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Gut Microbiota in Multiple Sclerosis
  1. Brandi L. Cantarel, PhD*†,
  2. Emmanuelle Waubant, MD, PhD,
  3. Christel Chehoud§,
  4. Justin Kuczynski, PhD§,
  5. Todd Z. DeSantis, MSc§,
  6. Janet Warrington, PhD§,
  7. Arun Venkatesan, MD, PhD,
  8. Claire M. Fraser, PhD†¶,
  9. Ellen M. Mowry, MD, MCR
  1. From the *Baylor Institute for Immunology Research, Baylor Health, Dallas, TX; †Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD; ‡Department of Neurology, UCSF School of Medicine, San Francisco; and §Second Genome Inc, South San Francisco, CA; and ∥Department of Neurology, Johns Hopkins University School of Medicine; and ¶Department of Medicine, University of Maryland School of Medicine, Baltimore, MD.
  1. Received July 28, 2014, and in revised form December 28, 2014.
  2. Accepted for publication February 6, 2015.
  3. The study was funded by NIH K23 NS067055 (to E.M.M.) and an Irene Perstein Award (to E.M.M.).
  4. E.M.M. is currently receiving free glatiramer acetate in support of the conduct of a clinical trial, and some of the authors (C.C., J.K., T.Z.D., and J.W.) are employees of Second Genome, Inc.
  5. Reprints: Ellen M. Mowry, MD, MCR, The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287. E-mail: emowry1{at}
  6. Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal’s Web site (

Possible Influence of Immunomodulators


Objectives Differences in gut bacteria have been described in several autoimmune disorders. In this exploratory pilot study, we compared gut bacteria in patients with multiple sclerosis and healthy controls and evaluated the influence of glatiramer acetate and vitamin D treatment on the microbiota.

Methods Subjects were otherwise healthy white women with or without relapsing-remitting multiple sclerosis who were vitamin D insufficient. Patients with multiple sclerosis were untreated or were receiving glatiramer acetate. Subjects collected stool at baseline and after 90 days of vitamin D3 (5000 IU/d) supplementation. The abundance of operational taxonomic units was evaluated by hybridization of 16S rRNA to a DNA microarray.

Results While there was overlap of gut bacterial communities, the abundance of some operational taxonomic units, including Faecalibacterium, was lower in patients with multiple sclerosis. Glatiramer acetate–treated patients with multiple sclerosis showed differences in community composition compared with untreated subjects, including Bacteroidaceae, Faecalibacterium, Ruminococcus, Lactobacillaceae, Clostridium, and other Clostridiales. Compared with the other groups, untreated patients with multiple sclerosis had an increase in the Akkermansia, Faecalibacterium, and Coprococcus genera after vitamin D supplementation.

Conclusions While overall bacterial communities were similar, specific operational taxonomic units differed between healthy controls and patients with multiple sclerosis. Glatiramer acetate and vitamin D supplementation were associated with differences or changes in the microbiota. This study was exploratory, and larger studies are needed to confirm these preliminary results.

Key Words
  • multiple sclerosis
  • gut microbiome
  • vitamin D
  • glatiramer acetate
  • autoimmunity

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