Gut Microbiome

Functional Training Mitigates Reduced Circulating Indole-3-Lactate Levels in Persons With Relapsing-Remitting Multiple Sclerosis.

TL;DR

Multimodal functional training over 10 weeks led to an improved ILA/IAA index suggesting a neuroprotective shift in gut microbiota composition, and a single bout acutely increases the circulating level of ILA in persons with relapsing-remitting multiple sclerosis.

Key Findings

Baseline indole levels in RRMS patients differed from those of matched healthy controls, with reduced ILA levels observed in RRMS patients.

  • Blood samples from RRMS patients at baseline were compared to a matched healthy control group.
  • Indole-3-lactate (ILA) was specifically identified as reduced in persons with MS at baseline.
  • Serum indole concentrations were measured using LC-MS/MS methodology.
  • This finding aligns with prior literature suggesting ILA is reduced in persons with MS.

A 10-week multimodal functional training intervention increased the ILA/IAA (neuroprotection) index in RRMS patients.

  • Thirty-one RRMS patients with at least 70% session attendance completed the intervention.
  • The intervention consisted of 60-minute sessions, 3 times per week, over 10 weeks.
  • The ILA/IAA index is considered a neuroprotection index reflecting gut microbiota composition.
  • The training group was compared to a waitlist control group in a randomized controlled trial design (DRKS00017091).
  • The increase in ILA/IAA index suggests a neuroprotective shift in gut microbiota composition.

A single bout of exercise acutely increased both circulating ILA levels and the ILA/IAA index in RRMS patients.

  • Acute effects were assessed with blood samples collected before, during, and immediately after one interim training session.
  • Both ILA concentration and the ILA/IAA index were elevated following the single exercise bout.
  • This acute response was observed within the context of the multimodal functional training program.
  • Serum indole concentrations were measured using LC-MS/MS.

Indole-3-lactate has anti-inflammatory and remyelinating properties that may influence the gut-microbiota-brain axis in multiple sclerosis.

  • ILA is a tryptophan-derived metabolite produced by the gut microbiota.
  • ILA improves MS clinical scores in animal models via its anti-inflammatory remyelinating properties.
  • The ILA/IAA (indole-3-acetate) index is considered a neuroprotection index.
  • Physical exercise and diet can modify gut microbiota and indole metabolism.

The study design was a secondary analysis of a randomized controlled trial comparing multimodal functional training to a waitlist control group in RRMS patients.

  • Trial registration number: DRKS00017091.
  • Thirty-one RRMS patients met the inclusion criterion of at least 70% session attendance.
  • The intervention was 10 weeks of multimodal functional training (60 min, 3×/week).
  • Blood samples were collected at baseline, after 10 weeks, and acutely around one interim training session.
  • Baseline samples were also compared to a matched healthy control group.

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Citation

Wences Chirino T, Adammek F, Belen S, Winker M, Proschinger S, Rademacher A, et al.. (2026). Functional Training Mitigates Reduced Circulating Indole-3-Lactate Levels in Persons With Relapsing-Remitting Multiple Sclerosis.. Acta physiologica (Oxford, England). https://doi.org/10.1111/apha.70166