{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:48:51Z","timestamp":1788050931884,"version":"build-2784847793"},"reference-count":136,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union-NextGenerationEU","award":["BG-RRP-2.004-0007-C03"],"award-info":[{"award-number":["BG-RRP-2.004-0007-C03"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS) is a disabling clinical condition, whose hallmark characteristic is post-exertional malaise (PEM). It can affect many organs and systems, leading to severe impairment of patients\u2019 quality of life. Although numerous post-infectious, immunological, neurological, metabolic, and endocrine alterations have been documented, neither a definitive diagnostic marker nor approved treatments are available. The etiology and pathophysiology remain incompletely understood; however, emerging evidence suggests that the gut microbiome plays a role in immune responses and the development of ME\/CFS. It is hypothesized that specific disturbances in gut microbiome composition, known as dysbiosis, may compromise the integrity of the intestinal barrier. This consequently leads to translocation of microbial components, which further triggers an immune response and systemic inflammation complicating the clinical presentation of ME\/CFS. Furthermore, in terms of the so-called gut\u2013brain axis, microbiome changes may lead to distinct neurocognitive impairments observed in ME\/CFS patients. This review offers the readers a broad perspective on the topic on ME\/CFS, with a particular emphasis on the interplay between the gut microbiome and disease mechanisms. Last but not least, recent data on potential treatment strategies for intestinal dysbiosis in ME\/CFS patients have been included.<\/jats:p>","DOI":"10.3390\/ijms27010425","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T16:08:00Z","timestamp":1767197280000},"page":"425","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Gut Microbiome and Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS): Insights into Disease Mechanisms"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9028-6937","authenticated-orcid":false,"given":"Ralitsa","family":"Nikolova","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Immunology\u2014\u201cProf. Dr. Elissay Yanev\u201d, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Division of Innovative Diagnostic Methods, Research Institute at Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Laboratory of Microbiology, University Hospital St. George, 4002 Plovdiv, Bulgaria"},{"name":"Strategic Research and Innovation Program for the Development of Medical University of Plovdiv (SRIPD-MUP), 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7447-7627","authenticated-orcid":false,"given":"Deyan","family":"Donchev","sequence":"additional","affiliation":[{"name":"Strategic Research and Innovation Program for the Development of Medical University of Plovdiv (SRIPD-MUP), 4002 Plovdiv, Bulgaria"},{"name":"National Reference Laboratory for Control and Monitoring of Antimicrobial Resistance, Department of Microbiology, National Center of Infectious and Parasitic Diseases, 26 Yanko Sakazov Blvd., 1504 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8657-1548","authenticated-orcid":false,"given":"Katya","family":"Vaseva","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology\u2014\u201cProf. Dr. Elissay Yanev\u201d, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Strategic Research and Innovation Program for the Development of Medical University of Plovdiv (SRIPD-MUP), 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2616-894X","authenticated-orcid":false,"given":"Ivan N.","family":"Ivanov","sequence":"additional","affiliation":[{"name":"Strategic Research and Innovation Program for the Development of Medical University of Plovdiv (SRIPD-MUP), 4002 Plovdiv, Bulgaria"},{"name":"National Reference Laboratory for Control and Monitoring of Antimicrobial Resistance, Department of Microbiology, National Center of Infectious and Parasitic Diseases, 26 Yanko Sakazov Blvd., 1504 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1002\/jclp.21880","article-title":"Understanding Long-Term Outcomes of Chronic Fatigue Syndrome","volume":"68","author":"Brown","year":"2012","journal-title":"J. Clin. Psychol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1186\/s12967-020-02455-0","article-title":"Review of Case Definitions for Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS)","volume":"18","author":"Lim","year":"2020","journal-title":"J. Transl. Med."},{"key":"ref_3","first-page":"40","article-title":"Examining Case Definition Criteria for Chronic Fatigue Syndrome and Myalgic Encephalomyelitis","volume":"2","author":"Jason","year":"2014","journal-title":"Fatigue"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Agarwal, P., and Friedman, K.J. (2025). Reframing Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS): Biological Basis of Disease and Recommendations for Supporting Patients. Healthcare, 13.","DOI":"10.20944\/preprints202504.2355.v1"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1093\/aje\/kwx029","article-title":"Multi-Site Clinical Assessment of Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (MCAM): Design and Implementation of a Prospective\/Retrospective Rolling Cohort Study","volume":"185","author":"Unger","year":"2017","journal-title":"Am. J. Epidemiol."