Accumulating evidence suggests that multiple sclerosis (MS) is influenced by environmental factors, including gut microbiome composition and diet. A deficiency in propionic acid, a short-chain fatty acid produced by gut bacteria, may contribute to MS pathology. A recent review in Nutrients explores the potential of propionic acid supplementation as a therapeutic strategy for MS, highlighting its immunoregulatory, neuroprotective, and neurogenerative effects.
Propionic Acid's Role in MS
MS is characterized by immune-mediated damage to myelin in the central nervous system. Propionate appears to exert beneficial effects on the immune, peripheral, and central nervous systems of people with MS (pwMS). These functions are crucial, given that MS is characterized by immune-mediated damage of myelin in the central nervous system. Accordingly, propionate supplementation or a modulated increase in its levels through the microbiome and diet may help counteract the pro-inflammatory state in MS by directly regulating the immune system and/or by decreasing permeability of the gut barrier and blood-brain barrier.
Immunomodulatory and Neuroprotective Effects
Propionic acid's potential benefits stem from its ability to modulate the immune system and protect neural tissues. The review suggests that propionate supplementation could help regulate the immune system and reduce the permeability of both the gut barrier and the blood-brain barrier. This could potentially improve outcomes when used with immune-modulating therapy.
Clinical Trial Needs
While the broad effects of propionic acid are promising, the authors emphasize the need for further large clinical trials. These trials are necessary to evaluate its efficacy and safety in pwMS and clarify its role as a complementary therapeutic strategy. The review provides a comprehensive analysis of the evidence, challenges, and limitations concerning propionic acid supplementation in MS.
Expert Commentary
According to Lorena Lorefice, who has received honoraria for consultancy and speaking from Biogen, Novartis, Sanofi Genzyme, Sereno and Teva and Almirall, "Propionic acid shows promise as a complementary therapy for MS due to its immunomodulatory and neuroprotective properties. However, rigorous clinical trials are essential to confirm its benefits and safety." Magdalena Zoledziewska declares no conflicts of interest.
