Assessment of Serum Zonulin as a Marker of Altered Intestinal Permeability in Patients with Multiple Sclerosis

Abstract

S is an autoimmune-mediated disorder that affects the central nervous system (CNS) and often leads to severe physical or cognitive incapacitation as well as neurological problems in young adults. Subtypes of MS are considered important for treatment decisions and include: RRMS, PPMS, and SPMS. RRMS is the most common subtype (approximately 87%) being characterized by acute attacks (exacerbated by inflammatory attacks on myelin and nerve fibers) followed by periods of remission. The relation between intestinal permeability and autoimmune diseases has been investigated in many studies, yet few studies have investigated the relation between intestinal permeability and MS using different biomarkers. One study focused on the experimental autoimmune encephalomyelitis (EAE) mouse model of MS has further described how Zonulin is involved in MS. Intestinal permeability and intestinal Zonulin are increased during the pre-clinical phase of neurological symptoms, suggesting a role for Zonulin in disease development. Zonulaoccludens toxin (Zot) is an enterotoxin which is able to reversibly open intracellular tight junctions. Zot is able to interact with epithelial cells along the gastrointestinal tract