{"id":38881,"date":"2025-03-04T11:45:00","date_gmt":"2025-03-04T11:45:00","guid":{"rendered":"https:\/\/www.lifeandnews.com\/articles\/?p=38881"},"modified":"2025-03-04T07:46:30","modified_gmt":"2025-03-04T07:46:30","slug":"out-of-balance-bacteria-is-linked-to-multiple-sclerosis-%e2%88%92-the-ratio-can-predict-severity-of-disease","status":"publish","type":"post","link":"https:\/\/www.lifeandnews.com\/articles\/out-of-balance-bacteria-is-linked-to-multiple-sclerosis-%e2%88%92-the-ratio-can-predict-severity-of-disease\/","title":{"rendered":"Out-of-balance bacteria is linked to multiple sclerosis \u2212 the ratio can predict severity of&nbsp;disease"},"content":{"rendered":"\n<p><a href=\"https:\/\/theconversation.com\/profiles\/ashutosh-mangalam-2334587\">Ashutosh Mangalam<\/a>, <em><a href=\"https:\/\/theconversation.com\/institutions\/university-of-iowa-723\">University of Iowa<\/a><\/em><\/p>\n\n\n\n<p>Multiple sclerosis is a disease that results when the immune system mistakenly attacks the brain and spinal cord. It affects <a href=\"https:\/\/doi.org\/10.1212\/wnl.0000000000007035\">nearly one million people in the U.S.<\/a> and over <a href=\"https:\/\/doi.org\/10.1177\/1352458520970841\">2.8 million worldwide<\/a>. While genetics play a role in the risk of developing multiple sclerosis, <a href=\"https:\/\/doi.org\/10.1002\/acn3.50862\">environmental factors<\/a> such as diet, infectious disease and gut health are major contributors.<\/p>\n\n\n\n<p>The environment plays a key role in determining who develops multiple sclerosis, and this is evident from twin studies. Among identical twins who share 100% of their genes, one twin has a <a href=\"https:\/\/doi.org\/10.1056\/nejm198612253152603\">roughly 25% chance<\/a> of developing MS if the other twin has the disease. For fraternal twins who share 50% of their genes, this rate drops to around 2%.<\/p>\n\n\n\n<p>Scientists have long suspected that gut bacteria may influence a person\u2019s risk of developing multiple sclerosis. But studies so far have had <a href=\"https:\/\/doi.org\/10.1080\/19490976.2024.2387794\">inconsistent findings<\/a>.<\/p>\n\n\n\n<p>To address these inconsistencies, my colleagues and I used what researchers call a <a href=\"https:\/\/my.clevelandclinic.org\/podcasts\/neuro-pathways\/bedside-to-bench-to-bedside-the-keys-to-successful-collaboration-in-neuroscience-research\">bedside-to-bench-to-bedside<\/a> approach: starting with samples from patients with multiple sclerosis, conducting lab experiments on these samples, then confirming our findings in patients.<\/p>\n\n\n\n<p>In our newly published research, we found that the ratio of two bacteria in the gut can <a href=\"https:\/\/www.pnas.org\/cgi\/doi\/10.1073\/pnas.2413953122\">predict multiple sclerosis severity<\/a> in patients, highlighting the importance of the microbiome and gut health in this disease.<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img src=\"https:\/\/images.theconversation.com\/files\/652207\/original\/file-20250228-38-sko32o.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\" alt=\"Microscopy image of large clump of rod-like bacteria\" \/><figcaption><em>Akkermansia<\/em> is commonly found in the human gut microbiome. <a href=\"https:\/\/doi.org\/10.1111\/1751-7915.13410\">Zhang et al\/Microbial Biotechnology<\/a>, <a href=\"http:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA<\/a><\/figcaption><\/figure>\n\n\n\n<h2>Bedside to bench<\/h2>\n\n\n\n<p>First, we analyzed the chemical and bacterial gut composition of patients with multiple sclerosis, confirming that they had gut inflammation and <a href=\"https:\/\/doi.org\/10.1080\/19490976.2024.2387794\">different types of gut bacteria<\/a> compared with people without multiple sclerosis.<\/p>\n\n\n\n<p>Specifically, we showed that a group of bacteria called <em>Blautia<\/em> was more common in multiple sclerosis patients, while <a href=\"https:\/\/doi.org\/10.1017\/s0007114519000680\"><em>Prevotella<\/em>, a bacterial species<\/a> consistently linked to a healthy gut, was found in lower amounts.<\/p>\n\n\n\n<p>In a separate experiment in mice, we observed that the <a href=\"https:\/\/www.pnas.org\/cgi\/doi\/10.1073\/pnas.2413953122\">balance between two gut bacteria<\/a>, <em>Bifidobacterium<\/em> and <em>Akkermansia<\/em>, was critical in distinguishing mice with or without multiple sclerosis-like disease. Mice with multiple sclerosis-like symptoms had increased levels of <em>Akkermansia<\/em> and decreased levels of <em>Bifidobacterium<\/em> in their stool or gut lining.<\/p>\n\n\n\n<h2>Bench to bedside<\/h2>\n\n\n\n<p>To explore this further, we treated mice with antibiotics to remove all their gut bacteria. Then, we gave either <em>Blautia<\/em>, which was higher in multiple sclerosis patients; <em>Prevotella<\/em>, which was more common in healthy patients; or a control bacteria, <em>Phocaeicola<\/em>, which is found in patients with and without multiple sclerosis. We found that mice with <em>Blautia<\/em> developed more gut inflammation and <a href=\"https:\/\/www.pnas.org\/cgi\/doi\/10.1073\/pnas.2413953122\">worse multiple sclerosis-like symptoms<\/a>.<\/p>\n\n\n\n<p>Even before symptoms appeared, these mice had low levels of <em>Bifidobacterium<\/em> and high levels of <em>Akkermansia<\/em>. This suggested that an imbalance between these two bacteria might not just be a sign of disease, but could actually <a href=\"https:\/\/www.pnas.org\/cgi\/doi\/10.1073\/pnas.2413953122\">predict how severe<\/a> it will be.