome than the specific treatments themselves.

This large-scale, multi-center study clarifies the complex relationship between the gut microbiome and MS, distinguishing disease-specific microbial shifts from treatment-related effects. By providing a comprehensive reference dataset and identifying specific functional metabolic pathways linked to disease progression, these findings offer a new framework for investigating microbial-based therapeutic interventions and personalized approaches to managing MS.