Tabriz University of Medical Sciences Advanced Pharmaceutical Bulletin 2228-5881 12 3 2022 05 21 Combination of Probiotics and Natural Compounds to Treat Multiple Sclerosis via Warburg Effect 515 523 10.34172/apb.2022.057 EN Anjali Kandiruthi Ravi https://orcid.org/0000-0001-6625-8918 Saradhadevi Kuppusami Muthukrishnan https://orcid.org/0000-0002-2639-3186 Journal Article 10.34172/apb.2022.057 2020 07 25 2021 09 27 Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system (CNS). It is an auto-immune disorder. Its usual symptoms are unique to each person. In MS lesions vast fractions of pyruvate molecules are instantly transformed into lactate. This reprogramming mechanism of glycolysis is known as the Warburg effect. MS has no efficient treatment yet. Hence, there is a requirement for profitable immunomodulatory agents in MS. Probiotics perform as an immunomodulator because they regulate the host’s immune responses. Its efficacy gets enhanced for an extended period when it combines with prebiotics. In this review, we focus on the metabolic alterations behind the MS lesions via the Warburg effect, and also suggesting, the combined efficacy of prebiotics and probiotics for the effective treatment of MS without side effects. The Warburg effect mechanism intensifies the infiltration of activated T-cells and B-cells into the CNS. It provokes the inflammation process on the myelin sheath. The infiltration of immune cells can be inhibited by the combination therapy of probiotics and prebiotics. By this review, we can recommend that the idea of this combinational therapy can do miracles in the treatment of MS in the future.