What role does the gut microbiome play in multiple sclerosis — and how close are we to translating microbiome research into meaningful clinical interventions?

In this episode of the ECTRIMS Podcast, host Brett Drummond is joined by Mahesh Desai (Luxembourg Institute of Health) and Ashutosh Mangalam (University of Iowa), two internationally recognised leaders in microbiome and MS research, to explore how gut microbes influence disease susceptibility, progression, and immune regulation in MS.

The discussion moves beyond simple "good vs bad bacteria" narratives, highlighting why microbial function, community structure, and host–microbiome dialogue are far more informative than individual taxa alone. The speakers examine evidence from animal models and human studies, including twin studies, microbial networks, and immune markers such as IgA coating, to understand whether microbiome changes are drivers or consequences of disease.

They also explore the potential of the gut microbiome as a predictive biomarker, the challenges of causality, and why diet and personalised approaches may be key to restoring immune balance in MS.