Associations of the gut microbiota with inflammatory disease activity in multiple sclerosis

Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system characterized by a wide clinical heterogeneity. Recent advances indicate a role for the gut microbial community, the so-called gut microbiota, in MS. Via the gut-brain axis, a bidirectional communication system involving immune, neural, metabolic, and endocrine pathways between the gut and the brain, the gut microbiota have the potential to influence neuronal activity and inflammatory processes. This project will study the associations between the gut microbiota and inflammatory disease activity in MS through the use of metagenomics, and clinical, immunological, and radiological observations. First, microbes and microbial features related to inflammation in MS will be identified in a pre-recruited cohort of patients with several well-defined MS phenotypes, which are characterized by different levels of inflammation. Then, a prospective study in early onset MS patients will investigate whether changes in gut microbiota properties are related to inflammatory disease activity in MS. Subsequently, a dietary intervention trial in a cross over design in active relapsing MS patients will focus on fatigue severity and investigate whether potential dietary effects can be explained by changes in the microbial features of the gut. Finally, to move beyond associations and towards the development of microbiota-based interventions, cultures of target bacteria will be developed.