# Autoimmune mechanisms of gastrointestinal dysmotility in multiple sclerosis

> **NIH NIH R01** · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · 2020 · $461,790

## Abstract

Project Summary/Abstract
Individuals with multiple sclerosis (MS) frequently suffer from autonomic dysfunction in addition to the
neuromuscular ailments that represent their hallmark symptoms, and one of the most common and debilitating
of their autonomic problems is constipation. Our theory is that constipation develops as a form of collateral
damage from the central nervous system (CNS) inflammatory response that occurs in MS. During this
inflammatory response, the patient's immune system generates antibodies that target proteins in the cellular
debris of dying neurons and glial cells in affected areas, and these autoantibodies could have actions at distant
sites. The enteric nervous system (ENS) is unique in that it contains intrinsic reflex circuitry that regulates
motility, secretion and vascular tone in the gut, independently of CNS innervation. The ENS contains glial cells
that share transcriptome features of oligodendrocytes and astrocytes, including proteolipid protein and myelin
basic protein. These are two known antigenic targets in MS that could be incidentally targeted where they are
also expressed in the ENS. This grant proposal is designed to test the hypothesis that autoantibodies
generated in MS patients can target proteins on neuronal and glial membranes in the ENS, resulting in altered
enteric neural reflex activity leading to constipation. In support of our hypothesis and the feasibility of our
proposed studies, we have demonstrated that GI function is altered in mice with experimental autoimmune
encephalomyelitis (EAE), the predominant mouse model of MS, in ways that are consistent with the
development of constipation. Furthermore, we have found that blood samples from MS patients and EAE mice
contain antibodies that bind to neurons and glial cells in the GI tract. In our proposed studies, we will examine
the features of GI dysfunction in EAE mice, and confirm that the changes in gut motility involve circulating
autoantibodies. We will determine the ENS cell types that MS autoantibodies bind to, and what effects these
antibodies have on GI function in naïve mice. We will also directly examine the physiological activities of glial
cells and neurons in the GI tract, and we will elucidate how these activities are altered in EAE mice, and in
response to treatment with autoantibodies from MS patients. In these studies, we will also use colons from
mice in which a calcium indicator protein is expressed by enteric glial cells or select populations of enteric
neurons, and we will use intracellular recording to evaluate the strength of excitatory and inhibitory
neuromuscular transmission. Finally, we will test potential therapeutic approaches for their effectiveness in
alleviating constipation in the MS mouse model. Understanding the mechanisms responsible for constipation
in MS is a clinically relevant goal since it is a critical step toward developing an effective therapeutic solution for
the GI ailments of affected MS patients and ...

## Key facts

- **NIH application ID:** 9990755
- **Project number:** 5R01DK113800-04
- **Recipient organization:** UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
- **Principal Investigator:** Gary M Mawe
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $461,790
- **Award type:** 5
- **Project period:** 2017-09-20 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9990755

## Citation

> US National Institutes of Health, RePORTER application 9990755, Autoimmune mechanisms of gastrointestinal dysmotility in multiple sclerosis (5R01DK113800-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9990755. Licensed CC0.

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