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Advanced Neurology

REVIEW ARTICLE
The gut microbiota and associated metabolites

in multiple sclerosis

1
Yunshu Wang , Zihao Li , Yun Xu , and Cun-Jin Zhang *
2
1,2
2
1 Department of Basic Research, Medical School of Nanjing University, Nanjing, Jiangsu, China
2 Department of Neurology, Nanjing Drum Tower Hospital, Nanjing University, Nanjing,
Jiangsu, China

Abstract

Multiple sclerosis (MS) is a severe central nervous system autoimmune inflammatory
disease featured by the presence of infiltrated immune cells, demyelination, and
degeneration. Recent research has shown that gut microbiota, including some
commensal bacteria, is capable of interacting with the host immune system
and remarkably influencing the development and outcome of experimental
autoimmune encephalomyelitis, a classic animal model of MS. In addition, gut
dysbiosis, presented with a significantly altered composition of commensal bacteria,
is linked to the immune response and inflammation, such as Th17 activation and B
cell function. Moreover, it has been observed that microbiota impacts the immune
system by regulating the metabolites in the gut. In this review, we summarize the
new research on the relationship and mechanism between the gut microbiota and
MS, as well as the implications for developing new strategies in MS by modulating
the gut microbiota and metabolites.

*Corresponding author: Keywords: Gut; Microbiota; Metabolites; Multiple sclerosis; Inflammation
Cun-Jin Zhang
(zhangcunjin516@163.com)
Citation: Wang Y, Li Z, Xu Y,
et al., 2023, The gut microbiota and 1. Introduction
associated metabolites in multiple
sclerosis. Adv Neuro, 2(3): 413. Multiple sclerosis (MS) is an inflammatory and degenerative disorder of the central
https://doi.org/10.36922/an.413 nervous system (CNS) with features of demyelination, neuronal loss, permanent
Received: March 30, 2023 axonal damage, and progressive neurological dysfunction. About 2.5 million people are
Accepted: July 10, 2023 diagnosed with MS, and it is more common in young women than in men [1-3] . Currently,
the mechanism of MS is only partially known and still requires further investigation.
Published Online: July 26, 2023
[4]
The pathophysiology of MS is thought to be driven by an autoimmune reaction . A key
Copyright: © 2023 Author(s). factor in the development of MS is abnormal immune cell activation. The blood-brain
This is an Open Access article
distributed under the terms of the barrier (BBB) can be breached by immune cells, cytokines, and inflammatory mediators,
Creative Commons Attribution allowing for neurological injury. Activation of myelin-specific CD4 T cells, in
+
License, permitting distribution, particular, is crucial in the pathogenesis and is shown in many animal models, including
and reproduction in any medium,
provided the original work is the experimental autoimmune encephalomyelitis (EAE) model. Targeting CNS self-
properly cited. antigens, Th1 and Th17 cells are thought to have a role in the etiology of MS. Interferon
Publisher’s Note: AccScience (IFN)-γ, which can act on microglia and trigger M1-type polarization, is mostly secreted
Publishing remains neutral with by Th1 cells, whereas interleukin-17A (IL-17A) and IL-21 are primarily produced by
regard to jurisdictional claims in
published maps and institutional Th17 cells. This may cause the astroglia to release IL-1 and IL-6, which amplify the
affiliations. inflammatory response associated with EAE [5,6] .

Volume 2 Issue 3 (2023) 1 https://doi.org/10.36922/an.413