Microbiota Dysbiosis in Amyotrophic Lateral Sclerosis: A Systematic Review of Human Studies

Eighteen eligible human studies were selected for a systematic review on gut microbiota dysbiosis in ALS.

• Altered microbial diversity was reported in most studies, indicating potential disruptions in gut health among ALS patients.
• Reduced levels of butyrate-producing bacteria, such as Faecalibacterium and Roseburia, were observed, along with increased pro-inflammatory bacteria like Escherichia coli and Bacteroides.
• Disruptions in short-chain fatty acids, bile acids, and lipid metabolism were revealed through integrated microbiome-metabolome analyses, some correlating with ALS progression and cognitive impairment.
• While some studies showed minimal or no differences, there is overall support for a connection between dysbiosis and ALS pathophysiology.
• Probiotic trials have demonstrated limited efficacy, suggesting a need for more targeted, patient-specific interventions.
• Variability in methodologies, small sample sizes, and limited longitudinal data hinder definitive conclusions about the role of gut microbiota in ALS.

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