},{"key":"ref_6","first-page":"277","article-title":"Research Update: The Relation between ME\/CFS Disease Burden and Research Funding in the USA","volume":"66","author":"Mirin","year":"2020","journal-title":"Work"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s12967-020-02269-0","article-title":"Systematic Review and Meta-Analysis of the Prevalence of Chronic Fatigue Syndrome\/Myalgic Encephalomyelitis (CFS\/ME)","volume":"18","author":"Lim","year":"2020","journal-title":"J. Transl. Med."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Hvidberg, M.F., Brinth, L.S., Olesen, A.V., Petersen, K.D., and Ehlers, L. (2015). The Health-Related Quality of Life for Patients with Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS). PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0132421"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1186\/s12967-017-1263-z","article-title":"The European ME\/CFS Biomarker Landscape Project: An Initiative of the European Network EUROMENE","volume":"15","author":"Scheibenbogen","year":"2017","journal-title":"J. Transl. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.1016\/j.mayocp.2023.07.032","article-title":"Diagnosis and Management of Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome","volume":"98","author":"Grach","year":"2023","journal-title":"Mayo Clin. Proc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1038\/s41591-022-01810-6","article-title":"Unexplained Post-Acute Infection Syndromes","volume":"28","author":"Choutka","year":"2022","journal-title":"Nat. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1186\/s12967-018-1644-y","article-title":"Chronic Viral Infections in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS)","volume":"16","author":"Rasa","year":"2018","journal-title":"J. Transl. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1136\/jcp.2009.070466","article-title":"Acute Enterovirus Infection Followed by Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS) and Viral Persistence","volume":"63","author":"Chia","year":"2010","journal-title":"J. Clin. Pathol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1136\/bmj.38933.585764.AE","article-title":"Post-Infective and Chronic Fatigue Syndromes Precipitated by Viral and Non-Viral Pathogens: Prospective Cohort Study","volume":"333","author":"Hickie","year":"2006","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Komaroff, A.L., and Lipkin, W.I. (2023). ME\/CFS and Long COVID Share Similar Symptoms and Biological Abnormalities: Road Map to the Literature. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1187163"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Wong, T.L., and Weitzer, D.J. (2021). Long COVID and Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS)-A Systemic Review and Comparison of Clinical Presentation and Symptomatology. Medicina, 57.","DOI":"10.3390\/medicina57050418"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1136\/gutjnl-2018-316723","article-title":"Human Gut Microbiome: Hopes, Threats and Promises","volume":"67","author":"Cani","year":"2018","journal-title":"Gut"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s13099-018-0230-4","article-title":"Involvement of Gut Microbiome in Human Health and Disease: Brief Overview, Knowledge Gaps and Research Opportunities","volume":"10","author":"Liang","year":"2018","journal-title":"Gut Pathog."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1053\/j.gastro.2019.07.025","article-title":"Metabolic Functions of Gut Microbes Associate With Efficacy Of Tumor Necrosis Factor Antagonists in Patients With Inflammatory Bowel Diseases","volume":"157","author":"Aden","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Seton, K.A., Defernez, M., Telatin, A., Tiwari, S.K., Savva, G.M., Hayhoe, A., Noble, A., de Carvalho-KoK, A.L.S., James, S.A., and Bansal, A. (2023). Investigating Antibody Reactivity to the Intestinal Microbiome in Severe Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS): A Feasibility Study. Int. J. Mol. Sci., 24.","DOI":"10.1101\/2023.05.21.23290299"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1186\/s40001-024-01747-1","article-title":"Clinical Evidence of the Link between Gut Microbiome and Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: A Retrospective Review","volume":"29","author":"Wang","year":"2024","journal-title":"Eur. J. Med. Res."},{"key":"ref_22","first-page":"13690","article-title":"The Microbiota-Gut-Brain Axis in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: A Narrative Review of an Emerging Field","volume":"35","author":"Ayoub","year":"2025","journal-title":"Eur. J. Transl. Myol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.molmed.2021.06.002","article-title":"Insights from Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome May Help Unravel the Pathogenesis of Postacute COVID-19 Syndrome","volume":"27","author":"Komaroff","year":"2021","journal-title":"Trends Mol. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1001\/jama.2015.1346","article-title":"Beyond Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: An IOM Report on Redefining an Illness","volume":"313","author":"Clayton","year":"2015","journal-title":"JAMA"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"387","DOI":"10.7326\/0003-4819-108-3-387","article-title":"Chronic Fatigue Syndrome","volume":"108","author":"Holmes","year":"1988","journal-title":"Ann. Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"953","DOI":"10.7326\/0003-4819-121-12-199412150-00009","article-title":"The Chronic Fatigue Syndrome: A Comprehensive Approach to Its Definition and Study","volume":"121","author":"Fukuda","year":"1994","journal-title":"Ann. Intern. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1177\/0163278711424281","article-title":"Contrasting Case Definitions for Chronic Fatigue Syndrome, Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome and Myalgic Encephalomyelitis","volume":"35","author":"Jason","year":"2012","journal-title":"Eval. Health Prof."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1300\/J092v11n01_02","article-title":"Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols","volume":"11","author":"Carruthers","year":"2003","journal-title":"J. Chronic Fatigue Syndr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/j.1365-2796.2011.02428.x","article-title":"Myalgic Encephalomyelitis: International Consensus Criteria","volume":"270","author":"Carruthers","year":"2011","journal-title":"J. Intern. Med."},{"key":"ref_30","unstructured":"NICE (2021). Myalgic Encephalomyelitis (or Encephalopathy)\/Chronic Fatigue Syndrome: Diagnosis and Management NICE Guideline, NICE."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2861","DOI":"10.1016\/j.mayocp.2021.07.004","article-title":"Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management","volume":"96","author":"Bateman","year":"2021","journal-title":"Mayo Clin. Proc."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Rivera, M.C., Mastronardi, C., Silva-Aldana, C.T., Arcos-Burgos, M., and Lidbury, B.A. (2019). Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: A Comprehensive Review. Diagnostics, 9.","DOI":"10.3390\/diagnostics9030091"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"121","DOI":"10.3389\/fped.2017.00121","article-title":"Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer","volume":"5","author":"Rowe","year":"2017","journal-title":"Front. Pediatr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1093\/ije\/dyp147","article-title":"A Systematic Review of Chronic Fatigue, Its Syndromes and Ethnicity: Prevalence, Severity, Co-Morbidity and Coping","volume":"38","author":"Dinos","year":"2009","journal-title":"Int. J. Epidemiol."},{"key":"ref_35","first-page":"22","article-title":"Post-Exertional Malaise in Patients with ME and CFS with Comorbid Fibromyalgia","volume":"3","author":"Mcmanimen","year":"2017","journal-title":"SRL Neurol. Neurosurg."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Cotler, J., Holtzman, C., Dudun, C., and Jason, L.A. (2018). A Brief Questionnairetoassess Post-Exertional Malaise. Diagnostics, 8.","DOI":"10.3390\/diagnostics8030066"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Stussman, B., Williams, A., Snow, J., Gavin, A., Scott, R., Nath, A., and Walitt, B. (2020). Characterization of Post\u2013Exertional Malaise in Patients With Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome. Front. Neurol., 11.","DOI":"10.3389\/fneur.2020.01025"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1515\/reveh-2015-0026","article-title":"Review of Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: An Evidence-Based Approach to Diagnosis and Management by Clinicians","volume":"30","author":"Bested","year":"2015","journal-title":"Rev. Environ. Health"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Chu, L., Valencia, I.J., Garvert, D.W., and Montoya, J.G. (2018). Deconstructing Post-Exertional Malaise in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: A Patient-Centered, Cross-Sectional Survey. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0197811"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Jurek, J.M., and Castro-Marrero, J. (2024). A Narrative Review on Gut Microbiome Disturbances and Microbial Preparations in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: Implications for Long COVID. Nutrients, 16.","DOI":"10.20944\/preprints202404.2021.v1"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"K\u00f6nig, R.S., Albrich, W.C., Kahlert, C.R., Bahr, L.S., L\u00f6ber, U., Vernazza, P., Scheibenbogen, C., and Forslund, S.K. (2022). The Gut Microbiome in Myalgic Encephalomyelitis (ME)\/Chronic Fatigue Syndrome (CFS). Front. Immunol., 12, Erratum in Front. Immunol. 2023, 13, 878196.","DOI":"10.3389\/fimmu.2021.628741"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Deumer, U.S., Varesi, A., Floris, V., Savioli, G., Mantovani, E., L\u00f3pez-carrasco, P., Rosati, G.M., Prasad, S., and Ricevuti, G. (2021). Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (Me\/Cfs): An Overview. J. Clin. Med., 10.","DOI":"10.3390\/jcm10204786"},{"key":"ref_43","unstructured":"Anne Evans, M., and Jason, L.A. (2018). Onset Patterns of Chronic Fatigue Syndrome and Myalgic Encephalomyelitis. [Ph.D. Thesis, DePaul University]."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"105465","DOI":"10.1016\/j.phrs.2021.105465","article-title":"Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS): Where Will the Drugs Come From?","volume":"165","author":"Toogood","year":"2021","journal-title":"Pharmacol. Res."