Eat SH1 MouseDoc, it is the microbiome! Is this a new supplement to try?

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About time we posted on something other than COVID-F-ing-19, so whilst we are all hunting to zinc, panty liners, gloves, etc, something else to add to the shopping list…Only joking.

I admit it, I have not been following the microbiome as the major hope in MS, as I see it as a modifier, at best. At worst…Em. Whilst I don’t want to be a lemming rooting through your SH1 to find the answer, many others are doing so. I keep an open mind. So here is a study arguing why I should want to do it.

Propionic acid is a naturally occurring carboxylic acid that it is a liquid with a pungent and unpleasant smell somewhat resembling body odor.

Propionic acid is produced biologically as its coenzyme A ester, propionyl-CoA, from the metabolic breakdown of fatty acids containing odd numbers of carbon atoms, and also from the breakdown of some amino acidsBacteria of the genus Propionibacterium produce propionic acid as the end-product of their anaerobic metabolism. This class of bacteria is commonly found in the stomachs of ruminants (cows) and the sweat glands of humans, and their activity is partially responsible for the odor of both Swiss cheese and sweat. It is also biosynthesized in the large intestine of humans by bacterial fermentation of dietary fibre .

In this study they gave people PA and it increased T regulatory cells and the rest is history….A study in MS as a stand alone and then an add on study and MS was apparently inhibited compared to other people with DMT.

They supplemented with a 1g ( 2 x 500mg) a day in rheumatoid arthritis. Treg cell amounts increased significantly by about 45% after 14 days and by 72% after 28 days on oral PA supplementation. In this study the show an increase from about 2.5% to 5% in MS in 2 weeks. They looked at relapse rate with long term treatment as an add on and this dropped in people supplemented with PA (in addition to their DMT…CRAB and DMF). This was well-tolerated with a few people having gas and abit of nausea.

Then they did a bit of science to report it worked via an IL-10 dependent mechanism. After all what else could it be in this day an age? Yep it inhibited Th17, although this was less compelling. Then they did a gene array study as all good Cell papers do. All fancy stuff thay get my juices going, but I am sure you are not interested in, so I am not going to try explain. So I suspect you will all be off down the health food shop. However, until we see a properly controlled, randomised study there is no guarentee that this supplement will be of real benefit and remember a thing called regression to the mean, where things tend to get better.

Anyway let’s look forward to it being repeated and extended.

Also this is not Feacal transplantation so I will stay of the SH1 for now

Propionic Acid Shapes the Multiple Sclerosis Disease Course by an Immunomodulatory Mechanism. Duscha A, Gisevius B, Hirschberg S, Yissachar N, Stangl GI, Eilers E, Bader V, Haase S, Kaisler J, David C, Schneider R, Troisi R, Zent D, Hegelmaier T, Dokalis N, Gerstein S, Del Mare-Roumani S, Amidror S, Staszewski O, Poschmann G, Stühler K, Hirche F, Balogh A, Kempa S, Träger P, Zaiss MM, Holm JB, Massa MG, Nielsen HB, Faissner A, Lukas C, Gatermann SG, Scholz M, Przuntek H, Prinz M, Forslund SK, Winklhofer KF, Müller DN, Linker RA, Gold R, Haghikia A. Cell. 2020 Mar 5. pii: S0092-8674(20)30212-9. doi: 10.1016/j.cell.2020.02.035. [Epub ahead of print]

Short-chain fatty acids are processed from indigestible dietary fibers by gut bacteria and have immunomodulatory properties. Here, we investigate propionic acid (PA) in multiple sclerosis (MS), an autoimmune and neurodegenerative disease. Serum and faeces of subjects with MS exhibited significantly reduced PA amounts compared with controls, particularly after the first relapse. In a proof-of-concept study, we supplemented PA to therapy-naive MS patients and as an add-on to MS immunotherapy. After 2 weeks of PA intake, we observed a significant and sustained increase of functionally competent regulatory T (Treg) cells, whereas Th1 and Th17 cells decreased significantly. Post-hoc analyses revealed a reduced annual relapse rate, disability stabilization, and reduced brain atrophy after 3 years of PA intake. Functional microbiome analysis revealed increased expression of Treg-cell-inducing genes in the intestine after PA intake. Furthermore, PA normalized Treg cell mitochondrial function and morphology in MS. Our findings suggest that PA can serve as a potent immunomodulatory supplement to MS drugs.

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MouseDoctor

2 comments

  • Well, there seems to be something peculiar about the MS gut. But why would PA be wanting in PwMS? Wrong bacteria chewing up all that fibre? Genes predispose us to faulty metabolic breakdown? We aren’t drinking enough cow juices, ewww? All thoughts eagerly digested ….

  • Just to say, this is the best title EVER. Brightened up my day. And thank you for sharing microbiome stuff, even though you’re not a fan, shows integrity, I massively respect that.

    A point: even if the microbiome ‘only’ moderates the MS, worth it no?

    In it’s current state at least, it’s not a case of making moves to impact the microbiome OR take a DMD. Consider it an add-on, in the same way as neuroprotectors are add-ons.

    And from current research, improving people’s microbiomes has potential not just for MS, but a myriad of different diseases and conditions. So making your microbiome happy is potentially a win-win. (See effects of Symprove probiotic in clinical trials).

    My 2-pence: I’m not expecting a quick ‘single bullet’ in the form of these supplements, but instead I expect treatment in the future to comprise of personalised steps, which involves understanding an individual’s current microbiome, and then tailoring treatments based on this – we already know individual’s microbiomes can be VERY different, so a single treatment in the form of a pill is unlikely to show a uniform improvement no?
    Any trials done honing into 1 single treatment without understanding the variability in microbiome health is unlikely to show a ‘magic bullet’ imo.

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