Purpose: Multiple Sclerosis is a vascular disease in the central nervous system. There is evidence that Clostridium perfringens epsilon toxin causes damage to the myelin of the neuronal cells by increasing the permeability of the blood-brain barrier, and therefore contributes to the disease. Therefore, the aim of this study was the molecular identification of C. perfringens Epsilon toxin in samples isolated from multiple sclerosis patients using multiplex-PCR. Methods: In this descriptive cross-sectional study, 60 stool samples of patients with multiple sclerosis and 60 specimens of healthy individuals were studied. e-toxin producing C. perfringens infection was examined by the M-PCR method after genomic DNA extraction. Results: of 60 fecal specimens obtained from patients with multiple sclerosis, 11 (18.3%) and 2 (3.3%) samples were positive for 16S rRNA and ε-toxin-encoding gene, respectively. Conclusion: The results of this study showed that the prevalence of C. perfringens toxigenic strains in MS patients are higher than in the control group, which can indicate the association between the presence of this toxin and MS disease.
Lassmann H. Multiple sclerosis pathology. Cold Spring Harbor perspectives in medicine 2018; 8(3): a028936.
Hemmer B, Archelos JJ, Hartung H-P. New concepts in the immunopathogenesis of multiple sclerosis. Nature Reviews Neuroscience 2002; 3(4): 291-301.
Serafini B, Zandee S, Rosicarelli B, Scorsi E, et al. Epstein-Barr virus-associated immune reconstitution inflammatory syndrome as possible cause of fulminant multiple sclerosis relapse after natalizumab interruption. Journal of neuroimmunology 2018; 15; 9-12.
Frohman EM, Racke MK, Raine CS. Multiple sclerosis—the plaque and its pathogenesis. New England Journal of Medicine 2006; 354(9): 942-55.
Viglietta V, Baecher-Allan C, Weiner HL, Hafler DA. Loss of functional suppression by CD4+ CD25+ regulatory T cells in patients with multiple sclerosis. The Journal of experimental medicine 2004; 199(7): 971-979.
Hellings N, Raus J, Stinissen P. Insights into the immunopathogenesis of multiple sclerosis. Immunologic research 2002; 25(1): 27-51.
Rumah KR, Linden J, Fischetti VA, Vartanian T. Isolation of Clostridium perfringens type B in an individual at first clinical presentation of multiple sclerosis provides clues for environmental triggers of the disease. PLoS One 2013; 8(10): e76359.
Nourbakhsh B, Graves J, Casper TC, Lulu S, et al. Dietary salt intake and time to relapse in paediatric multiple sclerosis. J Neurol Neurosurg Psychiatry 2016; 87(12): 1350-3.
O'connor KC, Bar-Or A, Hafler DA. The neuroimmunology of multiple sclerosis: possible roles of T and B lymphocytes in immunopathogenesis. Journal of clinical immunology 2001; 21(2): 81-92.
Földes A, Kádár K, Kerémi B, Gyires K, et al. Mesenchymal stem cells of dental origin-their potential for antiinflammatory and regenerative actions in brain and gut damage. Current neuropharmacology 2016; 14(8): 914-934.
Segal BM, Cohen JA, Antel J. Americas Committee for Treatment and Research in Multiple Sclerosis Forum 2017: Environmental factors, genetics, and epigenetics in MS susceptibility and clinical course. Multiple Sclerosis Journal 2018; 24(1): 4-5.
Nasserinejad M, Pourhoseingholi MA, Rezasoltani S, Akbari S, et al. Single-nucleotide polymorphism of Exo1 gene is associated with risk of colorectal cancer based on Robust Bayesian approach. Gastroenterology and Hepatology from Bed to Bench. 2018; 11(Suppl 1): S146-S148.
Hussain K, Ijaz M, Durrani A, Anjum A, , et al. Bacterial count and predisposing factors of Clostridium perfringens (targeting CPA gene) infection along with antimicrobial sensitivity in diarrheic sheep in Pakistan. Tropical Biomedicine 2018; 35(2): 434-441.
