Are your microglia neurotoxic or neuroprotective?

Understanding the role of microglia in MS

There is mounting evidence, predominantly in the progressive stages of MS but also in the relapsing remitting stage, that there are ongoing widespread, “smouldering” immunopathological processes in the central nervous system (CNS) related to microglial over-activation.

These are associated with signs of neuro degeneration such as mobility and balance issues, memory and cognitive issues, sleep disturbances and problems with bladder and bowel function.

Microglia are the primary immune cells of the CNS and they make up about 10 to 16% of all cells found within the brain. Alongside other immune cells, they are very important for defending the CNS against intruders like microbes. They are constantly patrolling the brain for potential pathogens.

If they come across a pathogen, they get activated, engulf and eat the intruder or “phagocytose” and alert the rest of the immune system through the release of pro-inflammatory cytokines to come and take part defending against the microbial invasion.

Myelin repair

Alternatively, they can also promote neuroprotection, downregulation of inflammation, and stimulation of tissue repair in the CNS including myelin. They clear away debris, damaged cells as well as getting rid of unnecessary synapses known as “synaptic pruning” - an important function for maintaining a healthy brain and controlling the CNS wiring.

However, in MS, the microglia can become over-activated and can get stuck in a chronic pro-inflammatory neurotoxic state causing oxidative stress and tissue damage to axons, neurons and oligodendrocytes. Furthermore, this can prevent tissue repair in the brain and remyelination which is more successful in a non-inflammatory environment where the debris can be cleared away.

In addition, individuals with MS commonly lose barrier integrity such as intestinal barrier dysfunction and damage to the blood brain barrier (BBB), which results in even more pathogens, foreign invaders and inflammatory cells being able to enter the brain from the periphery, further compounding the situation.

Research into drugs that can calm over-activated microglia is ongoing and is set to be a hot treatment area in years to come.

But what can we do now to reduce the conditions that promote harmful microglial activation and increase the conditions that support the more anti-inflammatory reparative state?

You guessed it!

Diet and Lifestyle.

Diet and lifestyle are essential tools we can use and have control over when it comes to calming and regulating our microglia.

· Eat foods that that promote anti-inflammatory pathways (Nrf2) and decrease pro-inflammatory pathways (NFkappaB)

· Promote barrier integrity and heal the gut

· Support your gut bacteria – the brain and gut are connected by the vagus nerve and the microbes in our gut have a large effect on our brain and can regulate microglia and neuroinflammation. They are involved in the development, maintenance and overall health of microglia. https://pubmed.ncbi.nlm.nih.gov/26030851/

· Reduce exposure to pathogens and foreign invaders e.g. toxins, heavy metals, undigested and inflammatory food proteins

· Support detoxification pathways to effectively clear and eliminate harmful compounds

· Reduce oxidative stress with polyphenols/anti-oxidants

· Supplement with effective and targeted compounds that can cross the BBB, improve cellular health as well as reduce peripheral inflammation

· Support the mitochondria (this is a big area that I will talk more about)

· Improve sleep quality - microglia repair the brain and improve memory whilst you sleep and lack of sleep promotes their inflammatory form https://jneuroinflammation.biomedcentral.com/articles/10.1186/s12974-017-0998-z

· Manage the stress response – microglia can sense stress! https://www.sciencedirect.com/science/article/abs/pii/S1084952118300855

· Move more - a recent review found that exercise directly affects microglia and shifts them towards having a more protective form https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678635/

If you are interested to find out about some of the recommendations I make to my MS clients, I will be writing more about them in my April newsletter.

Or book a free call with me to discuss how I might be able to support you in a one-to-one or group programme.