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229 , 230 , 231 The etiology of MS is complex and involves the interaction of genetic and environmental factors, among which gut microbiota plays an increasingly important role in the pathogenesis of MS

B., Aschner, M., Tuck, S., Kuehnelt, D., Schwerdtle, T., & Bornhorst, J

However, SCFAs are also copiously produced from many other nutrients, including proteins and fructose 15,34 , and excessive SCFAs can contribute to hepatic lipogenesis and worsen metabolic disorders through the gutbrain axis 15,35

Those who are denied at this stage may require an additional step, or even two, to complete the process

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