A Gut Feeling in Amyotrophic Lateral Sclerosis: Microbiome of Mice and Men
Open accessAbstract
Amyotrophic lateral sclerosis (ALS) is a severely debilitating disease characterized by progressive degeneration of motor neurons. ALS etiology and pathophysiology are not well understood. It could be the consequences of complex interactions among host factors, microbiome, and the environmental factors. Recent data suggest the novel roles of intestinal dysfunction and microbiota in ALS etiology and progression. Although microbiome may indeed play a critical role in ALS pathogenesis, studies implicating innate immunity and intestinal changes in early disease pathology are limited. The gastrointestinal symptoms in the ALS patients before their diagnosis are largely ignored in the current medical practice. This review aims to explore existing evidence of gastrointestinal symptoms and progress of microbiome in ALS pathogenesis from human and animal studies. We discuss dietary, metabolites, and possible therapeutic approaches by targeting intestinal function and microbiome. Finally, we evaluate existing evidence and identify gaps in the knowledge for future directions in ALS. It is essential to understanding the microbiome and intestinal pathogenesis that determine when, where, and whether microbiome and metabolites critical to ALS progression. These studies will help us to develop more accurate diagnosis and better treatment not only for this challenging disease, but also for other neurodegenerative diseases.
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Gut microbiome alterations and intestinal barrier impairment have been observed in patients with MCI, AD, PD, and ALS.
“Gut microbiome alterations and intestinal barrier impairment have been observed in patients with MCI, AD, PD, and ALS patients.”
From Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases (2024) · cites this paper as [625]
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- Wingate D. (1999). Gastrointestinal Dysfunction in ALS. Amyotroph Lateral Scler Other Motor Neuron Disord. 1, 2. 12365062
Cited by
Sorted by citations
Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases
Loh, J. S., Mak, W. Q., Tan, L. K. S., Ng, C. X., Chan, H. H., Yeow, S. H., Foo, J. B., Ong, Y. S., How, C. W., & Khaw, K. Y. (2024) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-024-01743-1 · Cited by 1,193 · see citing works
Moțățăianu, A., Şerban, G. M., & Andone, S. R. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms242015094 · Cited by 90 · see citing works
Therapeutics for neurodegenerative diseases by targeting the gut microbiome: from bench to bedside
Ma, Y., Li, X., Yu, J., & Wang, Y. (2024) · Translational Neurodegeneration · doi:10.1186/s40035-024-00404-1 · Cited by 87 · see citing works
Bile acids and neurological disease
Hurley, M. J., Bates, R., Macnaughtan, J., & Schapira, A. H. V. (2022) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2022.108311 · Cited by 82 · see citing works
The Promise of Niacin in Neurology
Wuerch, E. C., Urgoiti, G. B. R., & Yong, V. W. (2023) · Neurotherapeutics · doi:10.1007/s13311-023-01376-2 · Cited by 68 · see citing works
What Are the Key Gut Microbiota Involved in Neurological Diseases? A Systematic Review
Bonnechère, B., Amin, N., & van Duijn, C. M. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms232213665 · Cited by 64 · see citing works
