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Neurotherapeutics. 2018 Jan;15(1):75-91. doi: 10.1007/s13311-017-0581-4.

Diet, Gut Microbiota, and Vitamins D + A in Multiple Sclerosis.

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Department of Sciences, University of Basilicata, Viale dell'Ateneo Lucano, 10, 85100, Potenza, Italy.
Department of Sciences, University of Basilicata, Viale dell'Ateneo Lucano, 10, 85100, Potenza, Italy.


Central to the understanding of the relationships between diet, gut microbiota, and vitamins D and A in multiple sclerosis is low-grade inflammation, which is involved in all chronic inflammatory diseases and is influenced by each of the above effectors. We show that food components have either proinflammatory or anti-inflammatory effects and influence both the human metabolism (the "metabolome") and the composition of gut microbiota. Hypercaloric, high-animal-fat Western diets favor anabolism and change gut microbiota composition towards dysbiosis. Subsequent intestinal inflammation leads to leakage of the gut barrier, disruption of the blood-brain barrier, and neuroinflammation. Conversely, a vegetarian diet, rich in fiber, is coherent with gut eubiosis and a healthy condition. Vitamin D levels, mainly insufficient in a persistent low-grade inflammatory status, can be restored to optimal values only by administration of high amounts of cholecalciferol. At its optimal values (>30 ng/ml), vitamin D requires vitamin A for the binding to the vitamin D receptor and exert its anti-inflammatory action. Both vitamins must be supplied to the subjects lacking vitamin D. We conclude that nutrients, including the nondigestible dietary fibers, have a leading role in tackling the low-grade inflammation associated with chronic inflammatory diseases. Their action is mediated by gut microbiota and any microbial change induced by diet modifies host-microbe interactions in a consequent way, to improve the disease or worsen it.


Diet; Gut Microbiota; Multiple Sclerosis; Neuroinflammation; Vitamin D

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