The Autoimmunity Reviews journal, in the January issue, highlighted the work 'Combined therapies to treat complex illnesses: the role of the intestinal microbiota in multiple sclerosis' carried out by doctors Carmen Espejo, principal investigator of the study, Laura Calvo-Barreiro, Herena Eixarc and Dr. Xavier Montalban, director of the Centre for Multiple Sclerosis of Catalonia (Cemcat) and head of the research group at Clinical Neuroimmunology of the Vall d'Hebron Research Institute (VHIR).

Multiple sclerosis (MS) is a chronic, degenerative, autoimmune and demyelinating disease of the central nervous system (CNS) and one of the main causes of disability in young adults. Its pathogenesis is not fully known, but it is believed that MS occurs in genetically predisposed individuals after exposure to environmental factors. Recently, as a result of the research on experimental models of autoimmune encephalomyelitis, the communal microbiota has been described as an essential actor in the onset of autoimmune demyelination which, therefore, has emerged as a new environmental risk factor.

In this review, "we focused on the immunological modulation performed by the communal microbiota in EAE mice and how these microorganisms influence not only the local environment, but also in the peripheral responses of innate and adaptive immune systems, barriers biological hosts and resident cells of the CNS," doctors explain.

In the same way, ongoing studies in patients reveal that the EM-related microbiota will direct the immune responses to the pathogenic profiles characteristic of the disease, while underrepresented populations appear to be related to immunoregulatory responses. "As a result, the modification of the microbiota is being considered as immunomodulatory therapy for multiple sclerosis," they comment.

As a consequence of that, it is proposed the modulation of the microbiota in the development of adjuvant treatments to be considered to complement the therapeutic options currently available. In our opinion, combined strategies that consider the complexity of the disease are a more complete immunotherapeutic approach and improve the clinical outcome of patients with multiple sclerosis.

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