Gut microbiota modification as an option in multiple sclerosis management

Abstract

Introduction: Multiple sclerosis (MS) is caused by the abnormal activity of the immune system. It is believed that the pathological immune response may be initiated in the intestines, the area of the largest antigen presentation. This is where autoreactive T and B cells are activated, which constitutes the pathomech-anism of this disease. In a healthy organism, normal gut microbiota mediates the balance between pro-and anti-inflammatory activity of the immune system. Aim: This paper aims at describing the healthy gut microbiota, its changes in MS patients, factors that influence its composition and therapeutic corrective possibilities. Material and methods: The paper is based on available medical literature. Results and discussion: It has been evidenced that in MS patients the gut microbiota is dominated by pro-inflammatory species. This may be caused by environmental factors, for instance, the diet, antibiotics or stimulants. Methods of the microbiota correction involve dietary change, prebiotics and probiotics as well as fecal microbiota transplantation (FMT). FMT is a particularly safe and promising method that has proven its efficiency on an animal model of MS. Conclusions: Experimental research has revealed that the correction of the gut microbiota may lead to MS remission or alleviation. FMT utilized in inflammatory bowel disease seems to be presently the most comprehensive interven-tion. Since only incidental reports of its efficiency in humans are presently avail-able, further clinical studies are necessary.