Relationship Between Multiple Sclerosis, Gut Dysbiosis, and Inflammation: Considerations for Treatment

Larissa Jank; Pavan Bhargava

doi:10.1016/j.ncl.2023.07.005

Relationship Between Multiple Sclerosis, Gut Dysbiosis, and Inflammation: Considerations for Treatment

Neurol Clin. 2024 Feb;42(1):55-76. doi: 10.1016/j.ncl.2023.07.005. Epub 2023 Aug 30.

Authors

Larissa Jank¹, Pavan Bhargava²

Affiliations

¹ Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-144, Baltimore, MD 21287, USA.
² Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-144, Baltimore, MD 21287, USA. Electronic address: pbharga2@jhmi.edu.

PMID: 37980123
DOI: 10.1016/j.ncl.2023.07.005

Abstract

Multiple sclerosis is associated with gut dysbiosis, marked by changes in the relative abundances of specific microbes, circulating gut-derived metabolites, and altered gut permeability. This gut dysbiosis promotes disease pathology by increasing circulating proinflammatory bacterial factors, reducing tolerogenic factors, inducing molecular mimicry, and changing microbial nutrient metabolism. Beneficial antiinflammatory effects of the microbiome can be harnessed in therapeutic interventions. In the future, it is essential to assess the efficacy of these therapies in randomized controlled clinical trials to help make dietary and gut dysbiosis management an integral part of multiple sclerosis care.

Keywords: Bacterial-derived metabolites; Diet; Gut dysbiosis; Gut-brain axis; Microbiome; Multiple sclerosis; Neuroinflammation.

Publication types

Review

MeSH terms

Dysbiosis / complications
Dysbiosis / metabolism
Dysbiosis / therapy
Humans
Inflammation / metabolism
Inflammation / therapy
Multiple Sclerosis* / therapy