Objective:

This systematic review aims to set evidence on the affect of gut microbiota modulation, through dietary interventions, probiotics, prebiotics, and fecal microbiota transplantation (FMT), on the clinical outcomes of MS patients. It evaluated the effects of DMTs on gut microbial composition and their effects on immune function and MS progression.

Background:

Multiple sclerosis (MS) which is a chronic autoimmune disease of the central nervous system that characterized by inflammation and demyelination. Recent studies suggest that the gut microbiome may play a major role in modulating immune responses in MS patients.

Design/Methods:

Public databases (PubMed, Scopus, Cochrane, Embase, and Web of Science) were searched extensively for relevant material. After being extracted, the data were categorized. The collected information was transferred into standardized Google spreadsheets and analyzed to assess the role of of Gut Microbiota Modulation on Disease Progression and Symptoms Management in Multiple Sclerosis.

Results:

A total number of 9 studies composed of 615 patients were included in our systematic review. Of these studies, 3 assessed the role of dietary interventions, 4 focused on probiotics and prebiotics, and 2 evaluated the fecal microbiota transplantation (FMT). According to the patients receiving gut microbiota-modulating therapies, 120 patients showed a decreasing relapse rates with an average improvement of 0.3 points on the Expanded Disability Status Scale (EDSS). FMT studies showed the most changes in microbial diversity, with 45 patients experiencing improved symptom management. Also, 5 studies showed that disease-modifying therapies (DMTs) affected gut microbiota composition, with 185 patients showing a decrease in pro-inflammatory bacterial strains.

Conclusions:

This review shows that gut microbiota modulation through dietary changes, probiotics, prebiotics, and FMT may have advantages for MS patients by minimizing relapse rates and relieving symptoms. The findings also suggest that DMTs can affect gut microbial structure, possibly affecting on immune response and disease progression.