Gut-oriented interventions in patients with multiple sclerosis: fact or fiction?

Area of Science:

• Neurology
• Immunology
• Microbiology

Background:

• Multiple sclerosis (MS) is a complex, multifactorial central nervous system disease with poorly understood origins.
• The gut-brain axis, a link between gut microbes, the intestinal barrier, and immunity, may play a role in MS pathogenesis.
• Emerging evidence suggests a connection between gut microbiome alterations, intestinal permeability, and the immune-inflammatory response in MS.

Purpose of the Study:

• To review the evidence linking the gut-brain axis to multiple sclerosis pathogenesis.
• To examine the role of gut-oriented interventions in managing MS.
• To explore potential therapeutic strategies targeting the gut microbiome for MS.

Main Methods:

• A narrative review of studies on gut-directed interventions and MS was conducted.
• PubMed database was searched using keywords related to MS, microbiome, gut-brain axis, and various dietary interventions.
• Studies focusing on nutritional factors, fecal microbiota transplantation, and their impact on MS were analyzed.

Main Results:

• Alterations in the gut microbiome and increased intestinal permeability are implicated in MS pathogenesis.
• Modifications to lifestyle and the microbiome, including specific diets and fecal microbiota transplantation, may positively impact MS.
• Supplementation with bile acids and intestinal barrier enhancers are potential therapeutic avenues.

Conclusions:

• Nutritional factors' role in MS pathogenesis requires further investigation.
• Gut-directed interventions like diet, nutritional supplements, or fecal transplantation may modulate the inflammatory response in MS.
• These interventions show promise as complementary treatments to improve the course of multiple sclerosis.