Multiple sclerosis and the microbiota

Engelenburg, Hendrik J.; Lucassen, Paul J.; Sarafian, Joshua T; Parker, William F.; Laman, Jon D.

doi:10.1093/emph/eoac009

Cited by 8 publications

(6 citation statements)

References 142 publications

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“…One area of particular interest lies in discerning the disparities between the microbiota of healthy individuals and those affected by MS. Such differences hold substantial promise for shedding light on the pathophysiology of MS [8].…”

Section: Gut-microbiome-based Therapeutic Interventions In Msmentioning

confidence: 99%

Modulating the Gut Microbiome in Multiple Sclerosis Management: A Systematic Review of Current Interventions

Tsogka,

Kitsos,

Stavrogianni

et al. 2023

JCM

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This review attempted to explore all recent clinical studies that have investigated the clinical and autoimmune impact of gut microbiota interventions in multiple sclerosis (MS), including dietary protocols, probiotics, fecal microbiota transplantation (FMT), and intermittent fasting (IF). Methods: Thirteen studies were held between 2011 and 2023 this demonstrated interventions in gut microbiome among patients with MS and their impact the clinical parameters of the disease. These included specialized dietary interventions, the supply of probiotic mixtures, FMT, and IF. Results: Dietary interventions positively affected various aspects of MS, including relapse rates, EDSS disability scores, MS-related fatigue, and metabolic features. Probiotic mixtures showed promising results on MS-related fatigue, EDSS parameters, inflammation; meanwhile, FMT—though a limited number of studies was included—indicated some clinical improvement in similar variables. IF showed reductions in EDSS scores and significant improvement in patients’ emotional statuses. Conclusions: In dietary protocols, clinical MS parameters, including relapse rate, EDSS, MFIS, FSS, and MSQoL54 scales, were significantly improved through the application of a specific diet each time. Probiotic nutritional mixtures promote a shift in inflammation towards an anti-inflammatory cytokine profile in patients with MS. The administration of such mixtures affected disability, mood levels, and quality of life among patients with MS. FMT protocols possibly demonstrate a therapeutic effect in some case reports. IF protocols were found to ameliorate EDSS and FAMS scores. All interventional means of gut microbiome modulation provided significant conclusions on several clinical aspects of MS and highlight the complexity in the relationship between MS and the gut microbiome.

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Section: Gut-microbiome-based Therapeutic Interventions In Msmentioning

confidence: 99%

Modulating the Gut Microbiome in Multiple Sclerosis Management: A Systematic Review of Current Interventions

Tsogka,

Kitsos,

Stavrogianni

et al. 2023

JCM

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“…Parkinson's [12], Huntington's disease [13], and multiple sclerosis [14]. Evidence for immunological aberrations in CFS suggests that the underlying pathomechanism may be due to enteric dysbiosis [10].…”

Section: Trial Registrationmentioning

confidence: 99%

Randomized, double-blinded, placebo-controlled pilot study: Efficacy of faecal microbiota transplantation on chronic fatigue syndrome

Salonen

Jokinen

Satokari

et al. 2023

Preprint

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Background Chronic fatigue syndrome (CFS) is a disabling illness of unknown aetiology. Disruption of gut microbiota may play a role in several neurological disorders. In this study, the effect of faecal microbiota transplantation (FMT) on fatigue severity and health-related quality of life (HRQOL) in patients with CFS was evaluated Methods Randomized, placebo-controlled pilot trial. Patients and researchers were blinded to treatment assignment. 11 patients with CFS (10 female and 1 male, mean age 42.2 years and mean duration of CFS 6.3 years) were randomly assigned to receive either FMT from a universal donor (n = 5) or autologous FMT (n = 6) via colonoscopy. Patients’ HRQOL was assessed by using visual analog scale (VAS) and self-reporting questionnaires Modified Fatigue Impact Scale (MFIS), 15D and EQ-5D-3L. Patients’ HRQOL was evaluated at baseline, and 1 and 6 months after the FMT. Results The baseline VAS scores in the FMT and placebo groups were 62.4 and 76.0 (p = 0.29). 1-month scores were 60.0 and 73.7 and 6-months scores 72.8 and 69.5, respectively. Total MFIS scores in the FMT and placebo groups were 59.6 and 61.0 at the baseline (p = 0.80), 53.5 and 62.0 at 1 month and 58.6 and 56.2 at 6 months. Compared to the baseline scores, differences at 1 and 6 months were statistically insignificant both in VAS and in MFIS. The 15D and EQ-5D-3L profiles did not change after the FMT or placebo. FMT-related adverse events were not reported. Conclusion FMT was safe but did not relieve symptoms or improve the HRQOL of patients with CFS. Small number of study subjects limits the generalizability of these results Trial registration ClinicalTrials.gov Identifier NCT04158427, https://register.clinicaltrials.gov, date of registration 08/08/2019

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“…Identifying a characteristic/diagnostic composition of microbial communities associated with the gut microbiota of MS patients is challenging due to variations between studies and individual profiles [ 31 , 32 ]. However, reduced microbial diversity is commonly observed, which is characterized by an increased Firmicutes/Bacteroides ratio and prevalence of species producing endogenous ethanol, lipopolysaccharide, and reactive oxygen species [ 33 , 34 ].…”

Section: The Gut-brain Axis In Msmentioning

confidence: 99%

Multiple Sclerosis—Related Dietary and Nutritional Issues: An Updated Scoping Review with a Focus on Pediatrics

Mandato,

Colucci,

Lanzillo

et al. 2023

Children

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Purpose. Lifestyle/dietetic habits play an important role in the development and progression of multiple sclerosis (MS) disease. Here, we examine the basic pathomechanisms underlying intestinal and brain barrier modifications in MS and consider diets and dietary supplementations proposed over time to complement pharmacological therapies for improving disease outcome both in adults and in children. Methods. Scoping literature search about evidence-based findings in MS-related gut-brain axis (GBA) pathophysiology and nutritional issues at all ages. Findings. Data show that (1) no universal best diet exists, (2) healthy/balanced diets are, however, necessary to safeguard the adequate intake of all essential nutrients, (3) diets with high intakes of fruits, vegetables, whole grains, and lean proteins that limit processed foods, sugar, and saturated fat appear beneficial for their antioxidant and anti-inflammatory properties and their ability to shape a gut microbiota that respects the gut and brain barriers, (4) obesity may trigger MS onset and/or its less favorable course, especially in pediatric-onset MS. Vitamin D and polyunsaturated fatty acids are the most studied supplements for reducing MS-associated inflammation. Conclusions. Pending results from other and/or newer approaches targeting the GBA (e.g., pre- and probiotics, engineered probiotics, fecal-microbiota transplantation), accurate counseling in choosing adequate diet and maintaining physical activity remains recommended for MS prevention and management both in adults and children.

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Multiple sclerosis and the microbiota

Cited by 8 publications

References 142 publications

Modulating the Gut Microbiome in Multiple Sclerosis Management: A Systematic Review of Current Interventions

Modulating the Gut Microbiome in Multiple Sclerosis Management: A Systematic Review of Current Interventions

Randomized, double-blinded, placebo-controlled pilot study: Efficacy of faecal microbiota transplantation on chronic fatigue syndrome

Multiple Sclerosis—Related Dietary and Nutritional Issues: An Updated Scoping Review with a Focus on Pediatrics

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