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Researchers at Johns Hopkins University report that levels of bile acids (produced by the liver to help the absorption of fats in the gut and other processes) may be reduced in people with MS, and especially in people with progressive MS. The team provides evidence that docking sites for these bile acids in brain cells are altered in people with MS; that bile acid signaling appears to reduce inflammatory activity of specific cells in the brain; and that administering bile acid supplements to mice with MS-like disease reduces disease severity. This team is now conducting a trial, funded by the National MS Society, of bile acid supplements in 60 people with progressive MS.

• People with MS may have abnormalities in the way they process energy and other maintenance activities (metabolism). One metabolic pathway identified by this team is bile acid metabolism. Bile acids can influence the composition of gut bacteria. Abnormalities in gut bacteria have been identified in people with MS and may be related to the observed abnormalities in bile acid metabolism.
• Bile acids can also interact with immune cells and brain cells and influence their function. In this study, the investigators examined tissue obtained from people with MS via autopsy, and found docking sites for bile acids on brain and immune cells, indicating that bile acids may modulate inflammation in the nervous system. The team administered a bile acid to cells isolated in lab dishes and found that it succeeded in blocking cells from promoting inflammation.
• Authors Drs. Pavan Bhargava and Kathryn Fitzgerald are funded by Career Transition Fellowships from the National MS Society.

“Bile acid metabolism is altered in multiple sclerosis and supplementation ameliorates neuroinflammation” is published by Dr. Pavan Bhargava (Johns Hopkins University) and colleagues in The Journal of Clinical Investigation.