Study under review: Clinical and metabolic response to probiotic supplementation in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled trial
Multiple sclerosis (MS) is a progressive autoimmune disease in which the immune system attacks the central nervous system (CNS), causing brain lesions and neurological degeneration.Severity and progression can vary greatly from case to case. In relapsing-remitting multiple sclerosis (RRMS), patients experience an acute attack on neurological function followed by a period of recovery. Recovery is partial and each attack contributes to the progression of disability in the disease. Incidence of the illness varies across the globe: two in 100,000 in Japan, to over 100 in 100,000 in North America, and 43.8 in 100,000 in Iran, where this study took place.
While there are theories that MS prevalence is related to lifestyle factors, such as vitamin D status, other researchers have examined the disease through the lens of the “hygiene hypothesis”, the popular idea that modern society’s germophobia and obsession with sanitation have caused immune systems to overreact and develop allergies or autoimmunity.
Some researchers believe that humans have altered the natural environment for the billions of bacteria living in our guts in a quest for cleanliness. It is possible that this altered microbiome is associated with the increase in some autoimmune diseases that has been observed over the past half century.
Further, it has been established that there is a gut-brain connection between microbiota and the CNS, and cross-talk between them affects everything from food intake to mood. Researchers have also shown a clear link between manipulation of gut microbiota in mice and the development and progression of experimental autoimmune encephalomyelitis (EAE), a disease induced in mice to study CNS inflammation and degeneration similar to that experienced by humans with MS. As shown in Figure 1, germ-free mice and those treated with antibiotics experience delayed onset of EAE. Additionally, mice fed oral probiotics experience varying effects on disease progression, both beneficial and harmful, depending on the strain.
Reference: Wang, Y, Kasper, L. Brain Behav Immun. 2014 May.
However, successful pharmacological mouse treatments extended to human trials have had mixed results. While a few were effective, some exacerbated illness in test patients. So, even effective probiotic supplementation in animal studies requires follow-up in human studies, a task that had not been previously accomplished. This study attempted to measure how probiotic supplementation affected progression and inflammation in RRMS.
Incidence of autoimmune diseases, such as MS, are increasing across the globe. Many researchers believe autoimmunity may be linked to changes in the gut microbiome. The study under review attempted to discern whether probiotic supplementation could affect systemic inflammation or alter the progression of RRMS. Secondary outcomes included examining metabolic factors, such as insulin resistance, and mental health parameters.
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Other Articles in Issue #25 (November 2016)
Interview: Jasmina Aganovic
How much do you know about the bacteria that live on your skin? Whether or not you have skin issues, this interview is worth a look.
Skip breakfast, lose fat?
The most popular type of intermittent fasting among people who lift weights seems to be a 16 hour fast, followed by an 8 hour eating window. This is the first trial to test that protocol in a trained population.
Milkshakes and insulin resistance: the perfect storm
There's a lot to be learned about how insulin resistance develops. This highly controlled study tested a saturated fat binge, in order to isolate its effects on glucose levels and insulin resistance.
Starches last for better blood glucose
Advice for blood sugar regulation ranges from "eat a balanced diet" to "beware carbs!". Macros and foods aside, could switching up the order in which you eat the same foods impact blood sugar?
A second look at protein quantity after exercise
Do muscular people require more protein after lifting? How much protein is needed to optimize muscle protein synthesis after a workout? This trial addressed both questions.
New data on vitamin D safety
Vitamin D supplementation would appear to have a pristine safety record, at least at first glance. This meta-analysis takes another look at that issue, specifically at potential effects on excessive calcium levels.
Interview: Julianne Taylor
Julianne is a New Zealand based nutritionist with a particular interest in autoimmune disease. Here, we pick her brain on what she’s found about the diet-disease connection. Julianne first trained as a registered general and obstetric nurse. She then retrained as a furniture designer, followed by a post-graduate diploma in design for disability in London. Back in NZ in the 1990’s Julianne designed, made, and fitted custom wheelchair seats and other aids for people with extreme physical disabilities.