Effects of probiotic therapy on immune system andinflammation in patients with multiple sclerosis

Background and Aim : Multiple sclerosis (MS) is an autoimmune inflammatory disease affectingthe myelin sheaths in the central nervous system (CNS). Gut microbiota dysbiosis has beenimplicated in a wide range of immune-mediated diseases, including MS. Regarding theinteractions between immune system and gut microbiota, the aim of this paper is to review theimmunomodulatory and anti-inflammatory role of probiotics in the progress and management ofmultiple sclerosis.Methods : A search was conducted on PubMed, Cochrane Library, and Web of Science databasesfrom ۲۰۱۱ to ۲۰۲۲ using the terms "probiotics", "multiple sclerosis ", "immune system", and"inflammation".Results : Different probiotics strains showed to influence the immune system in MS patientsthrough different mechanisms. The pro-inflammatory effects of Th۱- and Th۱۷-producedcytokines such as IL-۱۷, IL-۶, IL-۱β, IL-۴, IFN-γ, TGF-β, and IL-۲ as well as their serum levelswere attenuated by administration of L. acidipiscis, L. helveticus SBT۲۱۷۱ (LH۲۱۷۱), L. casei(Lca), lactobacilli mixture, B.coagulans, Escherichia coli strain Nissle ۱۹۱۷ (ECN), L. plantarumA۷ and B. animalis PTCC ۱۶۳۱ Combination, and Vivomixx. Also, these probiotics decreased thenumber of pro-inflammatory cytokine-producing cells, inhibiting the differentiation of CD۴+ cellsinto Th۱ and Th۱۷ cells. Furthermore, by increasing the production of the anti-inflammatorycytokines and transcription factors such as IL-۴, IL-۱۰, TGF-β, GATA۳, and Foxp۳ and increasingthe responses of the regulatory T cells, ECN, L. plantarum A۷ and B. animalis PTCC ۱۶۳۱Combination, IRT۵, L. acidipiscis, VSL۳, and Vivomixx probiotics showed to suppress theinflammation and promote the anti-inflammatory gene expression in multiple sclerosis patientsand animal models.Conclusion : Collectively our findings demonstrate that the probiotics could improve immune andinflammatory factors in MS disease. Probiotics may have beneficial effects on the managementand treatment of multiple sclerosis as co-therapeutic strategy, especially when administered incombined forms. However, more studies are needed to determine the most effective strains orcombinations and to validate them in human studies.

کلیدواژه ها:

Probiotics ، multiple sclerosis ، immune system ، inflammation