Altered intestinal permeability in patients with relapsing-remitting multiple sclerosis: A pilot study

Maria Chiara Buscarinu, Benedetta Cerasoli, Viviana Annibali, Claudia Policano, Luana Lionetto, Matilde Capi, Rosella Mechelli, Silvia Romano, Arianna Fornasiero, Gianluca Mattei, Eleonora Piras, Daniela Francesca Angelini, Luca Battistini, Maurizio Simmaco, Renato Umeton, Marco Salvetti, Giovanni Ristori

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Alterations of intestinal permeability (IP) may contribute to the pathophysiology of immune-mediated diseases.

OBJECTIVE: We investigated the possible association between IP changes and multiple sclerosis (MS).

METHODS: We studied 22 patients with relapsing-remitting multiple sclerosis (RRMS) and 18 age- and sex-matched healthy donors (HDs), including five twin pairs (one concordant, and four discordant for disease). Measurement of lactulose (L) and mannitol (M; two non-metabolized sugars) levels in urine samples, after an oral load, allowed to quantify gut dysfunction.

RESULTS: The proportion of participants with increased IP was significantly higher in patients than in HDs (16/22 (73%) versus 5/18 (28%); p = 0.001). Accordingly, the L/M urinary ratio showed significantly higher values in patients than in controls ( p = 0.0284). Urinary mannitol concentration was significantly lower in patients than in controls ( p = 0.022), suggesting a deficit of absorption from intestinal lumen. Such changes did not appear related to patients' clinical-radiological features.

CONCLUSION: The relatively high proportion of IP changes in RR-MS patients seems to confirm our work hypothesis and warrants more work to confirm the result on a larger sample, and to understand the implications for related immunological disturbances and intestinal microbiota alterations. Our finding may also have relevance for oral treatments, recently introduced in clinical practice.

Original languageEnglish
Pages (from-to)442-446
Number of pages5
JournalMultiple Sclerosis
Issue number3
Publication statusE-pub ahead of print - Jul 11 2016


  • Journal Article


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