Gut–brain connection in multiple sclerosis

Introduction and objective: The link between gut microbiota and multiple sclerosis has gained significant research interest in recent years. Multiple sclerosis, an autoimmune disease characterised by chronic inflammation and demyelination in the central nervous system, remains a complex condition with a multifactorial aetiology. Recent evidence suggests that alterations in gut microbiota composition, known as dysbiosis, may influence multiple sclerosis pathogenesis and progression. This paper aims to review the current state of knowledge regarding the gut–brain connection in multiple sclerosis, exploring how gut microbiota may affect disease mechanisms and potential therapeutic approaches. Summary of the state of knowledge: The gut–brain axis plays a crucial role in maintaining homeostasis. In multiple sclerosis, dysbiosis has been observed, with specific microbial profiles differing between patients and healthy controls. Gut microbiota can modulate immune responses, potentially influencing multiple sclerosis progression through pathways involving cytokine production and T-cell differentiation. Therapeutic interventions such as dietary modifications, probiotics, and faecal microbiota transplantation have shown promise in preliminary studies, indicating their potential to modulate gut microbiota and improve patient outcomes. Summary: Understanding the gut–brain axis in multiple sclerosis offers promising possibilities for new therapeutic strategies. Interventions targeting gut microbiota, such as probiotics, dietary changes, and faecal microbiota transplantation, show potential for modifying disease progression and enhancing treatment outcomes. However, current methodologies for assessing gut microbiota have limitations, requiring improved techniques for accurate analysis. Continued investigation into the gut–brain connection could lead to more effective and targeted treatments, ultimately improving the quality of life for multiple sclerosis patients.