Tsogka Anthi, Kitsos Dimitrios K, Stavrogianni Konstantina, Giannopapas Vasileios, Chasiotis Athanasios, Christouli Niki, Tsivgoulis Georgios, Tzartos John S, Giannopoulos Sotirios
Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 157 72 Athens, Greece.
Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece.
J Clin Med. 2023 Dec 11;12(24):7610. doi: 10.3390/jcm12247610.
This review attempted to explore all recent clinical studies that have investigated the clinical and autoimmune impact of gut microbiota interventions in multiple sclerosis (MS), including dietary protocols, probiotics, fecal microbiota transplantation (FMT), and intermittent fasting (IF). Thirteen studies were held between 2011 and 2023 this demonstrated interventions in gut microbiome among patients with MS and their impact the clinical parameters of the disease. These included specialized dietary interventions, the supply of probiotic mixtures, FMT, and IF. Dietary interventions positively affected various aspects of MS, including relapse rates, EDSS disability scores, MS-related fatigue, and metabolic features. Probiotic mixtures showed promising results on MS-related fatigue, EDSS parameters, inflammation; meanwhile, FMT-though a limited number of studies was included-indicated some clinical improvement in similar variables. IF showed reductions in EDSS scores and significant improvement in patients' emotional statuses. In dietary protocols, clinical MS parameters, including relapse rate, EDSS, MFIS, FSS, and MSQoL54 scales, were significantly improved through the application of a specific diet each time. Probiotic nutritional mixtures promote a shift in inflammation towards an anti-inflammatory cytokine profile in patients with MS. The administration of such mixtures affected disability, mood levels, and quality of life among patients with MS. FMT protocols possibly demonstrate a therapeutic effect in some case reports. IF protocols were found to ameliorate EDSS and FAMS scores. All interventional means of gut microbiome modulation provided significant conclusions on several clinical aspects of MS and highlight the complexity in the relationship between MS and the gut microbiome.
本综述试图探讨所有近期的临床研究，这些研究调查了肠道微生物群干预对多发性硬化症（MS）的临床和自身免疫影响，包括饮食方案、益生菌、粪便微生物群移植（FMT）和间歇性禁食（IF）。2011年至2023年间进行了13项研究，这些研究证明了对MS患者肠道微生物群的干预及其对该疾病临床参数的影响。这些干预包括特殊饮食干预、益生菌混合物供应、FMT和IF。饮食干预对MS的各个方面都有积极影响，包括复发率、扩展残疾状态量表（EDSS）残疾评分、MS相关疲劳和代谢特征。益生菌混合物在MS相关疲劳、EDSS参数、炎症方面显示出有前景的结果；同时，尽管纳入的研究数量有限，但FMT表明在类似变量上有一些临床改善。IF显示EDSS评分降低，患者情绪状态有显著改善。在饮食方案中，每次应用特定饮食后，MS的临床参数，包括复发率、EDSS、多维度疲劳影响量表（MFIS）、疲劳严重程度量表（FSS）和MS生活质量量表（MSQoL54）均有显著改善。益生菌营养混合物促进MS患者的炎症向抗炎细胞因子谱转变。给予此类混合物会影响MS患者的残疾程度、情绪水平和生活质量。在一些病例报告中，FMT方案可能显示出治疗效果。IF方案被发现可改善EDSS和疲劳评估量表（FAMS）评分。所有调节肠道微生物群的干预手段都在MS的几个临床方面得出了重要结论，并突出了MS与肠道微生物群之间关系的复杂性。
