Gut MicrobiomePEM-relevant

Gut Microbiome

38 studies in the atlas

Alterations in the gut microbiome have been reported in ME/CFS patients, with differences in bacterial diversity and composition compared to healthy controls. The gut-immune axis is a plausible pathway through which microbiome changes could influence systemic symptoms, though causal evidence remains limited.

What we know

Several studies have reported altered gut microbiome composition in ME/CFS patients compared to controls
Reduced bacterial diversity has been observed in some cohorts
Gut permeability (leaky gut) has been reported in a subset of patients
The gut-immune axis provides a plausible mechanistic pathway for systemic effects

What remains uncertain

Whether microbiome changes are a cause, consequence, or bystander in ME/CFS
Whether specific bacterial signatures are consistent enough to serve as biomarkers
Whether probiotic or dietary interventions meaningfully improve symptoms
The relationship between gut microbiome changes and immune activation in ME/CFS

What is emerging

Whether targeted microbiome interventions could benefit specific patient subgroups
The role of the gut-brain axis in cognitive symptoms
Whether microbiome profiles predict disease trajectory
How gut microbiome findings in ME/CFS compare to Long COVID

Start here

E0 ConsensusPEM unclear

The potential therapeutic approaches targeting gut health in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a narrative review.

Hsu, Chou-Yi, Ahmad, Irfan, Maya, Rana Warid et al.·Journal of translational medicine·2025

This review looked at how gut health might be connected to ME/CFS and found that people with ME/CFS often have different bacteria in their gut compared to healthy people. The researchers reviewed studies about various gut-focused treatments like probiotics, dietary changes, and other interventions that might help reduce ME/CFS symptoms by improving the gut-brain connection.

Gut Microbiome

What we know

What remains uncertain

What is emerging

The potential therapeutic approaches targeting gut health in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a narrative review.

Research Momentum

Top Studies

Gut Microbiome and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Insights into Disease Mechanisms.

The potential therapeutic approaches targeting gut health in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a narrative review.

Clinical evidence of the link between gut microbiome and myalgic encephalomyelitis/chronic fatigue syndrome: a retrospective review.

A systematic review of enteric dysbiosis in chronic fatigue syndrome/myalgic encephalomyelitis.

The impact of gut microbiome and diet on post-acute sequelae of SARS-CoV-2 infection.

Causes of symptoms and symptom persistence in long COVID and myalgic encephalomyelitis/chronic fatigue syndrome.

Persistent SARS-CoV-2 Infection, EBV, HHV-6 and Other Factors May Contribute to Inflammation and Autoimmunity in Long COVID.

Recognizing the Leaky Gut as a Trans-diagnostic Target for Neuroimmune Disorders Using Clinical Chemistry and Molecular Immunology Assays.

Systematic review: faecal microbiota transplantation therapy for digestive and nondigestive disorders in adults and children.

Sijunzi decoction, a classical Chinese herbal formula, improves fatigue symptoms with changes in gut microbiota in chronic fatigue syndrome: A randomized, double-blind, placebo-controlled, multi-center clinical trial.

Randomized, double-blinded, placebo-controlled pilot study: efficacy of faecal microbiota transplantation on chronic fatigue syndrome.

[Ginger-separated moxibustion for chronic fatigue syndrome and its effect on intestinal flora].

AI-driven multi-omics modeling of myalgic encephalomyelitis/chronic fatigue syndrome.

The gut microbial composition is different in chronic fatigue syndrome than in healthy controls.

Multi-'omics of gut microbiome-host interactions in short- and long-term myalgic encephalomyelitis/chronic fatigue syndrome patients.

Eukaryotes in the gut microbiota in myalgic encephalomyelitis/chronic fatigue syndrome.

Increased d-lactic Acid intestinal bacteria in patients with chronic fatigue syndrome.

Effect of supplement with lactic-acid producing bacteria on fatigue and physical activity in patients with chronic fatigue syndrome.

Assessment of the Gut Microbiome in Patients with Coexisting Irritable Bowel Syndrome and Chronic Fatigue Syndrome.

Systemic antibody responses against gut microbiota flagellins implicate shared and divergent immune reactivity in Crohn's disease and chronic fatigue syndrome.

Associations between the gut microbiome and fatigue in cancer patients.

Profiling Antibody Reactivity to Gut Microbes in ME/CFS Patients.

Dysregulation of the Kynurenine Pathway, Cytokine Expression Pattern, and Proteomics Profile Link to Symptomology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

KombOver: Efficient k-core and K-truss based characterization of perturbations within the human gut microbiome.

Investigating the Human Intestinal DNA Virome and Predicting Disease-Associated Virus-Host Interactions in Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Causal Effects between Gut Microbiome and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Two-Sample Mendelian Randomization Study.

Astragalus polysaccharide ameliorated complex factor-induced chronic fatigue syndrome by modulating the gut microbiota and metabolites in mice.

Integrated 'omics analysis for the gut microbiota response to moxibustion in a rat model of chronic fatigue syndrome.

[Mechanism of acupuncture and moxibustion in treatment of chronic fatigue syndrome from perspective of intestinal flora].

Mucosal Immunity and the Gut-Microbiota-Brain-Axis in Neuroimmune Disease.

A Pair of Identical Twins Discordant for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Differ in Physiological Parameters and Gut Microbiome Composition.

Fecal Microbiota Transplantation and Its Usage in Neuropsychiatric Disorders.

The Role of Toll-Like Receptors in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A New Promising Therapeutic Approach?

The gut microbiome and the brain.

A metagenomic approach to investigate the microbial causes of myalgic encephalomyelitis/chronic fatigue syndrome: moving beyond XMRV.

[Pathogenicity of fungi in the intestines--current status of the discussion].

The Gut Microbiome and Symptom Burden After Kidney Transplantation: An Overview and Research Opportunities.

Establishment and evaluation of prediction model for multiple disease classification based on gut microbial data.