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Poorna Prakash

The Gut-Brain Connection to Multiple Sclerosis

The gut microbiome is a bidirectional communication between the Enteric Nervous System (GI Tract) and the Central Nervous System. It plays a significant role in neural, endocrine, immune, and humoral links, as the gut secretes hormones and chemicals, influencing neurons and vice-versa. In individuals with Multiple Sclerosis, some changes in the composition of the gut microbiome have been found, which shows an association between gut dysbiosis and the development of MS.


One key aspect of the gut-brain connection in MS is the impact of the microbiome on the immune system. The gut microbiota actively communicates with the immune system, influencing its responses and regulatory mechanisms. However, individuals with MS experience an abnormal immune response, targeting the protective myelin sheath surrounding nerve fibers, in turn leading to inflammation and damage. This abnormal gut microbiome ultimately triggers this corrupted autoimmune response.


According to the NIH1, the gut-brain axis’s “role is to monitor and integrate gut functions as well as to link emotional and cognitive centers of the brain with peripheral intestinal functions and mechanisms such as immune activation, intestinal permeability, enteric reflex, and entero-endocrine signaling.” Poor communication between the gut-brain axis networks and gut microbiota disruption can cause gut inflammatory disorders, which change cognitive processes and favor the emergence of neurodegenerative diseases. Certain microbial metabolites produced in the gut can influence the immune response and inflammation in the central nervous system. Short-chain fatty acids (SCFAs)2, for example, are “byproducts of microbial metabolism that exhibit anti-inflammatory properties”. Changes in the production of SCFAs and other metabolites in those with MS could be a contributor to chronic inflammation.


Understanding the gut-brain connection in MS has significant implications for potential solutions. Modulating the gut microbiome through dietary changes or fecal microbiota transplantation has shown promise in preclinical studies and early clinical trials. It is critical to maintain a diverse and balanced gut microbiota, as it can mitigate the inflammatory processes associated with Multiple Sclerosis.



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