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Arron, H.E., Marsh, B.D., Kell, D.B., Khan, M.A., Jaeger, B.R., and Pretorius, E. (2024). Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: The Biology of a Neglected Disease. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1386607"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.jcv.2006.08.013","article-title":"Chronic Fatigue Syndrome","volume":"37","author":"Devanur","year":"2006","journal-title":"J. Clin. Virol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s11011-019-0388-6","article-title":"Myalgic Encephalomyelitis or Chronic Fatigue Syndrome: How Could the Illness Develop?","volume":"34","author":"Morris","year":"2019","journal-title":"Metab. Brain Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/S0140-6736(06)68073-2","article-title":"Chronic Fatigue Syndrome","volume":"367","author":"Prins","year":"2006","journal-title":"Lancet"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1186\/s12967-025-06625-w","article-title":"Elevated Risk of New-Onset Chronic Fatigue Syndrome\/Myalgic Encephalomyelitis up to Four Years after SARS-CoV-2 Infection","volume":"23","author":"Hadidchi","year":"2025","journal-title":"J. Transl. Med."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Stallmach, A., Quickert, S., Puta, C., and Reuken, P.A. (2024). The Gastrointestinal Microbiota in the Development of ME\/CFS: A Critical View and Potential Perspectives. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1352744"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.autrev.2018.01.009","article-title":"Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome\u2014Evidence for an Autoimmune Disease","volume":"17","author":"Sotzny","year":"2018","journal-title":"Autoimmun. Rev."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.bbi.2015.09.013","article-title":"Antibodies to \u03b2 Adrenergic and Muscarinic Cholinergic Receptors in Patients with Chronic Fatigue Syndrome","volume":"52","author":"Loebel","year":"2016","journal-title":"Brain Behav. Immun."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1038\/nrendo.2009.106","article-title":"Stress and Disorders of the Stress System","volume":"5","author":"Chrousos","year":"2009","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_54","first-page":"784520","article-title":"A Review of Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome","volume":"2013","author":"Tomas","year":"2013","journal-title":"Int. Sch. Res. Not."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"103198","DOI":"10.1016\/j.autneu.2024.103198","article-title":"Research Progress on Pathogenesis of Chronic Fatigue Syndrome and Treatment of Traditional Chinese and Western Medicine","volume":"255","author":"Liu","year":"2024","journal-title":"Auton. Neurosci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s11011-013-9435-x","article-title":"Mitochondrial Dysfunctions in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome Explained by Activated Immuno-Inflammatory, Oxidative and Nitrosative Stress Pathways","volume":"29","author":"Morris","year":"2014","journal-title":"Metab. Brain Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.freeradbiomed.2005.04.020","article-title":"Oxidative Stress Levels Are Raised in Chronic Fatigue Syndrome and Are Associated with Clinical Symptoms","volume":"39","author":"Kennedy","year":"2005","journal-title":"Free Radic. Biol. Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1097\/YCO.0b013e32831a4728","article-title":"Inflammatory and Oxidative and Nitrosative Stress Pathways Underpinning Chronic Fatigue, Somatization and Psychosomatic Symptoms","volume":"22","author":"Maes","year":"2009","journal-title":"Curr. Opin. Psychiatry"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.cmet.2016.05.005","article-title":"Intestinal Crosstalk between Bile Acids and Microbiota and Its Impact on Host Metabolism","volume":"24","author":"Sayin","year":"2016","journal-title":"Cell Metab."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1038\/nature11450","article-title":"A Metagenome-Wide Association Study of Gut Microbiota in Type 2 Diabetes","volume":"490","author":"Qin","year":"2012","journal-title":"Nature"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/1743-7075-7-79","article-title":"Gut Inflammation in Chronic Fatigue Syndrome","volume":"7","author":"Lakhan","year":"2010","journal-title":"Nutr. Metab."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Navaneetharaja, N., Griffiths, V., Wileman, T., and Carding, S.R. (2016). A Role for the Intestinal Microbiota and Virome in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS)?. J. Clin. Med., 5.","DOI":"10.3390\/jcm5060055"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Afzaal, M., Saeed, F., Shah, Y.A., Hussain, M., Rabail, R., Socol, C.T., Hassoun, A., Pateiro, M., Lorenzo, J.M., and Rusu, A.V. (2022). Human Gut Microbiota in Health and Disease: Unveiling the Relationship. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.999001"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1042\/BCJ20160510","article-title":"Introduction to the Human Gut Microbiota","volume":"474","author":"Thursby","year":"2017","journal-title":"Biochem. J."