Epsilon toxin produced by Clostridium perfringens may be a main factor for development of multiple sclerosis symptoms

Abstract

Introduction: Multiple sclerosis (MS) is a prevalent chronic autoimmune disease of the central nervous system. Clostridium perfringens epsilon toxin might be a cause of emerging MS complications due to its tendency to cross the blood-brain barrier. The aim of this study was to determine the molecular identity and toxigenicity of Clostridium perfringens isolated from multiple sclerosis patients and compare it with isolates obtained from other clinical and environmental sources.

Material and methods: In this cross-sectional descriptive study, 350 samples from clinical and environmental sources, such as feces of MS patients and healthy control individuals, soil, poultry carcasses, and sheep feces, were enriched and bacterial isolates were isolated by culture and biochemical methods. These isolates were tested by polymerase chain reaction method to identify Clostridium perfringens species and for the presence of alpha, beta, epsilon and iota toxin producing genes. Then, the level of toxicity and minimum lethality for each was evaluated.

Results: There was a high abundance of this type of bacteria in the intestines of patients with MS compared to non-afflicted people, on the other hand, epsilon toxin-producing toxinotypes (especially toxinotype D bacteria) also had a higher frequency. The lethality of toxins from the standard strain was significantly higher than the toxins from Clostridium perfringens from MS patients, soil, poultry carcasses, and sheep feces.

Conclusion: Due to the fact that the main causes of MS onset and its pathogenicity are yet to be clarified, it appears that more infections with epsilon toxin-producing toxinotypes and more lethality of the strains may be considered as a plausible factor for development of MS in the Iranian population.