Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2025, 169(1):37-43 | DOI: 10.5507/bp.2023.033

Impaired intestinal permeability in patients with multiple sclerosis

Lenka Fialova1, Pavla Barilly2, Ivana Stetkarova2, Ales Bartos2, Libuse Noskova1, Denisa Zimova2, Michal Zido2, Iva Hoffmanova3
1 Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
2 Department of Neurology, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
3 Department of Internal Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic

Background: A number of recent studies have shown that the intestinal microbiome, part of the brain-gut axis, is implicated in the pathophysiology of multiple sclerosis. An essential part of this axis, is the intestinal barrier and gastrointestinal disorders with intestinal barrier dysregulation appear to be linked to CNS demyelination, and hence involved in the etiopathogenesis of multiple sclerosis (MS).

Objective: The aim of this study was to evaluate the integrity of the intestinal barrier in patients with clinically definite multiple sclerosis (CDMS) and clinically isolated syndrome (CIS) using two serum biomarkers, claudin-3 (CLDN3), a component of tight epithelial junctions, and intestinal fatty acid binding protein (I-FABP), a cytosolic protein in enterocytes.

Methods: Serum levels of CLDN3 in 37 MS patients and 22 controls, and serum levels of I-FABP in 46 MS patients and 51 controls were measured using commercial ELISA kits. Complete laboratory tests excluded the presence of gluten-related disorders in all subjects. Thirty MS patients received either disease-modifying drugs (DMD), immunosuppression (IS) or corticosteroid treatment.

Results: CLDN3 levels were only significantly higher in the MS patients treated with DMD or IS compared to the control group (P=0.006). There were no differences in I-FABP serum levels between the groups. Serum CLDN3 levels did not correlate with serum I-FABP levels in CDMS, in CIS patients or controls.

Conclusions: In multiple sclerosis patients, the intestinal epithelium may be impaired with increased permeability, but without significant enterocyte damage characterized by intracellular protein leakage. Based on our data, CLDN3 serum levels appear to assess intestinal dysfunction in MS patients but mainly in treated ones.

Keywords: multiple sclerosis, clinically isolated syndrome, claudin-3, I-FABP, intestinal permeability

Received: April 3, 2023; Revised: July 10, 2023; Accepted: July 13, 2023; Prepublished online: August 11, 2023; Published: March 5, 2025  Show citation

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Fialova, L., Barilly, P., Stetkarova, I., Bartos, A., Noskova, L., Zimova, D., Zido, M., & Hoffmanova, I. (2025). Impaired intestinal permeability in patients with multiple sclerosis. Biomedical papers, 169(1), 37-43. doi: 10.5507/bp.2023.033
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