<\/p>\n\n\n\n<p>We then examined whether this same imbalance appeared in people. We measured the ratio of <em>Bifidobacterium adolescentis<\/em> and <em>Akkermansia muciniphila<\/em> in samples from multiple sclerosis patients in Iowa and <a href=\"https:\/\/doi.org\/10.1016\/j.cell.2022.08.021\">participants in a study<\/a> spanning the U.S., Latin America and Europe.<\/p>\n\n\n\n<p>Our findings were consistent: Patients with multiple sclerosis had a lower ratio of <em>Bifidobacterium<\/em> to <em>Akkermansia<\/em>. This imbalance was not only linked to having multiple sclerosis but also with worse disability, making it a stronger predictor of disease severity than any single type of bacteria alone.<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img src=\"https:\/\/images.theconversation.com\/files\/652204\/original\/file-20250228-32-hj7pci.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\" alt=\"Microscopy image of clusters of rod bacteria\" \/><figcaption><em>Bifidobacterium<\/em> both produces and consumes mucin, a glycoprotein that protects the gut lining. <a href=\"https:\/\/www.flickr.com\/photos\/92803392@N02\/9511080418\">Paola Mattarelli and Monica Modesto\/Katz Lab via Flickr<\/a>, <a href=\"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/\">CC BY-NC<\/a><\/figcaption><\/figure>\n\n\n\n<h2>How \u2018good\u2019 bacteria can become harmful<\/h2>\n\n\n\n<p>One of the most interesting findings from our study was that normally beneficial bacteria can turn harmful in multiple sclerosis. <em>Akkermansia<\/em> is usually considered a helpful bacterium, but it became problematic in patients with multiple sclerosis.<\/p>\n\n\n\n<p>A previous study in mice showed a <a href=\"https:\/\/doi.org\/10.1080\/19490976.2022.2127446\">similar pattern<\/a>: Mice with severe disease had a lower <em>Bifidobacterium<\/em>-to-<em>Akkermansia<\/em> ratio. In that study, mice fed a diet rich in phytoestrogens \u2013 chemicals structurally similar to human estrogen that need to be broken down by bacteria for beneficial health effects \u2013 developed milder disease than those on a diet without phytoestrogens. Previously we have shown that people with multiple sclerosis lack gut bacteria that can metabolize phytoestrogen.<\/p>\n\n\n\n<p>Although the precise mechanisms behind the link between the <em>Bifidobacterium<\/em>-to- <em>Akkermansia<\/em> ratio and multiple sclerosis is unknown, researchers have a theory. Both types of bacteria consume <a href=\"https:\/\/theconversation.com\/slime-is-all-around-and-inside-you-new-research-on-its-origins-offers-insight-into-genetic-evolution-189278\">mucin, a substance<\/a> that protects the gut lining. However, <em>Bifidobacterium<\/em> both <a href=\"https:\/\/doi.org\/10.1038\/s41598-022-11819-z\">eats and produces mucin<\/a>, while <em>Akkermansia<\/em> only consumes it. When <em>Bifidobacterium<\/em> levels drop, such as during inflammation, <em>Akkermansia<\/em> overconsumes mucin and weakens the gut lining. This process can trigger more inflammation and potentially contribute to the progression of multiple sclerosis.<\/p>\n\n\n\n<p>Our finding that the <em>Bifidobacterium<\/em>-to-<em>Akkermansia<\/em> ratio may be a key marker for multiple sclerosis severity could help improve diagnosis and treatment. It also highlights how losing beneficial gut bacteria can allow other gut bacteria to become harmful, though it is unclear whether changing levels of certain microbes can affect multiple sclerosis.<\/p>\n\n\n\n<p>While more research can help clarify the link between the gut microbiome and multiple sclerosis, these findings offer a promising new direction for understanding and treating this disease.<\/p>\n\n\n\n<p><a href=\"https:\/\/theconversation.com\/profiles\/ashutosh-mangalam-2334587\">Ashutosh Mangalam<\/a>, Associate Professor of Pathology, <em><a href=\"https:\/\/theconversation.com\/institutions\/university-of-iowa-723\">University of Iowa<\/a><\/em><\/p>\n\n\n\n<p>This article is republished from <a href=\"https:\/\/theconversation.com\">The Conversation<\/a> under a Creative Commons license. Read the <a href=\"https:\/\/theconversation.com\/out-of-balance-bacteria-is-linked-to-multiple-sclerosis-the-ratio-can-predict-severity-of-disease-251020\">original article<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ashutosh Mangalam, University of Iowa Multiple sclerosis is a disease that results when the immune system mistakenly attacks the brain and spinal cord. It affects nearly one million people in the U.S. and over 2.8 million worldwide. While genetics play a role in the risk of developing multiple sclerosis, environmental factors such as diet, infectious [&hellip;]<\/p>\n","protected":false},"author":56,"featured_media":38882,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[292,15306,42,827,10,15533],"tags":[5042,1070,4808,16096,1074,2725,885,891,886,860,5273,2853,13078,5714,15373],"_links":{"self":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/38881"}],"collection":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/users\/56"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/comments?post=38881"}],"version-history":[{"count":1,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/38881\/revisions"}],"predecessor-version":[{"id":38883,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/38881\/revisions\/38883"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media\/38882"}],"wp:attachment":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media?parent=38881"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/categories?post=38881"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/tags?post=38881"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}