Dysbiosis of the gut bacteriome, phageome, archaeome, and mycobiome in multiple sclerosis: An in-depth review

Recent advances in next-generation sequencing technologies have enabled comprehensive characterization of the gut microbiota in multiple sclerosis (MS), revealing significant alterations across the bacteriome, phageome, archaeome, and mycobiome compared with healthy controls. In this review, we discuss how MS is linked to the imbalance of gut microbial communities. Furthermore, we provide mechanistic insights associated with dysbiosis, immunology, and microbial metabolites, including short-chain fatty acids and toxins. Investigations have revealed diminished microbial diversity and shifts in critical immunomodulatory taxa in the gut microbiota of MS patients. It is evident that disruptions in these microbial communities influence the onset and progression of MS through the gut-brain axis. Future research should prioritize longitudinal studies, standardized methodologies, and detailed analysis of gut ecosystem dynamics. Understanding these complex microbial interactions is essential for improving MS management, suggesting that microbiota-targeted interventions may hold promise in future precision medicine strategies. Finally, we hope that this review will guide readers in keeping abreast of the latest research advancements in this field.