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Simonson, M., Simonson, T., and Nob\u00e9court, E. (2025). An Overview of Basic Pathophysiological Interactions between Gut Bacteria and Their Host. Front. Nutr., 12.","DOI":"10.3389\/fnut.2025.1565609"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1126\/science.aad9378","article-title":"How Colonization by Microbiota in Early Life Shapes the Immune System","volume":"352","author":"Gensollen","year":"2016","journal-title":"Science"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1038\/nature18849","article-title":"Interactions between the Microbiota and Pathogenic Bacteria in the Gut","volume":"535","author":"Sperandio","year":"2016","journal-title":"Nature"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Iacob, S., Iacob, D.G., and Luminos, L.M. (2019). Intestinal Microbiota as a Host Defense Mechanism to Infectious Threats. Front. Microbiol., 9.","DOI":"10.3389\/fmicb.2018.03328"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1038\/s42255-018-0017-4","article-title":"Microbial Regulation of Organismal Energy Homeostasis","volume":"1","author":"Cani","year":"2019","journal-title":"Nat. Metab."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1038\/nrn3346","article-title":"Mind-Altering Microorganisms: The Impact of the Gut Microbiota on Brain and Behaviour","volume":"13","author":"Cryan","year":"2012","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Rinninella, E., Raoul, P., Cintoni, M., Franceschi, F., Miggiano, G.A.D., Gasbarrini, A., and Mele, M.C. (2019). What Is the Healthy Gut Microbiota Composition? A Changing Ecosystem across Age, Environment, Diet, and Diseases. Microorganisms, 7.","DOI":"10.3390\/microorganisms7010014"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Salami, M. (2021). Interplay of Good Bacteria and Central Nervous System: Cognitive Aspects and Mechanistic Considerations. Front. Neurosci., 15.","DOI":"10.3389\/fnins.2021.613120"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.tim.2012.05.003","article-title":"Intestinal Microbiota Is a Plastic Factor Responding to Environmental Changes","volume":"20","author":"Candela","year":"2012","journal-title":"Trends Microbiol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1001\/archinte.160.2.221","article-title":"Overlapping Conditions Among Patients With Chronic Fatigue Syndrome, Fibromyalgia, and Temporomandibular Disorder","volume":"160","author":"Aaron","year":"2000","journal-title":"Arch. Intern. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s12967-019-1797-3","article-title":"Increased Risk of Chronic Fatigue Syndrome in Patients with Inflammatory Bowel Disease: A Population-Based Retrospective Cohort Study","volume":"17","author":"Tsai","year":"2019","journal-title":"J. Transl. Med."},{"key":"ref_76","first-page":"621","article-title":"Increased D-Lactic Acid Intestinal Bacteria in Patients with Chronic Fatigue Syndrome","volume":"23","author":"Sheedy","year":"2009","journal-title":"In Vivo"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.anaerobe.2013.06.002","article-title":"High-Throughput 16S RRNA Gene Sequencing Reveals Alterations of Intestinal Microbiota in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome Patients","volume":"22","author":"Coomans","year":"2013","journal-title":"Anaerobe"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Shukla, S.K., Cook, D., Meyer, J., Vernon, S.D., Le, T., Clevidence, D., Robertson, C.E., Schrodi, S.J., Yale, S., and Frank, D.N. (2015). Changes in Gut and Plasma Microbiome Following Exercise Challenge in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS). PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0145453"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s40168-016-0171-4","article-title":"Reduced Diversity and Altered Composition of the Gut Microbiome in Individuals with Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome","volume":"4","author":"Giloteaux","year":"2016","journal-title":"Microbiome"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"720","DOI":"10.12659\/AJCR.900314","article-title":"A Pair of Identical Twins Discordant for Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome Differ in Physiological Parameters and Gut Microbiome Composition","volume":"17","author":"Giloteaux","year":"2016","journal-title":"Am. J. Case Rep."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s40168-017-0261-y","article-title":"Fecal Metagenomic Profiles in Subgroups of Patients with Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome","volume":"5","author":"Williams","year":"2017","journal-title":"Microbiome"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"e4282","DOI":"10.7717\/peerj.4282","article-title":"Eukaryotes in the Gut Microbiota in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome","volume":"6","author":"Mandarano","year":"2018","journal-title":"PeerJ"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"19933","DOI":"10.1038\/s41598-020-77105-y","article-title":"Deep Phenotyping of Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome in Japanese Population","volume":"10","author":"Kitami","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"7043","DOI":"10.1038\/s41598-021-86425-6","article-title":"Potential Role of Microbiome in Chronic Fatigue Syndrome\/Myalgic Encephalomyelits (CFS\/ME)","volume":"11","author":"Lupo","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.chom.2023.01.001","article-title":"Multi-\u2018omics of Gut Microbiome-Host Interactions in Short- and Long-Term Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome Patients","volume":"31","author":"Xiong","year":"2023","journal-title":"Cell Host Microbe"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.chom.2023.01.004","article-title":"Deficient Butyrate-Producing Capacity in the Gut Microbiome Is Associated with Bacterial Network Disturbances and Fatigue Symptoms in ME\/CFS","volume":"31","author":"Guo","year":"2023","journal-title":"Cell Host Microbe"},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"He, G., Cao, Y., Ma, H., Guo, S., Xu, W., Wang, D., Chen, Y., and Wang, H. (2023). Causal Effects between Gut Microbiome and Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: A Two-Sample Mendelian Randomization Study. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1190894"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"33075","DOI":"10.1038\/s41598-025-16438-y","article-title":"The Gut Microbial Composition Is Different in Chronic Fatigue Syndrome than in Healthy Controls","volume":"15","author":"Tabisz","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1186\/s13643-018-0909-0","article-title":"A Systematic Review of Enteric Dysbiosis in Chronic Fatigue Syndrome\/Myalgic Encephalomyelitis","volume":"7","author":"Corbitt","year":"2018","journal-title":"Syst. Rev."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Varesi, A., Deumer, U.S., Ananth, S., and Ricevuti, G. (2021). The Emerging Role of Gut Microbiota in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (Me\/Cfs): Current Evidence and Potential Therapeutic Applications. J. Clin. Med., 10.","DOI":"10.3390\/jcm10215077"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1136\/gutjnl-2013-304833","article-title":"A Decrease of the Butyrate-Producing Species Roseburia Hominis and Faecalibacterium Prausnitzii Defines Dysbiosis in Patients with Ulcerative Colitis","volume":"63","author":"Machiels","year":"2014","journal-title":"Gut"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.3748\/wjg.v17.i12.1519","article-title":"Potential Beneficial Effects of Butyrate in Intestinal and Extraintestinal Diseases","volume":"17","author":"Canani","year":"2011","journal-title":"World J. Gastroenterol."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Parker, B.J., Wearsch, P.A., Veloo, A.C.M., and Rodriguez-Palacios, A. (2020). The Genus Alistipes: Gut Bacteria With Emerging Implications to Inflammation, Cancer, and Mental Health. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.00906"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1186\/s12967-025-06527-x","article-title":"The Potential Therapeutic Approaches Targeting Gut Health in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS): A Narrative Review","volume":"23","author":"Hsu","year":"2025","journal-title":"J. Transl. Med."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Grenham, S., Clarke, G., Cryan, J.F., and Dinan, T.G. (2011). Brain-Gut-Microbe Communication in Health and Disease. Front. Physiol., 2.","DOI":"10.3389\/fphys.2011.00094"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Zheng, Y., Bonfili, L., Wei, T., and Eleuteri, A.M. (2023). Understanding the Gut\u2013Brain Axis and Its Therapeutic Implications for Neurodegenerative Disorders. Nutrients, 15.","DOI":"10.3390\/nu15214631"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jpsychires.2015.02.021","article-title":"Collective Unconscious: How Gut Microbes Shape Human Behavior","volume":"63","author":"Dinan","year":"2015","journal-title":"J. Psychiatr. Res."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Warren, A., Nyavor, Y., Zarabian, N., Mahoney, A., and Frame, L.A. (2024). The Microbiota-Gut-Brain-Immune Interface in the Pathogenesis of Neuroinflammatory Diseases: A Narrative Review of the Emerging Literature. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1365673"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"555","DOI":"10.3390\/gastroent15030041","article-title":"Exploring Gut\u2013Brain Interaction Disorders: Mechanisms and Translational Therapies Crossing Neurology to Gastroenterology","volume":"15","author":"Vasilev","year":"2024","journal-title":"Gastroenterol. Insights"},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Biagioli, V., Matera, M., Cavecchia, I., Di Pierro, F., Zerbinati, N., and Striano, P. (2025). Gut Microbiota and Autism: Unlocking Connections. Nutrients, 17.","DOI":"10.3390\/nu17233706"},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Wallis, A., Jackson, M.L., Ball, M., Lewis, D.P., and Bruck, D. (2017). Sleep, Cognitive and Mood Symptoms in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome Examining the Role of the Gut-Brain Axis. The Handbook of Stress and Health: A Guide to Research and Practice, John Wiley & Sons.","DOI":"10.1002\/9781118993811.ch31"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1042\/BIO03902010","article-title":"The Gut Microbiome in Myalgic Encephalomyelitis","volume":"39","author":"Hanson","year":"2017","journal-title":"Biochemist"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/j.jad.2011.09.010","article-title":"Increased IgA Responses to the LPS of Commensal Bacteria Is Associated with Inflammation and Activation of Cell-Mediated Immunity in Chronic Fatigue Syndrome","volume":"136","author":"Maes","year":"2012","journal-title":"J. Affect. Disord."