https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8355737/
https://archive.is/CRTpt
Review: The Nutritional Management of Multiple Sclerosis With Propionate (potential cure: Sodium propionate!)
Abstract
Over the last 15 years there has been an accumulation of data supporting the concept of a gut-brain axis whereby dysbiosis of the gut microbiota can impact neurological function. Such dysbiosis has been suggested as a possible environmental exposure triggering multiple sclerosis (MS). Dysbiosis has been consistently shown to result in a reduction in short-chain fatty acid (SCFA) producing bacteria and a reduction in stool and plasma levels of propionate has been shown for MS patients independent of disease stage and in different geographies. A wealth of evidence supports the action of propionate on T-cell activity, resulting in decreased T-helper cell 1 (Th1) and T-helper cell 17 (Th17) numbers/activity and increased regulatory T cell (Treg cell) numbers/activity and an overall anti-inflammatory profile. These different T-cell populations play various roles in the pathophysiology of MS. A recent clinical study in MS patients demonstrated that supplementation of propionate reduces the annual relapse rate and slows disease progression. This review discusses this data and the relevant mechanistic background and discusses whether taming of the overactive immune system in MS is likely to allow easier bacterial and viral infection.
MS and the Gut-Brain Axis
Evidence of the gross pathophysiological effect of the gut content that may apply to MS has been demonstrated through fecal transplant studies.
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Propionate Deficiency in MS Patients
Five studies show that patients with MS have low levels of propionate in both feces and plasma (15–19).All 5 studies show that propionate levels in both feces and plasma are lower than those of healthy controls but there is less certainty for the other SCFAs, acetate and butyrate. Zeng et al. reported reduced fecal levels of all SCFAs in Chinese patients with MS compared to healthy controls (15). Interestingly the microbiota profile and level of SCFAs in feces were not affected by dietary and health habits (e.g., vegetarianism, physical activity, smoking, and alcohol intake), indicating that this pattern of dysbiosis may be a result of MS itself.
Park et al. assessed plasma SCFA levels in US patients with chronic MS (secondary progressive disease) and found significant reductions in acetate, propionate and butyrate (18). Duscha et al. measured SCFA levels in German patients with relapsing remitting MS (RRMS) and secondary progressive MS (SPMS) and found decreased propionate in plasma and feces for both MS subtypes, but no differences in butyrate and acetate (16). The findings between the two studies may be discordant with regards to acetate and butyrate levels due to the differences in the MS subtypes studied. However, both studies support a deficiency in propionate and a sub-analysis by Duscha et al. confirms that a propionate deficiency exists in both RRMS and SPMS.
Takewaki et al. studied 12 patients with RRMS and 9 patients with SPMS and showed reduced acetate, propionate and butyrate in the feces of RRMS patients, and a non-statistically significant reduction in SPMS patients (17). Table 2 presents the outcomes of SCFA measurements in MS studies.
Recently, Trend et al. have demonstrated a small but statistically significant reduction in propionate amongst patients with MS, without reductions in butyrate and acetate (19).
Contradictory data has come from the recent study of 58 patients with MS (a mix of RRMS and clinically isolated syndrome) and 50 healthy controls. Here, the serum level of acetate was significantly lower in MS patients but propionate and butyrate levels were similar in patients with MS and healthy controls (20).
Across the studies, there is a clear reduction in propionate levels in feces and plasma in patients with MS, independent of the subtype of MS and across different populations. These studies therefore provide complementary and consistent evidence that patients with MS have a dysbiosis leading to reduced numbers of SCFA producing bacteria which results in reduced levels of propionate across different geographies and disease forms.
Possible solution regarding MS:
Sodium propionate
2x 500 mg daily
very inexpensive