Are you seeing any correlation with particular microbes associated with MS? My patient has had EBV, has shown positive on 4+ on Citrobacter on the GI Effects panel we ran. Also discuss running Doctor’s Data to be current. Wanted your take on the viral microbial possible contribution.

Chris Kresser:  Yeah, so in the literature, it’s well established that both viral infections and bacterial infections are contributors to autoimmune disease, not just MS but other autoimmune conditions as well, including inflammatory bowel disease, rheumatoid arthritis, etc. The bigger question is whether, once those microbes have already triggered the autoimmune disease, will treating the microbe, eradicating it at that point have any impact on the course of the autoimmunity? My belief is it will because an ongoing infection can trigger immune dysregulation and that could definitely cause autoimmunity or exacerbate existing autoimmunity, I guess, in this case. But it’s not clear that addressing the infection will heal the autoimmunity or cure it, if by cure we mean “completely disappears.” So I don’t know that it’s important to know what the specific pathogen is. And I’m not aware of, I mean I’ve seen studies linking Epstein-Barr and I think cytomegalovirus and H. pylori and other infections as triggers to autoimmunity. But I’m not sure how important it is to know in each individual case other than just knowing that it is a potential trigger and I think can be treated should be treated if present to see if there’s any improvement.