Research on  Multiple Sclerosis (MS) has pointed towards environmental causes, or triggers, to the auto-immune disease.  Most studies looked at infections of the Central Nervous System by viruses [1] such as the:

  • Torque Teno virus,
  • Epstein-Barr virus
  • Human Herpes virus 6

As an illustration of the brain tissue lesions caused by MS, we show an image from a team at the Weill Cornell Medical College [2]

FLAIR image PLOS One [2]

However, besides viruses, pathogen bacteria are also receiving  attention as a one class of MS trigger candidates:

A recent study at Weill Cornell [1] found that Clostridium (C.) perfringens type B could be a trigger.  That bacteria produces a toxin called “epsilon”, and  ” epsilon toxin antibodies in MS patients were 10 times higher than in the healthy controls”.  So that much more epsilon antibodies could points toward that bacteria as a possible trigger. The geographical origin of the patients followed is not specified, but could be from the USA, because of the university umbrella.

The Weill Cornell study claims a “…specificity of C. Perfringens Epsilon Toxin for CNS Endothelial Cells and White Matter…”, which adds to the connection probability with MS.

So where is this bacteria found?

“…C. perfringens, found in soil, is one of the most common bacteria in the world. It is divided into five types. C. perfringens type A is commonly found in the human gastrointestinal tract and is believed to be largely harmless. ” [2]. What is not harmless is when the bacteria secretes the “epsilon” toxin which attacks the Central Nervous System (CNS) tissues, particularly the neuron myelin, and the brain blood vessels.  

An older study (2011 ) evaluated another bacteria, Mycobacterium avium subsp. paratuberculosis (MAP), also as a possible trigger:

“We found presence of MAP DNA in 42% of the MS patients and an extremely significant humoral immune response revealed by the MS patients against the MAP protein. In our opinion, this is the first report that significantly associates MAP infection with MS.”

The team there is from Italy, India and Malaysia. We tracked a  follow up on that avenue, and indeed the investigation of the MAP bacteria continues, as shown by the article published in the SAGE journal [5]. This study also on patients from the island of Sardinia, Italy.

It is by no means certain that MS has only one trigger, or that only one type of bacteria could be a trigger, so it is not surprising that the US and Sardinia could have different trigger bacteria.

 Those pilot studies are small: Approximately 100 patients, so the need for confirmation by larger studies is necessary. That does not prevent the Khumar-Vartarian team to already look to possible treatments:

“…one of my favorite approaches is development of a probiotic cocktail that delivers bacteria that compete with, and destroy, C. perfringens types B and D,” Vartanian says…”

There could be gut flora  connections:  The  Clostridium perfringens  Type B organism  was isolated from fecal matter and  is likely to ” exist usually in low abundance in the upper GI tract…”

We have discussed a connection MS / gut flora [7]. Quoting the Max Planck Institute: “…Natural intestinal flora involved in the emergence of multiple sclerosis…”

To be Continued…



  1. Results and problems in cell differentiation ; “Potential Multiple Sclerosis Triggers” ; 2010
  2. Weill Cornell Medical College ; News Release ; Oct 2013
  3. PLOS One ; “Isolation of Clostridium perfringens Type B in an Individual at First Clinical Presentation of Multiple Sclerosis Provides Clues for Environmental Triggers of the Disease” ; Oct 2013
  4. PLOs One ; “Association of Mycobacterium avium subsp. paratuberculosis with Multiple Sclerosis in Sardinian Patients” ; April 2011
  5. SAGE ; “Mycobacterium avium subsp. paratuberculosis and multiple sclerosis in Sardinian patients: epidemiology and clinical features”;  Feb 2013
  6. PLOS One ; “Gray Matter Is Targeted in First-Attack Multiple Sclerosis” ; Sept 2013
  7. medinewsdigest ; “Are Probiotics Gut Bacteria Good or Bad For Multiple Sclerosis Or Other Autoimmune Diseases?; Oct 2011

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