Multiple sclerosis occurs when a person’s immune system attacks the protective covering of nerve cells, leading to inflammation, muscle weakness, changes in vision and trouble thinking. Treatments involve suppression of the immune system, which brings risks of its own according to UVA doctoral candidate Andrea Merchak.
“It can increase your risk of an infection. If you do get an infection, it can be a lot more severe. Generally, they’re pretty strong medications that, if we can avoid, we would like to.”
That's why she and her colleagues in the research lab run by Alban Gaultier are excited. They’ve discovered a link between substances found in the digestive system – bile salts -- and the body’s immune response. When those bile salts were fed to laboratory mice with multiple sclerosis, Merchak says, they actually got well.
“The T-cells, which are one of the immune cells that’s really important for the development of multiple sclerosis, when they’re exposed to these bile salts they are less active, and they actually die prematurely, and so they aren’t able to cause as much damage.”
And she says bile salts may suppress the production of inflammation in other medical conditions.
"That interaction is the seed of a lot of different neurodegenerative diseases – not just multiple sclerosis. By understanding some of these basic mechanisms we are going to be able to help a lot of multiple sclerosis patients, but also patients with a variety of auto-immune disorders and neurodegenerative diseases."
So how soon might doctors here in Virginia begin testing bile salts in patients?
"There are a couple of medications on the market currently that have been approved by the FDA that can change the bile salt production or metabolism in the body, and so we know that there are already safe options out there that potentially could be repurposed."
Still, she guesses clinical trials will not begin for at least two years.
