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{{Cleanup | date = May 2019|reason=References needed}} '''Dysbiosis''' is an imbalance in the [[microbiome|microbial ecosystem]] in a part of the body, usually [[Gastrointestinal system|the gut]], that is associated with disease processes.<ref name="Zilberman2016">{{Cite journal | title = Analysis of the Human Gut Microbiome and Association With Disease | date = 2013-07-01| url = https://www.cghjournal.org/article/S1542-3565(13)00596-X/abstract|journal=Clinical Gastroenterology and Hepatology|volume=11|issue=7 | pages = 774–777 | last = Wu | first = Gary D. | last2 = Lewis | first2 = James D. |language=English|doi=10.1016/j.cgh.2013.03.038|issn=1542-3565}}</ref> Gut microbiota must be normal for immune [[homeostasis]].<ref name="Zilberman2016" /> == Causes of gut dysbiosis == === Psychological stress === Psychological [[stress]] can alter the gut microbiota, decreasing numbers of [[Bifidobacteria]] and [[Lactobacillus|Lactobacilli]].<ref name="Logan2003" /> === Infection === ===Antibiotic use === Antibiotics negatively alter the healthy combination of phyla within the gut microbiota, e.g. by reducing the ratio of [[Firmicutes]] to [[Bacteroidetes]], and increasing levels of [[Proteobacteria]].<ref name="Khan2019">{{Cite journal | title = Association of gut dysbiosis with intestinal metabolites in response to antibiotic treatment | date = 2019-03-01| url = https://www.sciencedirect.com/science/article/pii/S2452231718300265|journal=Human Microbiome Journal|volume=11 | pages = 100054 | last = Khan | first = Tariq Jamal | last2 = Hasan | first2 = Mohammed Nihal | last3 = Azhar | first3 = Esam I. | last4 = Yasir | first4 = Muhammad|language=en|doi=10.1016/j.humic.2018.11.004|issn=2452-2317}}</ref> The antibiotics [[ciprofloxacin]], [[vancomycin]], [[ampicillin]], [[cefazolin]] and [[cefoperazone]] reduce the diversity of gut microbiota, although in one study [[ciprofloxacin]] increased rather than decreased the Firmicutes to Bacteroidetes ratio.<ref name="Khan2019" /> Combination antibiotics cause more severe dysbiosis than using a single antibiotic.<ref name="Khan2019" /> Lifetime antibiotic use alters the gut microbiome and is a proposed risk factor for ME/CFS.<ref name="Konig2022" /> ===Long-term probiotic use=== Degirolamo et al (2014) states that Bifidobacterium and Lactobacillus [[probiotic]] strains may provide additional ''good'' bacteria, reducing the harm from antibiotics, but in long term use may also disturb the balance of gut microbiota.<ref name="Khan2019" /> ==ME/CFS== [[File:ME-CFS_Dysbiosis_leakygut.png|thumb|left|Role of dysbiosis and gut permeability in ME/CFS pathogenesis.<br> '''Source:''' {{Cite journal | url = https://www.mdpi.com/2077-0383/10/21/5077/htm | title = The Emerging Role of Gut Microbiota in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Current Evidence and Potential Therapeutic Applications | date = Oct 29, 2021|journal=Journal of Clinical Medicine|volume=10|issue=21 | pages = 5077 | last = Varesi | first = A | last2 = Deumer | first2 = U-S | last3 = Ananth | first3 = S | last4 = Ricevuti | first4 = G}} doi: 10.3390/jcm10215077]]] There is evidence that dysbiosis or an imbalance in the microbial ecology of the gut plays a role in the symptoms of [[ME/CFS]]. On average, ME/CFS patients have lower levels of [[Bifidobacteria]], [[Escherichia coli]] and higher levels of [[aerobic bacteria]],<ref name="Logan2003" /> in particular [[Enterococcus]] and [[Streptococcus]] species.