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.jad.2006.08.021","article-title":"Increased Serum IgA and IgM against LPS of Enterobacteria in Chronic Fatigue Syndrome (CFS): Indication for the Involvement of Gram-Negative Enterobacteria in the Etiology of CFS and for the Presence of an Increased Gut-Intestinal Permeability","volume":"99","author":"Maes","year":"2007","journal-title":"J. Affect Disord."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1007\/s12035-013-8425-7","article-title":"Role of the Toll like Receptor (TLR) Radical Cycle in Chronic Inflammation: Possible Treatments Targeting the TLR4 Pathway","volume":"48","author":"Lucas","year":"2013","journal-title":"Mol. Neurobiol."},{"key":"ref_106","doi-asserted-by":"crossref","unstructured":"Watai, K., Taniguchi, M., and Azuma, K. (2025). The Gut\u2013Brain\u2013Immune Axis in Environmental Sensitivity Illnesses: Microbiome-Centered Narrative Review of Fibromyalgia Syndrome, Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome, and Multiple Chemical Sensitivity. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26209997"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s40168-016-0189-7","article-title":"Cardiorespiratory Fitness as a Predictor of Intestinal Microbial Diversity and Distinct Metagenomic Functions","volume":"4","author":"Estaki","year":"2016","journal-title":"Microbiome"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1038\/s41564-018-0257-9","article-title":"Recovery of Gut Microbiota of Healthy Adults Following Antibiotic Exposure","volume":"3","author":"Palleja","year":"2018","journal-title":"Nat. Microbiol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1038\/nrn3071","article-title":"Gut Feelings: The Emerging Biology of Gut-Brain Communication","volume":"12","author":"Mayer","year":"2011","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Jenkins, T.A., Nguyen, J.C.D., Polglaze, K.E., and Bertrand, P.P. (2016). Influence of Tryptophan and Serotonin on Mood and Cognition with a Possible Role of the Gut-Brain Axis. Nutrients, 8.","DOI":"10.3390\/nu8010056"},{"key":"ref_111","doi-asserted-by":"crossref","unstructured":"Raij, T., and Raij, K. (2024). Association between Fatigue, Peripheral Serotonin, and L-Carnitine in Hypothyroidism and in Chronic Fatigue Syndrome. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1358404"},{"key":"ref_112","doi-asserted-by":"crossref","unstructured":"Chojnacki, M., B\u0142o\u0144ska, A., Kaczka, A., Chojnacki, J., Walecka-Kapica, E., Romanowska, N., Przybylowska-Sygut, K., and Pop\u0142awski, T. (2025). Assessment of the Gut Microbiome in Patients with Coexisting Irritable Bowel Syndrome and Chronic Fatigue Syndrome. Nutrients, 17.","DOI":"10.3390\/nu17132232"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.3892\/ijmm.2016.2750","article-title":"Indoleamine 2,3-Dioxygenase, by Degrading L-Tryptophan, Enhances Carnitine Palmitoyltransferase i Activity and Fatty Acid Oxidation, and Exerts Fatty Acid-Dependent Effects in Human Alloreactive CD4+ T-Cells","volume":"38","author":"Eleftheriadis","year":"2016","journal-title":"Int. J. Mol. Med."},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"Kashi, A.A., Davis, R.W., and Phair, R.D. (2019). The IDO Metabolic Trap Hypothesis for the Etiology of ME\/CFS. Diagnostics, 9.","DOI":"10.3390\/diagnostics9030082"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"698","DOI":"10.14336\/AD.2021.0824","article-title":"The Role of Kynurenine Pathway and NAD+ Metabolism in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome","volume":"13","author":"Dehhaghi","year":"2022","journal-title":"Aging Dis."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1042\/CS20171330","article-title":"Does the Microbiome and Virome Contribute to Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome?","volume":"132","author":"Newberry","year":"2018","journal-title":"Clin. Sci."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1757-4749-1-6","article-title":"A Randomized, Double-Blind, Placebo-Controlled Pilot Study of a Probiotic in Emotional Symptoms of Chronic Fatigue Syndrome","volume":"1","author":"Rao","year":"2009","journal-title":"Gut Pathog."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2019\/1684198","article-title":"Modification of Immunological Parameters, Oxidative Stress Markers, Mood Symptoms, and Well-Being Status in CFS Patients after Probiotic Intake: Observations from a Pilot Study","volume":"2019","author":"Venturini","year":"2019","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1475-2891-8-4","article-title":"Effect of Supplement with Lactic-Acid Producing Bacteria on Fatigue and Physical Activity in Patients with Chronic Fatigue Syndrome","volume":"8","author":"Sullivan","year":"2009","journal-title":"Nutr. J."