The Gut-Brain Axis in Multiple Sclerosis: A Systematic Review of Microbiome Modulation and Neurological Outcomes

Abstract

Background: The disease multiple sclerosis (MS) is an autoimmune chronic disorder that afflicts the central nervous system with demyelination and is associated with a variety of neurological symptoms. Increasing research interest is focused on the gut-brain axis, which constitutes a communication network between the gastrointestinal tract and the central nervous system, especially regarding the modulation of immune responses and the influence on neurological health.
Objective: The current systematic review looks to establish whether alterations in the human microbiome due to dietary change, probiotics, and prebiotics relate to neurological effects in patients with multiple sclerosis via the gut-brain axis.
Methods: The inclusion criteria will be original research articles that include randomized controlled trials, cohort studies, case-control studies, and observational studies on human subjects with all types of MS. The studies should report neurological outcomes such as symptoms, disease progression, and biomarkers of neuroinflammation. Articles published within the last ten years will be included, while animal studies, non-pertinent neurological disorders, and those lacking relevant methodologies will be excluded.
Results: The review synthesized the effects of microbiome modulation on immune responses, focusing on cytokine production and inflammatory cell activation. Preliminary findings suggest that dysbiosis exacerbates neuroinflammation and contributes to disease progression. Therapies targeting the gut microbiome, such as probiotics, prebiotics, and fecal microbiota transplantation, show potential for improving clinical outcomes, although results remain variable. The variability of individual microbiota, lack of robust clinical trials specifically for MS, and concerns regarding safety and efficacy of these interventions present significant challenges. Membrane technology enhances the study of the gut-brain axis in multiple sclerosis (MS) by enabling the isolation of gut-derived biomolecules, which influence immune responses and neuroinflammation. This integration offers insights into microbial signatures and potential therapeutic interventions, paving the way for innovative treatments targeting gut health to improve MS outcomes. Understanding the interplay between gut microbiota and MS is essential for developing innovative therapeutic strategies. This review aims to provide insights into the GBA's role in MS, paving the way for future research and clinical applications.