The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS)
Myalgic encephalomyelitis (ME) or Chronic Fatigue Syndrome (CFS) is a neglected, debilitating multi-systemic disease without diagnostic marker or therapy. Despite evidence for neurological, immunological, infectious, muscular and endocrine pathophysiological abnormalities, the etiology and a clear p...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2021.628741/full |
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| author | Rahel S. König Werner C. Albrich Christian R. Kahlert Christian R. Kahlert Lina Samira Bahr Lina Samira Bahr Ulrike Löber Ulrike Löber Ulrike Löber Pietro Vernazza Carmen Scheibenbogen Sofia K. Forslund Sofia K. Forslund Sofia K. Forslund Sofia K. Forslund |
| author_facet | Rahel S. König Werner C. Albrich Christian R. Kahlert Christian R. Kahlert Lina Samira Bahr Lina Samira Bahr Ulrike Löber Ulrike Löber Ulrike Löber Pietro Vernazza Carmen Scheibenbogen Sofia K. Forslund Sofia K. Forslund Sofia K. Forslund Sofia K. Forslund |
| author_sort | Rahel S. König |
| collection | DOAJ |
| description | Myalgic encephalomyelitis (ME) or Chronic Fatigue Syndrome (CFS) is a neglected, debilitating multi-systemic disease without diagnostic marker or therapy. Despite evidence for neurological, immunological, infectious, muscular and endocrine pathophysiological abnormalities, the etiology and a clear pathophysiology remains unclear. The gut microbiome gained much attention in the last decade with manifold implications in health and disease. Here we review the current state of knowledge on the interplay between ME/CFS and the microbiome, to identify potential diagnostic or interventional approaches, and propose areas where further research is needed. We iteratively selected and elaborated on key theories about a correlation between microbiome state and ME/CFS pathology, developing further hypotheses. Based on the literature we hypothesize that antibiotic use throughout life favours an intestinal microbiota composition which might be a risk factor for ME/CFS. Main proposed pathomechanisms include gut dysbiosis, altered gut-brain axis activity, increased gut permeability with concomitant bacterial translocation and reduced levels of short-chain-fatty acids, D-lactic acidosis, an abnormal tryptophan metabolism and low activity of the kynurenine pathway. We review options for microbiome manipulation in ME/CFS patients including probiotic and dietary interventions as well as fecal microbiota transplantations. Beyond increasing gut permeability and bacterial translocation, specific dysbiosis may modify fermentation products, affecting peripheral mitochondria. Considering the gut-brain axis we strongly suspect that the microbiome may contribute to neurocognitive impairments of ME/CFS patients. Further larger studies are needed, above all to clarify whether D-lactic acidosis and early-life antibiotic use may be part of ME/CFS etiology and what role changes in the tryptophan metabolism might play. An association between the gut microbiome and the disease ME/CFS is plausible. As causality remains unclear, we recommend longitudinal studies. Activity levels, bedridden hours and disease progression should be compared to antibiotic exposure, drug intakes and alterations in the composition of the microbiota. The therapeutic potential of fecal microbiota transfer and of targeted dietary interventions should be systematically evaluated. |
| first_indexed | 2024-12-18T11:03:06Z |
| format | Article |
| id | doaj.art-ddf59507dd584643ae1adee542c0aa80 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-12-18T11:03:06Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-ddf59507dd584643ae1adee542c0aa802022-12-21T21:10:11ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-01-011210.3389/fimmu.2021.628741628741The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS)Rahel S. König0Werner C. Albrich1Christian R. Kahlert2Christian R. Kahlert3Lina Samira Bahr4Lina Samira Bahr5Ulrike Löber6Ulrike Löber7Ulrike Löber8Pietro Vernazza9Carmen Scheibenbogen10Sofia K. Forslund11Sofia K. Forslund12Sofia K. Forslund13Sofia K. Forslund14Faculty of Medicine, University of Basel, Basel, SwitzerlandDivision of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, SwitzerlandDivision of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, SwitzerlandDivision of Infectious Diseases and Hospital Epidemiology, Children’s Hospital of Eastern Switzerland, St. Gallen, SwitzerlandCharité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyExperimental and Clinical Research Center, A Joint Cooperation of Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, GermanyCharité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyExperimental and Clinical Research Center, A Joint Cooperation of Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, GermanyHost-Microbiome Factors in Cardiovascular Disease, Max Delbruck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, GermanyDivision of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, SwitzerlandInstitute for Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, GermanyCharité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyExperimental and Clinical Research Center, A Joint Cooperation of Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, GermanyHost-Microbiome Factors in Cardiovascular Disease, Max Delbruck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, GermanyEuropean Molecular Biology Laboratory, Structural and Computational Biology Unit, Heidelberg, GermanyMyalgic encephalomyelitis (ME) or Chronic Fatigue Syndrome (CFS) is a neglected, debilitating multi-systemic disease without diagnostic marker or therapy. Despite evidence for neurological, immunological, infectious, muscular and endocrine pathophysiological abnormalities, the etiology and a clear pathophysiology remains unclear. The gut microbiome gained much attention in the last decade with manifold implications in health and disease. Here we review the current state of knowledge on the interplay between ME/CFS and the microbiome, to identify potential diagnostic or interventional approaches, and propose areas where further research is needed. We iteratively selected and elaborated on key theories about a correlation between microbiome state and ME/CFS pathology, developing further hypotheses. Based on the literature we hypothesize that antibiotic use throughout life favours an intestinal microbiota composition which might be a risk factor for ME/CFS. Main proposed pathomechanisms include gut dysbiosis, altered gut-brain axis activity, increased gut permeability with concomitant bacterial translocation and reduced levels of short-chain-fatty acids, D-lactic acidosis, an abnormal tryptophan metabolism and low activity of the kynurenine pathway. We review options for microbiome manipulation in ME/CFS patients including probiotic and dietary interventions as well as fecal microbiota transplantations. Beyond increasing gut permeability and bacterial translocation, specific dysbiosis may modify fermentation products, affecting peripheral mitochondria. Considering the gut-brain axis we strongly suspect that the microbiome may contribute to neurocognitive impairments of ME/CFS patients. Further larger studies are needed, above all to clarify whether D-lactic acidosis and early-life antibiotic use may be part of ME/CFS etiology and what role changes in the tryptophan metabolism might play. An association between the gut microbiome and the disease ME/CFS is plausible. As causality remains unclear, we recommend longitudinal studies. Activity levels, bedridden hours and disease progression should be compared to antibiotic exposure, drug intakes and alterations in the composition of the microbiota. The therapeutic potential of fecal microbiota transfer and of targeted dietary interventions should be systematically evaluated.https://www.frontiersin.org/articles/10.3389/fimmu.2021.628741/fullME/CFSChronic Fatigue Syndrome (CFS)Myalgic Encephalomyelitis (ME)microbiomegut dysbiosisprobiotics |
| spellingShingle | Rahel S. König Werner C. Albrich Christian R. Kahlert Christian R. Kahlert Lina Samira Bahr Lina Samira Bahr Ulrike Löber Ulrike Löber Ulrike Löber Pietro Vernazza Carmen Scheibenbogen Sofia K. Forslund Sofia K. Forslund Sofia K. Forslund Sofia K. Forslund The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) Frontiers in Immunology ME/CFS Chronic Fatigue Syndrome (CFS) Myalgic Encephalomyelitis (ME) microbiome gut dysbiosis probiotics |
| title | The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) |
| title_full | The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) |
| title_fullStr | The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) |
| title_full_unstemmed | The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) |
| title_short | The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) |
| title_sort | gut microbiome in myalgic encephalomyelitis me chronic fatigue syndrome cfs |
| topic | ME/CFS Chronic Fatigue Syndrome (CFS) Myalgic Encephalomyelitis (ME) microbiome gut dysbiosis probiotics |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2021.628741/full |
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