Introduction: Multiple Sclerosis (MS) is a chronic inflammatory disease characterized by central nervous system (CNS) defects that lead to physical or cognitive disability and neurological defects. The etiology of MS remains unclear because the cause of MS is multifactorial and includes genetic and environmental factors such as infectious agents, vitamin deficiencies, heavy metals, and smoking. These agents can trigger a cascade of events in the immune system, leading to neuronal cell death, nerve demyelination, and neuronal dysfunction. Material and methods: In this study, the concentration of heavy metals was measured in stool samples of MS patients by ICP-Mass method and compared with healthy people. Statistical analysis is performed by using Graphpad Prism software. Also, another goal of this study is to investigate the alteration of the gut microbiome of MS patients by Metagenomics technique based on the 16SrRNA gene sequencing. Result: The IL-10 ELISA assay showed no significant differences between the serum level of the IL-10 in the patients and the control group (p=0.510). ICP-Maas analysis showed a significantly higher level of heavy metals such as Ars, Ni, Mn, and Zn, and in contrast, significantly lower concentrations of the Fe, Pb, Ti, and Sn in the stool samples of the MS group compared to the control group. The first result of gut microbiome analysis showed an increase in Akkermansiaceae and Methanobacteriaceae families. In addition the relative abundance of the Lachnospiraceae and Ruminococcaceae families was considerably reduced in MS patients. Conclusion:This study reports that high levels of heavy metals such as Ars, Ni, Mn, and ZN, deficiency of Fe, Pb, Ti, and Sn, and alteration of the gut microbiome are involved in the pathogenesis of MS. In addition, exploring the convergence of IL-10, heavy metals, and the gut microbiome holds promise for unraveling critical insights into MS etiology and potential avenues for therapeutic interventions, ultimately aiming to alleviate the burden of this debilitating neurological disorder.
