Focus on the gut-brain axis: Multiple sclerosis, the intestinal barrier and the microbiome

World J Gastroenterol. 2018 Oct 7;24(37):4217-4223. doi: 10.3748/wjg.v24.i37.4217.


The brain-gut axis serves as the bidirectional connection between the gut microbiome, the intestinal barrier and the immune system that might be relevant for the pathophysiology of inflammatory demyelinating diseases. People with multiple sclerosis have been shown to have an altered microbiome, increased intestinal permeability and changes in bile acid metabolism. Experimental evidence suggests that these changes can lead to profound alterations of peripheral and central nervous system immune regulation. Besides being of pathophysiological interest, the brain-gut axis could also open new avenues of therapeutic targets. Modification of the microbiome, the use of probiotics, fecal microbiota transplantation, supplementation with bile acids and intestinal barrier enhancers are all promising candidates. Hopefully, pre-clinical studies and clinical trials will soon yield significant results.

Keywords: Bile acids; Gut-brain axis; Intestinal barrier; Microbiome; Multiple sclerosis.

Publication types

  • Editorial

MeSH terms

  • Animals
  • Bile Acids and Salts / chemistry
  • Brain / physiopathology
  • Central Nervous System / physiology
  • Clinical Trials as Topic
  • Fecal Microbiota Transplantation
  • Gastrointestinal Microbiome*
  • Gastrointestinal Tract
  • Humans
  • Immune System
  • Intestines / physiology
  • Multiple Sclerosis / microbiology*
  • Multiple Sclerosis / physiopathology*
  • Probiotics


  • Bile Acids and Salts