The chicken or the egg dilemma: intestinal dysbiosis in multiple sclerosis

Ochoa‐Repáraz, Javier; Mágori, Krisztián; Kasper, Lloyd H.

doi:10.21037/atm.2017.01.18

Cited by 30 publications

(24 citation statements)

References 45 publications

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“…More specifically, gut microbiota (i) contribute to the maintenance of the motility and permeability of the gut; (ii) prevent colonization by pathogens; (iii) mediate nutrient metabolism; (iv) participate in the production of vitamins, such as vitamin B complex, vitamin K, and folate; and (v) promote intestinal epithelial functions, such as absorption and secretion [18]. Recently, gut microbiota have been shown to shape the immune responses of innate and adaptive immunity, both locally (at the level of the GI mucosa) and systemically, thus affecting remote organs [19]. Data stemming from two large metagenomic databases, i.e., the MetaHIT (Metagenomics of the Human Intestinal Tract) and the Human Microbiome Project, isolated 2172 species in humans that were classified into 12 different phyla, with 93.5% of them belonging to the Proteobacteria, Firmicutes, Actinobacteria, and Bacteroidetes [20].…”

Section: Gut Microbiota and The Role Of Intestinal Dysbiosismentioning

confidence: 99%

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Microbiome in Multiple Sclerosis: Where Are We, What We Know and Do Not Know

et al. 2020

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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.

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Section: Gut Microbiota and The Role Of Intestinal Dysbiosismentioning

confidence: 99%

“…Intestinal microbiota have been proven to shape immune responses and to affect the neural and endocrine systems of the gut. All these pathways exert remote signaling in the human body and thus bear implications for systemic and organ-specific autoimmunity, as in the case of the CNS [19].…”

Section: Gut Microbiota and The Role Of Intestinal Dysbiosismentioning

confidence: 99%

Microbiome in Multiple Sclerosis: Where Are We, What We Know and Do Not Know

et al. 2020

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“…An important question remains: does gut dysbiosis precede MS, or does MS lead to gut dysbiosis [123]? This is the classic Bchicken or egg^dilemma.…”

Section: Discussionmentioning

confidence: 99%

Diet, Gut Microbiota, and Vitamins D + A in Multiple Sclerosis

2018

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Central to the understanding of the relationships between diet, gut microbiota, and vitamins D and A in multiple sclerosis is low-grade inflammation, which is involved in all chronic inflammatory diseases and is influenced by each of the above effectors. We show that food components have either proinflammatory or anti-inflammatory effects and influence both the human metabolism (the "metabolome") and the composition of gut microbiota. Hypercaloric, high-animal-fat Western diets favor anabolism and change gut microbiota composition towards dysbiosis. Subsequent intestinal inflammation leads to leakage of the gut barrier, disruption of the blood-brain barrier, and neuroinflammation. Conversely, a vegetarian diet, rich in fiber, is coherent with gut eubiosis and a healthy condition. Vitamin D levels, mainly insufficient in a persistent low-grade inflammatory status, can be restored to optimal values only by administration of high amounts of cholecalciferol. At its optimal values (>30 ng/ml), vitamin D requires vitamin A for the binding to the vitamin D receptor and exert its anti-inflammatory action. Both vitamins must be supplied to the subjects lacking vitamin D. We conclude that nutrients, including the nondigestible dietary fibers, have a leading role in tackling the low-grade inflammation associated with chronic inflammatory diseases. Their action is mediated by gut microbiota and any microbial change induced by diet modifies host-microbe interactions in a consequent way, to improve the disease or worsen it.

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“…It is hypothesized that there is a bi-directional relationship between the gut microbiota and MS [ 68 ]. The composition of the gut microbiome might shape MS pathology at the same time MS disease progression also could alter the gut microbiome.…”

Section: Multiple Sclerosis and Autoimmunitymentioning

confidence: 99%

The Gut Microbiome in Multiple Sclerosis: A Potential Therapeutic Avenue

Kirby

Ochoa‐Repáraz

2018

Medical Sciences

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Recently, there has been a substantial increase in the number of studies focused upon connecting the gut microbiome with cases of central nervous system (CNS) autoimmunity. Multiple sclerosis (MS) is a neurodegenerative autoimmune disorder of the CNS. Recent experimental and clinical evidence suggests the presence of microbial imbalances in the gut of MS sufferers. The gut microbiome is defined as the summation of all the microbial entities as well as their genes, proteins, and metabolic products in a given space and time. Studies show the MS gut microbiome as having general alterations in specific taxa, some associated with the promotion of inflammatory cytokines and overall inflammation. In conjunction with these findings, experimental models of the disease have reported that T regulatory (Treg) cells have deficits in their function as a result of the aberrant gut microbiota composition. The findings suggest that the interactions between the host and the microbiota are reciprocal, although more extensive work is required to confirm this. Moreover, evidence indicates that changes in microbiota composition may result in imbalances that could result in disease, with the gut as a potential novel therapeutic avenue. By understanding the biological effects of aberrant gut microbiome composition, it is possible to contemplate current therapeutic options and their efficacy. Ultimately, more research is necessary in this field, but targeting the gut microbiota may lead to the development of novel therapeutic strategies.

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The chicken or the egg dilemma: intestinal dysbiosis in multiple sclerosis

Cited by 30 publications

References 45 publications

Microbiome in Multiple Sclerosis: Where Are We, What We Know and Do Not Know

Microbiome in Multiple Sclerosis: Where Are We, What We Know and Do Not Know

Diet, Gut Microbiota, and Vitamins D + A in Multiple Sclerosis

The Gut Microbiome in Multiple Sclerosis: A Potential Therapeutic Avenue

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