Probiotics the Immune system and Multiple Sclerosis.

Over the past 20 years many studies have been conducted investigating the link between Gut bacteria and the immune system [1]. The gut microbiota helps us remain healthy by regulating various functions, including food metabolism, energy homeostasis, maintenance of the intestinal barrier, inhibition of colonization by pathogenic organisms, and shaping of both mucosal and systemic immune responses. Throughout the twentieth century, the incidence of MS (and other autoimmune and allergic diseases) has increased in developed countries; a phenomenon that correlates inversely with the incidence of infectious diseases such as measles and polio [2]. This observation led to development of the “hygiene hypothesis” according to which individuals who live in cleaner environments (developed countries where there is a strong emphasis on personal hygiene) have little exposure to orofecal microbes at an early age and are thus more likely to develop allergic and autoimmune diseases [2, 3].

While the microbiome provides numerous nutritional benefits to the host [4], including synthesizing vitamins and short chain-fatty acids (SCFAs), the presence of the microbiome is also vitally important for the development and functionality of the intestinal immune system.

Advancements in DNA sequencing technology, have led to remarkable progress in our understanding of the roles of the gut microbiota in autoimmune diseases [1]. Over the past 10 years a huge number of papers have been published investigating the link between gut microbiotica and autoimmune diseases. Recently published in Cell Reports was a study [5] reporting the human gut is colonized by a large number of microorganisms (1013 bacteria) that support various physiologic functions. Distress to gut micro biome can lead to the development of inflammatory diseases, such as multiple sclerosis (MS). Therefore, gut bacteria might provide promising therapeutic options for treating MS and other diseases. In particular this study looked at a particular bacteria, Prevotella histicola, which can suppress experimental autoimmune inflammation in the brain and central nervous system. The study provides evidence that the administration of gut bacteria may regulate a systemic immune response and may, therefore, have a possible role in treatment strategies for MS and other autoimmune diseases.

Differences in gut microbiome between PwMS and other health individuals has been shown to exist [6,7]. Mangalam led a study [6] published last year that found patients with MS have a distinct microbiota from healthy peers. Specifically, he found patients with MS had lower levels of “good” bacteria, such as that found in foods like soybeans and flaxseed. Claudia Cantoni et al [8] identified a number of gut micro-biota decreased in MS patients compared to healthy controls, and microbiota positively or negatively correlated with degree of disability in MS patients.

In a comparison [9] of PwMS and Healthy individuals two species were more abundant and 19 were less abundant in the micro- biota of MS subjects than in that of Healthy Control subjects. The 16S-based taxonomic assignment of the 21 species revealed that 4 species were assigned to the phylum Bacteroidetes, 1 was assigned to Actinobacteria, 1 was assigned to Proteobacteria, and 15 were assigned to Firmicutes. A more recent re-evaluation [10] of ten existing studies from a total of 152 identified entries, four trials were included using the same markers. An additional six studies with the same structure and different markers were also systematically re- viewed. From this it was concluded that probiotic supplementation can improve disease progression, suppress depression, and improve general health in MS patients.


Take aways

  • Our modern lifestyle is contributing to and increase in autoimmune diseases such as MS
  • Differences in gut microbiome between PwMS and healthy individuals exists
  • Probiotic supplementation can effect disease progression and disability in PwMS

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  1. Samantha N. Freedman, et al. The “Gut Feeling”: Breaking Down the Role of Gut Microbiome in Multiple Sclerosis. Neurotherapeutics (2018) 15:109–125
  2. Rook, G.A. Hygiene hypothesis and autoimmune diseases. Clin Rev Allergy Immunol 42, 5-15 (2012).
  3. Floreani, A., Leung, P.S. & Gershwin, M.E. Environmental Basis of Autoimmunity. Clin Rev Allergy Immunol 50, 287-300 (2016).
  4. McDermott, A. J. & Huffnagle, G. B. The microbiome and regulation of mucosal immunity. Immunology 142, 24–31 (2014).
  5. Mangalam et al., 2017, Cell Reports 20, 1269–1277 August 8, 2017 a 2017 The Author(s).
  6. Multiple sclerosis patients have a distinct gut microbiotica compared to health controls. Jun Chen, Nicholas Chia, et al. Scientific RepoRts | 6:28484 | DOI: 10.1038/srep28484
  7. Jangi, S., Gandhi, R., Cox, L. et al. Alterations of the human gut microbiome in multiple sclerosis. Nat Commun 7, 12015 (2016).
  8. Alteration of host-gut microbiome interactions in multiple sclerosis. Claudia Cantoni et al. eBioMedicine 2022;76: 103798 Published online 27 January 2022 ebiom.2021.103798
  9. Miyake S, Kim S, Suda W, Oshima K, Nakamura M, Matsuoka T, et al. (2015) Dysbiosis in the Gut Microbiota of Patients with Multiple Sclerosis, with a Striking Depletion of Species Belonging to Clostridia XIVa and IV Clusters. PLoS ONE 10(9): e0137429. doi:10.1371/journal.pone.0137429
  10. Mirashrafi S, Hejazi Taghanaki SZ, Sarlak F, Moravejolahkami AR, Hojjati Kermani MA, Haratian M. Effect of probiotics supplementation on disease progression, depression, general health, and anthropometric measurements in relapsing-remitting multiple sclerosis patients: A systematic review and meta-analysis of clinical trials. Int J Clin Pract. 2021;75:e14724. 


Probiotics: determinants of survival and growth in the gut.

Take Porbiotic Supplements after food when stomach pH is at its highest.

Anatoly Bezkorovainy

Viability, as expected, depended on the pH, the length of the exposure to acid, and the species and strains used.

Here’s a good overview, but they are pushing their technology.

Stomach pH

As with most questions that pertain to human anatomy there is a lot of natural variation. The normal human stomach has a pH which can range from approximately 1-3 but is usually closer to 2. When there is food in the stomach the pH can raise to as high as 4-5. After the food leaves the stomach bicarbonate ions are secreted to neutralize and alkalinize the mixture. The pH of the small intestine is approximately 8.

Here’s another good overview, but remember different strains have different tolerances to pH

Toughest strains are Lactobacillus and Bifidobacteria, and there are several different species of each.

According to U.K. food microbiologist Glenn Gibson, quoted in a 2008 story in "The Sunday Times," only highly resistant bacteria such as lactobacillus and bifidobacteria can survive stomach acid.