The Gut-Brain Axis as a Therapeutic Target in Multiple Sclerosis.
Ana Maria BugaVlad PadureanuAnca-Lelia RizaCarmen Nicoleta OanceaCarmen Valeria AlbuAlexandru Dan NicaPublished in: Cells (2023)
The CNS is very susceptible to oxidative stress; the gut microbiota plays an important role as a trigger of oxidative damage that promotes mitochondrial dysfunction, neuroinflammation, and neurodegeneration. In the current review, we discuss recent findings on oxidative-stress-related inflammation mediated by the gut-brain axis in multiple sclerosis (MS). Growing evidence suggests targeting gut microbiota can be a promising strategy for MS management. Intricate interaction between multiple factors leads to increased intra- and inter-individual heterogeneity, frequently painting a different picture in vivo from that obtained under controlled conditions. Following an evidence-based approach, all proposed interventions should be validated in clinical trials with cohorts large enough to reach significance. Our review summarizes existing clinical trials focused on identifying suitable interventions, the suitable combinations, and appropriate timings to target microbiota-related oxidative stress. Most studies assessed relapsing-remitting MS (RRMS); only a few studies with very limited cohorts were carried out in other MS stages (e.g., secondary progressive MS-SPMS). Future trials must consider an extended time frame, perhaps starting with the perinatal period and lasting until the young adult period, aiming to capture as many complex intersystem interactions as possible.
Keyphrases
- multiple sclerosis
- oxidative stress
- white matter
- clinical trial
- dna damage
- young adults
- mass spectrometry
- diabetic rats
- induced apoptosis
- physical activity
- traumatic brain injury
- cerebral ischemia
- ms ms
- blood brain barrier
- pregnant women
- case control
- open label
- phase ii
- cognitive impairment
- single cell
- drug delivery
- cancer therapy
- subarachnoid hemorrhage
- brain injury
- phase iii
- heat shock