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Advanced Neurology The role of gut in multiple sclerosis

Different diet preferences may have an impact on size, brief research duration, and the impossibility of a
MS. MS relapse rates and the expanded disability status blind clinical trial regarding the participating patients’
scale scores showed a decrease in the high-vegetable/ diet allocation.
low-protein diet group, and both Th17 cells and
programmed cell death protein 1-expressing CD4 T 4.4. Fecal microbiota transplantation (FMT)
+
cells were reduced [100] . In addition, the Mediterranean Many intestinal illnesses, such as Clostridium difficile
diet was found to have a favorable impact on MS in a infection [102] , ulcerative colitis [103] , and irritable bowel
multi-center, cross-sectional investigation [101] . An RCT syndrome [104] , respond well to FMT. FMT has mostly been
found that 15 days of a periodic calorie limitation diet used in animal models in MS investigations. Transplanting
was highly tolerable and showed a lower level of the the intestinal bacteria of EAE-resistant mice into EAE-
proinflammatory adipokine leptin without changes in susceptible or EAE-provoked mice can alleviate EAE [105,106] .
adiponectin among 16 MS patients recovering from However, there is evidence of the opposite effect, where the
relapsing MS as compared to an ad libitum diet. This study transfer of the gut microbes from PWD mice, which is
found that dietary restriction enriched Faecalibacterium, resistant to EAE, to EAE-susceptible B6 mice exasperates
Lachnospiraceae incertaesedis, and Blautia populations EAE, whereas the transfer of the gut microbes from B6 mice
in the gut and that adiponectin levels were positively to PWD mice increases susceptibility to EAE; this could
linked with Faecalibacterium [99] . The metabolic and gut be due to the presence of genetic susceptibility, making
microbiota alterations between mice and MS patients the role of gut microbes less important in EAE, implying
receiving IF showed a consistent pattern and highlighted that animal models with different genetic background may
the possibility for translation of IF. Nonetheless, there are interfere to some extent with the study of gut microbial
drawbacks to the human study, including limited sample facets of MS .
[87]

Table 1. The change and functions of gut microbiota in multiple sclerosis
Phylum Class Family Genus/species Functions in MS References
Decrease in Firmicutes Clostridia Lachnospiraceae Blautia, Dorea, Roseburia Produce SCFAs [41,50]
MS inulinivorans
7 Ruminococcaceae Faecalibacterium [8,41]
Faecalibacterium prausnitzii [51]
Oscillospiraceae Butyricicoccus desmolans [53]
Clostridium XIVb - - [41]
Bacilli Lactobacillaceae Lactobacillus Metabolize phytoestrogens [69,70,104]
Erysipelotrichaceae - Metabolize SCFAs [38]
Bacteroidetes Bacteroidia Bacteroidales - Affect cellular immunity [13]
Parabacteroides Metabolize [37,40,69]
(Parabacteroides distasonis) phytoestrogens and SCFAs
Affect cellular immunity
Prevotella Metabolize phytoestrogens [12,37]
Affect cellular immunity
Actinobacteria Coriobacteriia Eggerthellaceae Slackia Metabolize phytoestrogens [69,70,104]
Adlercreutzia Metabolize phytoestrogens [69,70,104]
Bacteroidota Bacteroidia Odoribacteraceae Odoribacter Produce SCFAs [44]
Increase in Firmicutes Clostridia Streptococcaceae - Affect cellular immunity [12]
MS Actinobacteria Coriobacteriia Coriobacteriaceae Collinsella - [29]

Proteobacteria Betaproteobacteria Sutterellaceae Sutterella - [37]
Gammaproteobacteria Moraxellaceae Acinetobacter calcoaceticus - [7]
Deltaproteobacteria Desulfovibrionaceae - - [9]
Verrucomicrobia Verrucomicrobiae Akkermansiaceae Akkermansia (Akkermansia Affect cellular immunity [7,36,37]
muciniphila) Produce SCFAs
Abbreviations: MS: Multiple sclerosis, SCFAs: Short-chain fatty acids.

Volume 2 Issue 3 (2023) 7 https://doi.org/10.36922/an.413