الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Multiple Sclerosis (MS) is the most common chronic demyelinating disease of the central nervous system, representing the main cause of non-traumatic disabling disorders in young adults.
The etiology of MS is not fully appreciated, although strong evidence points to genetic and environmental factors. The role of the gut microbiome in MS pathogenesis is a rapidly emerging area of study in the MS field.
This study was designed to identify first differences in the gut enterotypes of patients with MS compared with healthy controls, in an attempt to identify the enterotypes that are likely related to MS as well as their possible role in the severity of the disease.
Thirty patients with relapsing remitting multiple sclerosis, who presented to the MS Clinic of Alexandria University Hospital, were enrolled in our study. These were diagnosed according to McDonald 2010 criteria. A cross matching control group of 20 healthy subjects of similar age and sex were included. Stool specimens were taken from each for detection of gut microbiome profile by quantitative SYBR Green Real Time PCR assay.
The profiling of the gut microbiome of the study groups was done to characterize their enterotypes which are dominated by Bacteroides (enterotype 1), Prevotella (enterotype 2) or Ruminococcus (enterotype 3). Enterotype 1 is the most common enterotype detected in MS and control cases (80% versus 65%). For enterotype 3, it was not detected in any of the 20 control cases while detected in multiple sclerosis case (16.7%). However, by comparing the multiple sclerosis and control cases enterotype 2 is significantly less in multiple sclerosis than control (3.3% versus 35%). There is debate to the term of ”enterotype” to describe gut communities, Accordingly, we additionally selected B. fragilis and C. perfringens, for their reported role in MS.
The present study demonstrates that MS patients have significantly higher B. fragilis than the normal control. Although the level of C. perfringens is marginally higher in MS patients with constipation than the control, the difference is not statistically significant.
The overall results of our study agree with previous studies reporting that patients with MS exhibit microbial dysbiosis.