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"325","DOI":"10.4161\/gmic.25487","article-title":"Bifidobacterium Infantis 35624 Modulates Host Inflammatory Processes beyond the Gut","volume":"4","author":"Groeger","year":"2013","journal-title":"Gut Microbes"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.3390\/nu5041417","article-title":"Fiber and Prebiotics: Mechanisms and Health Benefits","volume":"5","author":"Slavin","year":"2013","journal-title":"Nutrients"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1194\/jlr.R036012","article-title":"The Role of Short-Chain Fatty Acids in the Interplay between Diet, Gut Microbiota, and Host Energy Metabolism","volume":"54","author":"Groen","year":"2013","journal-title":"J. Lipid Res."},{"key":"ref_123","doi-asserted-by":"crossref","unstructured":"R\u00edos-Covi\u00e1n, D., Ruas-Madiedo, P., Margolles, A., Gueimonde, M., De los Reyes-Gavil\u00e1n, C.G., and Salazar, N. (2016). Intestinal Short Chain Fatty Acids and Their Link with Diet and Human Health. Front. Microbiol., 7.","DOI":"10.3389\/fmicb.2016.00185"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"2471","DOI":"10.3168\/jds.2016-11890","article-title":"Bovine Milk Oligosaccharides Decrease Gut Permeability and Improve Inflammation and Microbial Dysbiosis in Diet-Induced Obese Mice","volume":"100","author":"Boudry","year":"2017","journal-title":"J. Dairy Sci."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"154767","DOI":"10.1016\/j.metabol.2021.154767","article-title":"FOS\/GOS Attenuates High-Fat Diet Induced Bone Loss via Reversing Microbiota Dysbiosis, High Intestinal Permeability and Systemic Inflammation in Mice","volume":"119","author":"Zhang","year":"2021","journal-title":"Metabolism"},{"key":"ref_126","doi-asserted-by":"crossref","unstructured":"Tan, P., Li, X., Shen, J., and Feng, Q. (2020). Fecal Microbiota Transplantation for the Treatment of Inflammatory Bowel Disease: An Update. Front. Pharmacol., 11.","DOI":"10.3389\/fphar.2020.574533"},{"key":"ref_127","doi-asserted-by":"crossref","unstructured":"Lahoud, C., Habib, T., Kalta, D., Dimachkie, R., El Sayegh, S., and Deeb, L. (2025). Intestinal Microbiota and Fecal Transplantation in Patients with Inflammatory Bowel Disease and Clostridioides Difficile: An Updated Literature Review. J. Clin. Med., 14.","DOI":"10.3390\/jcm14155260"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"100061","DOI":"10.1016\/j.humic.2019.100061","article-title":"A Retrospective Outcome Study of 42 Patients with Chronic Fatigue Syndrome, 30 of Whom Had Irritable Bowel Syndrome. Half Were Treated with Oral Approaches, and Half Were Treated with Faecal Microbiome Transplantation","volume":"13","author":"Kenyon","year":"2019","journal-title":"Hum. Microb. J."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1186\/s12967-023-04227-y","article-title":"Randomized, Double-Blinded, Placebo-Controlled Pilot Study: Efficacy of Faecal Microbiota Transplantation on Chronic Fatigue Syndrome","volume":"21","author":"Salonen","year":"2023","journal-title":"J. Transl. Med."},{"key":"ref_130","first-page":"4742","article-title":"The Role of Diet on Gut Microbiota Composition","volume":"20","author":"Bibbo","year":"2016","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_131","doi-asserted-by":"crossref","unstructured":"Ramasinghe, C., Bordiga, M., and Xu, B. (2025). A Comprehensive Review of the Triangular Relationship Among Diet, Gut Microbiota, and Aging. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26188785"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"11955","DOI":"10.1038\/s41598-017-12109-9","article-title":"Effect of Caloric Restriction on Gut Permeability, Inflammation Markers, and Fecal Microbiota in Obese Women","volume":"7","author":"Ott","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s12937-019-0475-x","article-title":"The Study Evaluating the Effect of Probiotic Supplementation on the Mental Status, Inflammation, and Intestinal Barrier in Major Depressive Disorder Patients Using Gluten-Free or Gluten-Containing Diet (SANGUT Study): A 12-Week, Randomized, Double-Blind, and Placebo-Controlled Clinical Study Protocol","volume":"18","author":"Rog","year":"2019","journal-title":"Nutr. J."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"114862","DOI":"10.1016\/j.biopha.2023.114862","article-title":"Astragalus Polysaccharide Ameliorated Complex Factor-Induced Chronic Fatigue Syndrome by Modulating the Gut Microbiota and Metabolites in Mice","volume":"163","author":"Wei","year":"2023","journal-title":"Biomed. Pharmacother."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jnutbio.2018.04.004","article-title":"Nutritional Modulation of the Intestinal Microbiota: Future Opportunities for the Prevention and Treatment of Neuroimmune and Neuroinflammatory Disease","volume":"61","author":"Lombardi","year":"2018","journal-title":"J. Nutr. Biochem."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1111\/jhn.12435","article-title":"Dietary and Nutrition Interventions for the Therapeutic Treatment of Chronic Fatigue Syndrome\/Myalgic Encephalomyelitis: A Systematic Review","volume":"30","author":"Campagnolo","year":"2017","journal-title":"J. Hum. Nutr. Diet."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/1\/425\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T16:08:42Z","timestamp":1767197322000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/1\/425"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,31]]},"references-count":136,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["ijms27010425"],"URL":"https:\/\/doi.org\/10.3390\/ijms27010425","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,31]]}}}