Diet and Nutrition in Neurological Disorders - Chapter 30: Linking diet and gut microbiota in multiple sclerosis

A healthy microbiome is essential for human health, and gut microbiota dysbiosis is a risk factor for various inflammatory and immune-mediated diseases, such as multiple sclerosis. There are two different perspectives on the role of diet in changing the composition of the gut microbiota. First, it can be a risk factor for dysbiosis; this category includes a high-salt concentration diet and a high-fat concentration diet. These diets reduce the abundance of SCFA-producing microorganisms and increase the abundance of pathological microorganisms, leading to a reduction in producing immunoregulatory metabolites such as SCFAs and a subsequent disturbance in immune homeostasis. Second, it can be a nutritional modifier of the gut microbiota, which regulates the gut microbiome composition, favoring the development of beneficial commensal microorganisms such as Lactobacilli, Bacteroides, and Prevotella, ultimately leading to balanced immune homeostasis and a healthy central nervous system (CNS). Immunoregulatory SCFAs, high-fiber concentration diet, prebiotic supplements, and different types of immunoregulatory probiotics can be administrated as adjunctive therapies to conventional treatments to regulate the microbiota-gut-brain axis involvement in multiple sclerosis. To find the complicated mechanisms linking these nutritional interventions to gut microbiota and MS, further well-designed longitudinal and interventional studies are required. It is best to consider interindividual differences in the microbiota composition. The studies of developing the novel therapeutics in this area need to be personalized for a specific approach is prescribed for each individual.