Abstract
An increase of multiple sclerosis (MS) incidence has been reported during the last decade, and this may be connected to environmental factors. This review article aims to encapsulate the current advances targeting the study of the gut–brain axis, which mediates the communication between the central nervous system and the gut microbiome. Clinical data arising from many research studies, which have assessed the effects of administered disease-modifying treatments in MS patients to the gut microbiome, are also recapitulated.
Highlights
The prevalence of multiple sclerosis (MS) has reportedly increased over the last few decades, showing both higher absolute numbers of patients and a real increase in MS incidence [1,2]
This review aims to summarize the recent advances that have been achieved in the analysis of gut microbiota, an environmental factor with a well-described impact in autoimmunity, and to provide a critical assessment of the derived knowledge with respect to the role of gut microbiota in MS pathogenesis
The gut–brain axis has been recognized as a bi-directional communication system from the central nervous system (CNS) to the gut and vice versa; this communication is mediated by neuronal connections, neuroendocrine signals, general humoral signals, and immune signaling [23]
Summary
The prevalence of multiple sclerosis (MS) has reportedly increased over the last few decades, showing both higher absolute numbers of patients and a real increase in MS incidence [1,2]. Brain Sci. 2020, 10, 234 in the health system and the medical services provided, a true increase in the incidence of MS has occurred in several ethnic populations over the last few decades. According to the hygiene hypothesis, advanced civilization and technological progress in the recent past led to an improvement of the hygiene level of the overall life conditions for several ethnic populations and this improvement may be linked to increased MS frequency. In this respect, the observed alterations in MS incidence may be linked to an environmental shift towards a more MS-predisposing status. We attempt to form key questions in order to position the derived knowledge into a valuable context with respect to personalized medicine and patient-tailored therapeutic approaches
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