Neuroinflammation in amyotrophic lateral sclerosis: pathogenic insights and therapeutic implications
Calma, A. D., Pavey, N., Menon, P., & Vucic, S. (2024) · Current Opinion in Neurology · doi:10.1097/wco.0000000000001279 · Cited by 47 · see citing works
López‐Pingarrón, L., Almeida, H., Soria-Aznar, M., Reyes-Gonzales, M. C., Terrón, M. P., & García, J. J. (2023) · Current Issues in Molecular Biology · doi:10.3390/cimb45040217 · Cited by 43 · see citing works
Gut microbiome correlates with plasma lipids in amyotrophic lateral sclerosis
Guo, K., Figueroa‐Romero, C., Noureldein, M. H., Murdock, B. J., Savelieff, M. G., Hur, J., Goutman, S. A., & Feldman, E. L. (2023) · Brain · doi:10.1093/brain/awad306 · Cited by 42 · see citing works
Zhang, Y., Xia, Y., & Sun, J. (2024) · Gut Microbes · doi:10.1080/19490976.2024.2363880 · Cited by 42 · see citing works
Self-citationAnderson, G. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms24010587 · Cited by 36 · see citing works
Nanoplastics and Neurodegeneration in ALS
Eisen, A., Pioro, E. P., Goutman, S. A., & Kiernan, M. C. (2024) · Brain Sciences · doi:10.3390/brainsci14050471 · Cited by 35 · see citing works
Uceda, S., Echeverry‐Alzate, V., Reiriz, M., Miguel, E. M., Pérez-Curiel, A., Gómez-Senent, S., & Beltrán-Velasco, A. I. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms241713294 · Cited by 35 · see citing works
Valori, C. F., Sulmona, C., Brambilla, L., & Rossi, D. (2023) · Cells · doi:10.3390/cells12111450 · Cited by 30 · see citing works
Immunology of amyotrophic lateral sclerosis – role of the innate and adaptive immunity
Mimic, S., Aru, B., Pehlivanoğlu, C., Sleiman, H., Anđjus, P. R., & Demirel, G. Y. (2023) · Frontiers in Neuroscience · doi:10.3389/fnins.2023.1277399 · Cited by 28 · see citing works
Yoshikawa, S., Taniguchi, K., Sawamura, H., Ikeda, Y., Tsuji, A., & Matsuda, S. (2022) · Metabolites · doi:10.3390/metabo12111052 · Cited by 25 · see citing works
Brain–body mechanisms contribute to sexual dimorphism in amyotrophic lateral sclerosis
Jacob, S. M., Lee, S., Kim, S. H., Sharkey, K. A., Pfeffer, G., & Nguyen, M. D. (2024) · Nature Reviews Neurology · doi:10.1038/s41582-024-00991-7 · Cited by 25 · see citing works
Dysautonomia in Amyotrophic Lateral Sclerosis
Oprisan, A. L., & Popescu, B. O. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms241914927 · Cited by 24 · see citing works
Gut Symptoms, Gut Dysbiosis and Gut-Derived Toxins in ALS
Lee, A., Henderson, R. D., Aylward, J., & McCombe, P. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25031871 · Cited by 23 · see citing works
Balakrishnan, R., Kang, S.-I., Lee, J. Y., Rho, Y., Kim, B.-K., & Choi, D. (2024) · Aging and Disease · doi:10.14336/ad.2024.1362 · Cited by 21 · see citing works
History of ALS and the competing theories on pathogenesis: IFCN handbook chapter
Eisen, A., Vucic, S., & Mitsumoto, H. (2023) · Clinical Neurophysiology Practice · doi:10.1016/j.cnp.2023.11.004 · Cited by 21 · see citing works
Target Metabolites to Slow Down Progression of Amyotrophic Lateral Sclerosis in Mice
Ogbu, D., Zhang, Y., Claud, K., Xia, Y., & Sun, J. (2022) · Metabolites · doi:10.3390/metabo12121253 · Cited by 20 · see citing works
Self-citationMicrobiome and micronutrient in ALS: From novel mechanisms to new treatments
Sun, J., & Zhang, Y. (2024) · Neurotherapeutics · doi:10.1016/j.neurot.2024.e00441 · Cited by 18 · see citing works
Self-citationDysbiosis and Neurodegeneration in ALS: Unraveling the Gut–Brain Axis
