MICROBIOTA

microbiotakapak

ROLE OF IMMUNITY IN THE PATHOPHYSIOLOGY OF MULTIPLE SCLEROSIS

Beria Nur Ertuğrul1
Mehmet Eranil2
Umur Poyraz3
Meral Öksüz4

1AnkaraEtlik City Hospital, Department of Neurology, Ankara, Türkiye
2AnkaraEtlik City Hospital, Department of Neurology, Ankara, Türkiye
3AnkaraEtlik City Hospital, Department of Neurology, Ankara, Türkiye
4AnkaraEtlik City Hospital, Department of Neurology, Ankara, Türkiye

Ertuğrul BN, Eranil M, Poyraz U, Öksüz M. Role of Immunity in the Pathophysiology of Multiple Sclerosis. Melek İM, Aydoğan S, eds. Microbiota. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.151-161.

ABSTRACT

Multiple sclerosis is a chronic disease of the central nervous system characterized by loss of function resulting from immune-mediated inflammation, demyelination and axonal damage. Inflammatory demyelination has been recognized as the basis of the pathogenesis of multiple sclerosis. Autoimmunity plays an important role in the etiology of multiple sclerosis. Autoimmune diseases are characterized by abnormal autoantibody production. Genetic and environmental factors affect the immune system and cause abnormal production of autoantibody-producing cells and proinflammatory cytokines. Increasing incidence of autoimmune diseases is related to multifactorial causes, such as dietary changes and widespread administration of antibiotics, leading to significant changes in the gut microbiota. The term microbiota refers to microorganisms and microbiome refers to microorganisms and their relationship with their environment. The microbiota actively influences multiple host functions, including circadian rhythm, metabolism and immunity, and maintains homeostasis of our immune system. Also gut microbiota is involved in important processes in the central nervous system, such as blood-brain barrier formation, myelination, neurogenesis, microglia maturation. Microbiota plays an important role in these neurological processes through bidirectional communication between the gut microbiota and brain, so-called microbiota-gut-brain axis. The effect of microbiome on immune system is proposed to be the main mechanism in the genesis of multiple sclerosis. This mechanism involves activation of the immune system by pathogens and subsequent changes in microbiome composition. It is known that pathological changes in the gut microbiota can affect inflammation in central nervous system. Immune-mediated inflammation, resulting from the link between microbiota and autoimmune response, plays an important role in the onset and development of multiple sclerosis by inducing demyelination and axonal damage. In this chapter, the role of immunity in the pathophysiology of multiple sclerosis, the relationship between microbiota and immunity, the relationship between microbiota and central nervous system and multiple sclerosis are explained.

Keywords: Multiple sclerosis; Microbiota; Brain-gut axis; Autoimmunity; Central nervous system

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