The Gut-Brain Axis as a Therapeutic Target in Multiple Sclerosis

Area of Science:

• Neuroscience
• Immunology
• Microbiology

Background:

• The central nervous system (CNS) is vulnerable to oxidative stress.
• Gut microbiota dysbiosis can trigger oxidative damage, leading to mitochondrial dysfunction, neuroinflammation, and neurodegeneration.
• The gut-brain axis plays a critical role in mediating these processes, particularly in multiple sclerosis (MS).

Purpose of the Study:

• To review recent findings on oxidative-stress-related inflammation mediated by the gut-brain axis in MS.
• To summarize existing clinical trials targeting microbiota-related oxidative stress for MS management.
• To identify suitable interventions, combinations, and timings for microbiota-based therapies.

Main Methods:

• Evidence-based review of existing clinical trials.
• Analysis of studies focusing on gut microbiota interventions in MS.
• Assessment of trial designs, cohort sizes, and MS subtypes studied.

Main Results:

• Growing evidence supports targeting the gut microbiota as a promising strategy for MS management.
• Most reviewed trials focused on relapsing-remitting MS (RRMS), with limited data on other MS stages like secondary progressive MS (SPMS).
• Significant heterogeneity in study designs and outcomes highlights the need for standardized, large-scale clinical validation.

Conclusions:

• Gut microbiota modulation represents a potential therapeutic avenue for MS.
• Further research and well-designed clinical trials with larger cohorts and extended follow-up are essential.
• Future trials should consider early life interventions and long-term monitoring to capture complex intersystem interactions.