Sharma, V. (2025) · NeuroMolecular Medicine · doi:10.1007/s12017-025-08870-0 · Cited by 14 · see citing works
Helgudóttir, S. S., Mørkholt, A. S., Lichota, J., Bruun-Nyzell, P., Andersen, M. C., Kristensen, N. M. J., Johansen, A. K., Zinn, M. R., Jensdóttir, H. M., & Nieland, J. D. (2023) · Neural Regeneration Research · doi:10.4103/1673-5374.387965 · Cited by 14 · see citing works
Zhang, Y., Robinson, K., Xia, Y., & Sun, J. (2025) · Comprehensive physiology · doi:10.1002/cph4.70009 · Cited by 11 · see citing works
Self-citationKrothapalli, M., Buddendorff, L., Yadav, H., Schilaty, N. D., & Jain, S. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25126678 · Cited by 10 · see citing works
Ageing, proteostasis, and the gut: Insights into neurological health and disease
Akbar, M., Toppo, P., & Nazir, A. (2024) · Ageing Research Reviews · doi:10.1016/j.arr.2024.102504 · Cited by 10 · see citing works
The Scientific and Therapeutic Rationale for Off‐Label Treatments in Amyotrophic Lateral Sclerosis
Bedlack, R., Li, X., Evangelista, B., Panzetta, M. E., Kwan, J. Y., Gittings, L. M., & Sattler, R. (2024) · Annals of Neurology · doi:10.1002/ana.27126 · Cited by 9 · see citing works
Nabakhteh, S., Lotfi, A., Afsartaha, A., Khodadadi, E. S., Abdolghaderi, S., Mohammadpour, M., Shokri, Y., Kiani, P., Ehtiati, S., Khakshournia, S., et al. (2025) · Molecular Neurobiology · doi:10.1007/s12035-025-04830-8 · Cited by 8 · see citing works
Zhu, H., He, H., Yang, M., Zhu, H., Hagiwara, A., Shu, L., Xu, J., Miao, Y., Han, X., & Wang, C. (2025) · iScience · doi:10.1016/j.isci.2025.114044 · Cited by 8 · see citing works
Diet, gut microbiome, and cognition in neurodegeneration: a review and methodological framework
Raber, J., & Sharpton, T. J. (2026) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2026.1771904 · Cited by 5 · see citing works
Sun, J., Ince, M. N., Abraham, C., Barrett, T. A., Brenner, L. A., Cong, Y., Dashti, R., Dudeja, P. K., Elliott, D. E., Griffith, T. S., et al. (2023) · Gut Microbes · doi:10.1080/19490976.2023.2267180 · Cited by 5 · see citing works
Self-citationAmyotrophic Lateral Sclerosis (ALS) Genetics and Microbiota: A Comprehensive Review
Kurdi, M. A., Alotaibi, H. M., Alkhuraymi, A. T., Aldahery, L. N., Alhawaj, A. F., & Aldali, H. J. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27041978 · Cited by 5 · see citing works
Microbiome and metabolites impact enteric and central nervous systems in ALS
Walton, E. I., & Sun, J. (2026) · Gut Microbes · doi:10.1080/19490976.2026.2692737 · Cited by 4 · see citing works
Self-citationA molecular systems architecture of neuromuscular junction in amyotrophic lateral sclerosis
Ayyadurai, V. A. S., Deonikar, P., & Kamm, R. D. (2025) · npj Systems Biology and Applications · doi:10.1038/s41540-025-00501-5 · Cited by 4 · see citing works
Das, S., Patel, M., Khandelwal, S., Rawat, R., Shukla, S., Kumari, A., Singh, K., & Kumar, A. (2025) · Journal of Neurochemistry · doi:10.1111/jnc.70278 · Cited by 3 · see citing works
Gut microbiota and ALS: cause, consequence or correlation? - a systematic review
Chakraborty, D. K., Roy, T., Ngo, S. T., Al‐Chalabi, A., & Khleifat, A. A. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1774417 · Cited by 3 · see citing works
Sonkodi, B. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26157211 · Cited by 3 · see citing works
