| Autor: |
Ghezzi L; Department of Neurology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.; University of Milan, Milan, Italy., Cantoni C; Department of Neurology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA., Pinget GV; Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia., Zhou Y; Department of Medicine, School of Medicine, UConn Health, Farmington, Connecticut, USA., Piccio L; Department of Neurology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.; Brain and Mind Centre, School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia.; Hope Center for Neurological Disorders, Department of Neurology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA. |
| Abstrakt: |
The gut-brain axis (GBA) refers to the complex interactions between the gut microbiota and the nervous, immune, and endocrine systems, together linking brain and gut functions. Perturbations of the GBA have been reported in people with multiple sclerosis (pwMS), suggesting a possible role in disease pathogenesis and making it a potential therapeutic target. While research in the area is still in its infancy, a number of studies revealed that pwMS are more likely to exhibit altered microbiota, altered levels of short chain fatty acids and secondary bile products, and increased intestinal permeability. However, specific microbes and metabolites identified across studies and cohorts vary greatly. Small clinical and preclinical trials in pwMS and mouse models, in which microbial composition was manipulated through the use of antibiotics, fecal microbiota transplantation, and probiotic supplements, have provided promising outcomes in preventing CNS inflammation. However, results are not always consistent, and large-scale randomized controlled trials are lacking. Herein, we give an overview of how the GBA could contribute to MS pathogenesis, examine the different approaches tested to modulate the GBA, and discuss how they may impact neuroinflammation and demyelination in the CNS. |
