Ameera Alshinnawy

Egypt

Exploring the Potential Role of Gut Microbiota in the Pathogenesis and Progression of Multiple Sclerosis

Ameera Saeed Alshinnawy , Elham A. Badiea 1, Mahmoud Saad Elsayed , Ahmed A. Sayed 1, , Mohamed R. Mohamed 1.
Department of Biochemistry, Faculty of Science, Ain Shams University, Cairo, Egypt, 11566
Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Children’s Cancer Hospital 57357, Cairo, Egypt

Abstract

Background

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system characterized by neuroinflammation and neurodegeneration. Emerging evidence suggests that gut microbiota dysbiosis contributes to immune dysregulation and MS progression. While most microbiome studies have been conducted in Western populations, region-specific data are needed to understand how local genetic and environmental factors influence disease-related microbial patterns.

Methods

This study investigated gut microbiota alterations in Egyptian MS patients using long-read Oxford Nanopore sequencing of the full 16S rRNA gene. Fecal samples were collected from 33 newly diagnosed MS patients (20 with relapsing-remitting MS [RRM] and 13 with progressive MS [PMS]) and 10 healthy controls. Microbial diversity, community structure, and functional pathways were analyzed to identify microbial signatures associated with disease activity and progression.

Results

MS patients exhibited increased microbial richness but reduced evenness and presented distinct microbiome profiles compared to healthy controls. Progressive MS was associated with an enrichment of pro-inflammatory bacteria such as Enterococcus faecium and Romboutsia timonensis, alongside a reduction in short-chain fatty acid–producing species including Ruminococcus bromii and Faecalibacterium duncaniae, potentially contributing to heightened neuroinflammation. Relapsing MS displayed microbial shifts suggestive of immune dysregulation, including increased Clostridium saudiense and decreased levels of the gut-protective Faecalibacterium butyricigenerans. Functional predictions linked these microbial alterations to oxidative stress, neurotransmitter imbalance, and suppressed lipid and carbohydrate metabolism.

Conclusions

This study highlights the significant role of gut microbiota dysbiosis in MS pathogenesis and identifies distinct microbial signatures associated with both progressive and relapsing forms of the disease. By focusing on an underexplored Egyptian cohort, the findings reveal region-specific microbial shifts that may inform the development of targeted microbiota-based therapeutic strategies for MS patients.