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The Role of the Gut Microbiome in Multiple Sclerosis Risk and Progression : Towards Characterization of the “MS Microbiome.”
Open accessAbstract
Multiple sclerosis (MS) is the prototypic complex disease, in which both genes and the environment contribute to its pathogenesis. To date, > 200 independent loci across the genome have been associated with MS risk. However, these only explain a fraction of the total phenotypic variance, suggesting the possible presence of additional genetic factors, and, most likely, also environmental factors. New DNA sequencing technologies have enabled the sequencing of all kinds of microorganisms, including those living in and around humans (i.e., microbiomes). The study of bacterial populations inhabiting the gut is of particular interest in autoimmune diseases owing to their key role in shaping immune responses. In this review, we address the potential crosstalk between B cells and the gut microbiota, a relevant scenario in light of recently approved anti-B-cell therapies for MS. In addition, we review recent efforts to characterize the gut microbiome in patients with MS and discuss potential challenges and future opportunities. Finally, we describe the international MS microbiome study, a multicenter effort to study a large population of patients with MS and their healthy household partners to define the core MS microbiome, how it is shaped by disease-modifying therapies, and to explore potential therapeutic interventions.
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“Interestingly, even MS patients with active disease have an altered microbiota compared to patients in the remission phase, which in turn have a microbiota more similar to healthy controls (25, 134–138).”
From The gut-brain axis: how microbiota and host inflammasome influence brain physiology and pathology (2020) · cites this paper as [138]
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Vazifedoust, S., Ghaleh, H. E. G., Khafaei, M., Azemati, F., & Kondori, B. J. (2022) · PubMed · doi:10.30699/ijp.2022.541483.2755 · Cited by 2
Jafari-Nakhjavanlou, A., Irajian, P., & Bialvaei, A. Z. (2025) · Infectious Medicine · doi:10.1016/j.imj.2025.100219 · Cited by 1
Qin, R., Lai, X., Qin, Q., Xu, W., & Chen, L. (2026) · Immunologic Research · doi:10.1007/s12026-025-09742-2 · Cited by 1
Immunotherapies in progressive multiple sclerosis
Neziraj, T., Kappos, L., & Pröbstel, A. (2026) · Handbook of clinical neurology · doi:10.1016/b978-0-323-90887-0.00021-3 · Cited by 2
Self-citationLi, L., Liu, H., Ye, Z., & Xu, W. (2026) · Mediators of Inflammation · doi:10.1155/mi/3572399 · Cited by 1
The Role of Human Microbiota in Autoimmune Diseases: Exploring Dysbiosis and Mechanisms
Liu, S., Sanaie, S., Abdollahi, H., Yazdanfar, F., Khaki, S. N., kheiri, S. V., & Mobed, A. (2026) · Apmis · doi:10.1111/apm.70159 · Cited by 2
Zhang, S.-M., Tang, W.-C., Liu, F.-F., Bai, Q.-Q., Guo, Y., Bai, X.-Z., Wang, Y. J., Xw, M., Pan, S.-J., Yang, Y.-H., et al. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1803309 · Cited by 1
The gut microbiota plays a modifiable role in MS progression—YES
Passali, M., Krishnamoorthy, G., & Pröbstel, A. (2026) · Multiple Sclerosis Journal · doi:10.1177/13524585261471341 · Cited by 1
Self-citationHohlfeld, R. (2021) · Multiple Sclerosis Journal · doi:10.1177/13524585211018990 · Cited by 1
The gut microbiome in neurodegenerative disorders
Abughazaleh, S. J., Euers, L. A., & Quigley, E. M. M. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-821039-0.00006-x · Cited by 1
The next frontier in multiple sclerosis therapies: Current advances and evolving targets
Koduru, T. S., Gupta, N., Kannan, A., Dutta, S., Osmani, R. A. M., Balamuralidhara, V., Ramkishan, A., & Shanmuganathan, S. (2024) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2024.177080 · Cited by 1
Sviridova, A. A., Кабаева, А. Р., Rogovskii, V., Kozhieva, M. K., Melnikov, M., & Boyko, A. N. (2019) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro20191191028 · Cited by 1
Role of antibodies in autoimmunity of the central nervous system
Gómez, C. C. (2020) · eDiss (Georg-August-Universität Göttingen) · doi:10.53846/goediss-8074 · Cited by 1
Insights into microbiome research 5: Mapping is first but function must come next
Baranzini, S. E. (2019) · Multiple Sclerosis Journal · doi:10.1177/1352458518811203
Self-citationThe future of microbiome research in neuroinflammatory disorders
Waubant, E. L., Pröbstel, A., Levy, M., Hawkes, C. H., Giovannoni, G., Lechner‐Scott, J., & Tremlett, H. L. (2020) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2020.102098
Self-citationThe Gut Microbiome in Neurodegenerative Disorders
Euers, L. A., & Quigley, E. M. M. (2020) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780190931544.013.11 · Cited by 1
Human Gut Microbiota: Friend or Foe?
Pliszka, M., & Szablewski, L. (2020) · OBM Hepatology and Gastroenterology · doi:10.21926/obm.hg.2003050
The gut microbiome as a therapeutic target in systemic disease
Morrissette, M. (2021) · Digital Repository Service (Northeastern University) · doi:10.17760/d20423512
Prognostic Markers in Multiple Sclerosis
Alifirova, V. M., Kamenskikh, E. M., Koroleva, E. S., Kolokolova, E. V., & Petrakovich, A. M. (2022) · Neuroscience and Behavioral Physiology · doi:10.1007/s11055-022-01310-7
Metadata
- Authors
- Pröbstel, A.-K., & Baranzini, S. E.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Baranzini, Sergio E.
- Venue
- Neurotherapeutics
- Publisher
- Elsevier BV
- Published
- 2018-01
- Volume
- 15
- Issue
- 1
- Pages
- 126-134
- ISSN
- 1878-7479 (ISSN-L)
- PMC
- PMC5794700
- OpenAlex
- W2769299506
- Cited by
- 110
- References
- 76
- Citations by year
- 2026: 11 · 2025: 7 · 2024: 12 · 2023: 9 · 2022: 22 · 2021: 13 · 2020: 18 · 2019: 8 · 2018: 9
- FWCI
- 1.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Neurotherapeutics (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Multiple Sclerosis Society (US) (CA_1072-A)
- U.S. Department of Defense (US) (W81XWH-15-1-0652)
- Valhalla Charitable Foundation (N/A)
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (CH) (P2SKP3_164938)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Keywords
- multiple sclerosis, gut microbiota, B cells, autoimmune disease, disease-modifying therapy, anti-B-cell therapy, disease progression, risk factors, core microbiome, therapeutic interventions
- MeSH terms
- Gastrointestinal Microbiome, Animals, B-Lymphocytes, Humans, Multiple Sclerosis, Risk Factors, Disease Progression, Dysbiosis
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