Yesterday the Reta Lila Weston Trust announced that they will be funding Dr Nikhil Sharma and colleagues at the Leonard Wolfson Experimental Neurology Centre (LWENC) to investigate whether the bacteria that live in our guts could alter the progression of MND. The grant is for £1.2 million over a period of four years. The LWENC is run jointly by the National Hospital for Neurology and Neurosurgery (NHNN) and University College London (UCL).
Incredibly, researchers have found a link between the bacteria that live in our guts and important cells called microglia. We know that microglia help regulate the function of the motor neurones. This study aims to find out whether the balance of gut bacteria in MND could be linked to changes in microglia.
Microglia and MND
Motor neurones are supported to conduct messages from our brains to our muscles by a group of cells known as glia. This research project focuses on a particular type of glial cells known as microglia.
Scientists already know a lot about the role of microglia in MND. In the early stages of the disease microglia help protect motor neurones from damage. However, as MND progresses the role of microglia changes, and they become toxic to the motor neurones rather than protecting them.
Why look at our gut bacteria?
We have more than a trillion (that’s 1 with 12 zeroes or 1 x 1012) bacteria living in our guts (our intestines) – sometimes called ‘gut flora’ or the ‘microbiome’. Collectively the bacteria have more genes than we do! There’s already evidence that changing the range of gut bacteria present in our bodies is beneficial for some diseases such as ulcerative colitis.
In the last few years research has shown that the way that the microglia work in the body is affected by which bacteria are present in the gut. Dr Sharma and colleagues want to investigate whether these changes are present in people with MND, and if so, whether altering the levels of bacteria might be beneficial.
Dr Sharma said: “It is remarkable that there is a two-way conversation between gut flora and cells in the brain. However, we do not know how this relates to progression in people living with MND. Not only will our research address this question, but we will explore whether changing the gut flora could slow progression in ‘real world’ patients. This could fundamentally change our approach to treating neurodegenerative diseases.”
What will the study involve?
This is a research study involving a small number of people with MND who attend the early diagnosis MND clinic at the LWENC. They will be asked to give stool samples to investigate the pattern and levels of bacteria present in their gut. A few weeks later they will undergo combined MRI and PET brain scan and transcranial magnetic stimulation (TMS).
MRI scans will tell Dr Sharma and colleagues how the motor neurones have been affected by MND so far. The PET scan will give the researchers information on the activity levels of the microglia present around the motor neurones. The TMS gives the researchers information about the electrical activity of the neurones, it is particularly sensitive to changes early on in the disease.
The idea is to link together the information about the gut bacteria, the microglia levels and the motor neurone damage and see if there are differences between people with MND and healthy control participants undergoing the same tests.
Dr Sharma will also ask people with MND taking part to stay in the study. They will be asked to repeat the samples and scans after a few months, to see if there are any changes in the gut bacteria that match any changes seen in microglia activity. Ultimately, the researchers will see if they can improve the balance of gut bacteria by asking the participants to take a pill that alters which bacteria are present.
It’s expected that the results, due in 2021, could be applied to a wide range of neurodegenerative disorders including Alzheimer’s and dementia as well as MND.
You can read the full press release on the University College London Hospitals website.