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Metabolomics in Multiple Sclerosis: Advances, Challenges, and Clinical Perspectives-A Systematic Review.
Jan Smusz1, Patrycja Mojsak2, Paulina Matys1
1Department of Neurology, University Clinical Hospital in Bialystok, Marii Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.
International Journal of Molecular Sciences
|September 27, 2025
Summary
Metabolomics reveals key metabolic shifts in multiple sclerosis (MS), including inflammation and gut dysbiosis, offering potential for new diagnostic biomarkers and personalized treatments for this chronic neurodegenerative disorder.
Area of Science:
- Neuroimmunology
- Biomarker Discovery
- Metabolomics
Background:
- Multiple sclerosis (MS) is a chronic, immune-mediated neurodegenerative disease.
- Current diagnostic tools for MS lack sufficient sensitivity and specificity.
- Metabolomics offers a promising avenue for understanding MS pathophysiology and identifying novel biomarkers.
Purpose of the Study:
- To systematically review and synthesize findings from metabolomic studies in adult patients with MS.
- To identify consistent metabolic alterations associated with MS.
- To explore the potential of metabolomics for biomarker discovery and personalized medicine in MS.
Main Methods:
- PRISMA-guided systematic review of 29 original studies.
- Analysis of biological samples including serum, cerebrospinal fluid, and feces.
- Inclusion of studies using validated metabolomic techniques.
Main Results:
- Consistent alterations observed in the kynurenine pathway (shift towards neurotoxic metabolites), energy metabolism (impaired glycolysis, TCA cycle, mitochondrial function), and lipid metabolism.
- Evidence of inflammation and gut dysbiosis indicated by changes in the kynurenine pathway and microbial-derived indoles.
- Metabolomic profiles reflected host-microbiome-environment interactions and were modulated by MS treatments.
- Machine learning approaches using metabolomics showed potential for distinguishing MS subtypes.
Conclusions:
- Metabolomics reveals significant metabolic dysregulation in MS across multiple pathways.
- Metabolomic data holds promise for developing sensitive and specific biomarkers for MS diagnosis and prognosis.
- Integration of metabolomics into personalized therapeutic strategies could improve MS management.