Manusha, S., Varsha, N., Varshini, R., Sivamani, Y., Pokkuluri, K. S., & Elayaperumal, S. (2025) · International review of neurobiology · doi:10.1016/bs.irn.2025.04.006 · Cited by 3 · see citing works
Li, C., Leying, Y., Ma, C., Wen, H., Han, L., & Zhao, X. (2025) · Brain and Behavior · doi:10.1002/brb3.70571 · Cited by 2 · see citing works
Immunology and microbiome: Implications for motor systems
Mahjoub, Y., & Martino, D. (2023) · Handbook of clinical neurology · doi:10.1016/b978-0-323-98818-6.00001-7 · Cited by 2 · see citing works
Pribac, M., Moțățăianu, A., Andone, S. R., Mardale, E., & Nemeth, S. (2024) · Current Issues in Molecular Biology · doi:10.3390/cimb46050271 · Cited by 2 · see citing works
The gut microbiota is a determinant of sexual dimorphism in ALS-linked TDP43 micePreprint
Beraldi, E. J., Lee, S., Jiang, Y., Rea, I. M., Phull, R., Keenan, C. M., Stephens, M., Bardhi, M., Bankole, O. O., Pfeffer, G., et al. (2024) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2024.08.29.610355 · Cited by 2 · see citing works
Metabolites and micronutrition in modulating amyotrophic lateral sclerosis
Claud, K., & Sun, J. (2023) · Neural Regeneration Research · doi:10.4103/1673-5374.385861 · Cited by 1 · see citing works
Self-citationSporadic amyotrophic lateral sclerosis: integral model of pathogenesis and therapy optionsPreprint
Doroshenko, O. (2022) · Research Square · doi:10.21203/rs.3.rs-1643391/v1
Sporadic amyotrophic lateral sclerosis: integral model of pathogenesis and therapy optionsPreprint
Doroshenko, O. (2022) · Research Square · doi:10.21203/rs.3.rs-1643391/v2
"The Relevance of the Microbiota in the Treatment of Amyotrophic Lateral Sclerosis"
Ferreira, S. B. (2023) · Biomedical Journal of Scientific & Technical Research · doi:10.26717/bjstr.2023.49.007790
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Sanchis, E. S., Ortí, J. E. D. L. R., Sancho-Cantus, D., Cunha-Pérez, C., & Mohedo, J. C. (2026) · Pathophysiology · doi:10.3390/pathophysiology33030059
The Microbiota-Gut-Brain Axis in Neurological and Neuropsychiatric Disorders: A Literature Review
Brar, H., Do, N., Kelser, C., Pattipati, S. N., & Nalamolu, K. R. (2026) · Cureus · doi:10.7759/cureus.118684
- Authors
- Martin, S., Battistini, C., & Sun, J.
- Affiliations
- University of Illinois Chicago (US)
- Corresponding author
- Sun, Jun
- Venue
- Frontiers in Cellular and Infection Microbiology
- Publisher
- Frontiers Media SA
- Published
- 2022-03-11
- Volume
- 12
- Pages
- 839526-839526
- ISSN
- 2235-2988 (ISSN-L)
- PMC
- PMC8963415
- OpenAlex
- W4220656356
- Cited by
- 54
- References
- 91
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 14 · 2023: 15 · 2022: 7
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Cellular and Infection Microbiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- U.S. Department of Veterans Affairs (I01BX004824-01, 1i01bx004824-01, VA Merit Award 1 I01BX004824-01, I01 BX004824)
- National Institutes of Health (DK105118)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK105118, R01DK114126, R01DK105118)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- amyotrophic lateral sclerosis, gut microbiota, intestinal dysfunction, gastrointestinal symptoms, motor neuron degeneration, innate immunity, microbial metabolites, dietary intervention, microbiome-targeted therapy, neurodegenerative diseases, mouse model
- MeSH terms
- Gastrointestinal Microbiome, Amyotrophic Lateral Sclerosis, Animals, Humans, Immunity, Innate, Microbiota
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