Linden JR, Ma Y, Zhao B, Harris JM, et al. Clostridium perfringens epsilon toxin causes selective death of mature oligodendrocytes and central nervous system demyelination. MBio 2015; 6(3): e02513-2514.
Uzal FA, Songer JG. Diagnosis of Clostridium perfringens intestinal infections in sheep and goats. Journal of Veterinary Diagnostic Investigation 2008; 20(3): 253-65.
Wagley S, Bokori-Brown M, Morcrette H, Malaspina A, et al. Evidence of Clostridium perfringens epsilon toxin associated with multiple sclerosis. Multiple Sclerosis Journal. 2018 :1352458518767327.
Miyamoto O, Sumitani K, Nakamura T, Yamagami SI, et al. Clostridium perfringens epsilon toxin causes excessive release of glutamate in the mouse hippocampus. FEMS microbiology letters 2000; 189(1): 109-113.
Vartanian T, Rumah K, Linden J. Identification of Clostridium Perfringens Epsilon Toxin As A Candidate Trigger For New Lesion Formation In Multiple Sclerosis (P6. 151). Neurology 2014; 82(10 Supplement): P6-151.
Ebringer A, Hughes L, Rashid T, Wilson C. Acinetobacter immune responses in multiple sclerosis: etiopathogenetic role and its possible use as a diagnostic marker. Archives of neurology 2005; 62(1): 33-6
.Samedly lii J, Fisher D, Smedley Sayeed S, Chakrabarti G, McClane B. The enteric toxins of Clostridium perfringens. Reviews of physiology, biochemistry and pharmacology: Springer: 2004; 183-204
Zorzon M, Zivadinov R, Bragadin LM, Moretti R, et al. Sexual dysfunction in multiple sclerosis: a 2-year follow-up study. Journal of the neurological sciences 2001; 187(1): 1-5.
Attarian HP, Brown KM, Duntley SP, Carter JD, Cross AH. The relationship of sleep disturbances and fatigue in multiple sclerosis. Archives of neurology 2004; 61(4): 525-8.
Mc Donnell G, Hawkins S. An assessment of the spectrum of disability and handicap in multiple sclerosis: a population-based study. Multiple sclerosis 2001;7(2): 111-117.
Brunham S, Tremleet H. Assessing Balance in MS: Relationship between motor control and sensory integration. International Journal of MS care 2002; 6: 83.
Klewer J, Pöhlau D, Nippert I, Haas J, Kugler J. Problems reported by elderly patients with multiple sclerosis. Journal of Neuroscience Nursing 2001; 33(3): 167-71.
Steck B. The psychosocial impact of multiple sclerosis on families and children. International MS Journal. 2000;7(2):62-.
Asgharzadeh, S., & Amini, K. (2020). Molecular Identification of Epsilon Toxin-Producing Clostridium perfringens in Stool Samples in Patients with Multiple Sclerosis. Journal of Paramedical Sciences & Rehabilitation, 8(4), 36-41. doi: 10.22038/jpsr.2020.23379.1612
MLA
S Asgharzadeh; K Amini. "Molecular Identification of Epsilon Toxin-Producing Clostridium perfringens in Stool Samples in Patients with Multiple Sclerosis", Journal of Paramedical Sciences & Rehabilitation, 8, 4, 2020, 36-41. doi: 10.22038/jpsr.2020.23379.1612
HARVARD
Asgharzadeh, S., Amini, K. (2020). 'Molecular Identification of Epsilon Toxin-Producing Clostridium perfringens in Stool Samples in Patients with Multiple Sclerosis', Journal of Paramedical Sciences & Rehabilitation, 8(4), pp. 36-41. doi: 10.22038/jpsr.2020.23379.1612
VANCOUVER
Asgharzadeh, S., Amini, K. Molecular Identification of Epsilon Toxin-Producing Clostridium perfringens in Stool Samples in Patients with Multiple Sclerosis. Journal of Paramedical Sciences & Rehabilitation, 2020; 8(4): 36-41. doi: 10.22038/jpsr.2020.23379.1612