<ref name="Sheedy2009" /> The latter produce [[D-lactate]], a form of lactic acid only produced by non-human cells that is poorly metabolized in humans. [[D lactate]] is associated with a wide variety of cognitive and neurological symptoms, such as in patients who suffer from [[Lactic acidosis|D-lactic acidosis]]. A study found that higher levels of Enterococcus bacteria in CFS patients were associated with more severe neurological and cognitive dysfunction.<ref name="Sydney2001">{{Cite book | url = https://www.worldcat.org/oclc/52595685 | title = Myalgic encephalopathy--chronic fatigue syndrome : the medical practitioners'--challenge informed accurate diagnosis : proceedings of international clinical and scientific meeting, Sydney, Australia, 1-2, December 2001 | date =2002| publisher = Alison Hunter Memorial Foundation|editor-last = Ring|editor-first = Jenny|isbn=9780958186506|location=Bowral, Australia|oclc=52595685}}</ref><ref name="Logan2003" /> "In one study researchers were able to classify 83% of the ME/CFS patients correctly based on their dysbiosis in gut and increased inflammatory markers in blood as a consequence of microbial translocation (13)."<ref name="Konig2022" /> A study by Pimentel et al. (2000) found that 77% of CFS patients may suffer from [[small intestinal bacterial overgrowth]] (SIBO), which is a significantly higher rate than in the general population.<ref name="Pimentel2000">{{Cite journal | last1 = Pimentel | first1 = M | author-link1 = Mark Pimentel | last2 = Hallegua | first2 = D | authorlink2 = David Hallegua | last3 = Chow | first3 = EJ | authorlink3 = | last4 = Wallace | first4 = D | authorlink4 = Daniel Wallace | last5 = Bonorris | first5 = G | authorlink5 = | last6 = Lin | first6 = HC | author-link6 = Henry Lin| title = Eradication of small intestinal bacterial overgrowth decreases symptoms in chronic fatigue syndrome: A double blind, randomized study | journal = Gastroenterology | volume = 118 | issue = 4| pages = 414 | date = Apr 1, 2000| doi = 10.1016/S0016-5085(00)83765-8| url = http://www.gastrojournal.org/article/S0016508500837658/abstract }}</ref> One hypothesized consequence of dysobiosis is an overproduction of [[hydrogen sulfide]] (H2S) by pathogenic bacteria. H2S can inhibit [[Mitochondrion|mitochondria]]l respiration by blocking [[cytochrome c oxidase]].{{Citation needed}} Sheedy et al. (2009) studied Norwegian and Belgian ME/CFS patients and found significantly decreased proportions of [[Firmicute]]s genera [[Holdemania]] and increased proportions of [[bacteroidete]]s genera [[Alistipe]]s in the Norwegian but not the Belgian sample. Significantly increased proportions of Firmicutes genera [[Lactonifactor]] were found in both.<ref name="Fremont2013" /> ==Notable studies== * 2003, Chronic fatigue syndrome: lactic acid bacteria may be of therapeutic value<ref name="Logan2003">{{Cite journal | title = Chronic fatigue syndrome: lactic acid bacteria may be of therapeutic value | date = 2003-06-01| url = https://www.sciencedirect.com/science/article/pii/S0306987703000963|journal=Medical Hypotheses|volume=60|issue=6 | pages = 915–923 | last = Logan | first = Alan C | last2 = Venket Rao | first2 = A | last3 = Irani | first3 = Dinaz|language=en|doi=10.1016/S0306-9877(03)00096-3|issn=0306-9877}}</ref> - [https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.598.6148&rep=rep1&type=pdf (Full text)] * 2007, Normalization of the increased translocation of endotoxin from gram negative enterobacteria (leaky gut) is accompanied by a remission of chronic fatigue syndrome<ref name="Maes2007a">{{Cite journal | title = Normalization of the increased translocation of endotoxin from gram negative enterobacteria (leaky gut) is accompanied by a remission of chronic fatigue syndrome | date = Dec 2007| url = https://pubmed.ncbi.nlm.nih.gov/18063928/?dopt=Abstract|journal=Neuro Endocrinology Letters|volume=28|issue=6 | pages = 739–744 | last = Maes | first = Michael | authorlink = Michael Maes | last2 = Coucke | first2 = Francis | authorlink2 = | last3 = Leunis | first3 = Jean-Claude | authorlink3 = |doi=|pmc=|pmid=18063928|access-date=|issn=0172-780X|quote=|via=}}</ref> - [https://www.researchgate.net/profile/Michael-Maes-5/publication/5784249_Normalization_of_the_increased_translocation_of_endotoxin_from_Gram_negative_enterobacteria_leaky_gut_is_accompanied_by_a_remission_of_chronic_fatigue_syndrome/links/5bbed49945851572315ed4a6/Normalization-of-the-increased-translocation-of-endotoxin-from-Gram-negative-enterobacteria-leaky-gut-is-accompanied-by-a-remission-of-chronic-fatigue-syndrome.pdf?origin=publication_detail (Full text)] *2007, Increased serum IgA and IgM against LPS of enterobacteria in chronic fatigue syn- drome (CFS): indication for the involvement of gram-negative enterobacteria in the etiology of CFS and for the presence of an increased gut-intestinal permeability<ref name="Maes2007b">{{Cite journal | 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 | date = 2007-04-01| url = https://www.sciencedirect.com/science/article/pii/S0165032706003557|journal=Journal of Affective Disorders|volume=99|issue=1 | pages = 237–240 | last = Maes | first = Michael | authorlink = Michael Maes | last2 = Mihaylova | first2 = Ivana | authorlink2 = | last3 = Leunis | first3 = Jean-Claude | authorlink3 = Jean Leunis|doi=10.1016/j.jad.2006.08.021|pmc=|pmid=|access-date=|issn=0165-0327|quote=|via=}}</ref> - [https://www.academia.edu/download/63389849/j.jad.2006.08.02120200521-7203-5ck8jy.pdf (Full text)] * 2009, Increased d-lactic Acid intestinal bacteria in patients with chronic fatigue syndrome<ref name="Sheedy2009">{{cite journal | last1 = Sheedy | first1 = John R | author-link1 = | last2 = Wettenhall | first2 = Richard EH | authorlink2 = | last3 = Scanlon | first3 = Denis | authorlink3 = Denis Scanlon | last4 = Gooley | first4 = Paul R | authorlink4 = | last5 = Lewis | first5 = Donald P | authorlink5 = Donald Lewis | last6 = McGregor | first6 = Neil | author-link6 = Neil McGregor | last7 = Stapleton | first7 = David I | author-link7 = | last8 = Butt | first8 = Henry L | author-link8 = Henry Butt | last9 = De Meirleir | first9 = Kenny L | author-link9 = Kenny de Meirleir| display-authors =| title = Increased d-lactic Acid intestinal bacteria in patients with chronic fatigue syndrome| journal = In Vivo | volume = 23 | issue =4| pages = 621-628| date = Jul 2009 | pmid = 19567398| url = http://iv.iiarjournals.org/content/23/4/621.long }}</ref> - [http://iv.iiarjournals.org/content/23/4/621.long (Full text)] *2013, High-throughput 16S rRNA gene sequencing reveals alterations of intestinal microbiota in myalgic encephalomyelitis/chronic fatigue syndrome patients<ref name="Fremont2013">{{Cite journal | title = High-throughput 16S rRNA gene sequencing reveals alterations of intestinal microbiota in myalgic encephalomyelitis/chronic fatigue syndrome patients | date = 2013-08-01| url = https://www.sciencedirect.com/science/article/pii/S1075996413000929|journal=Anaerobe|volume=22 | pages = 50–56 | last = Frémont | first = Marc | last2 = Coomans | first2 = Danny | last3 = Massart | first3 = Sebastien | last4 = De Meirleir | first4 = Kenny | authorlink4 = Kenny De Meirleir |doi=10.1016/j.anaerobe.2013.06.002|issn=1075-9964}}</ref> - [https://www.sciencedirect.com/science/article/pii/S1075996413000929 (Full text)] *2015, Increased expression of activation antigens on CD8+ T lymphocytes in Myalgic Encephalomyelitis/chronic fatigue syndrome: inverse associations with lowered CD19+ expression and CD4+/CD8+ ratio, but no associations with (auto) immune, leaky gut, oxidative and nitrosative stress biomarkers<ref name="Maes2015a">{{Cite journal | title = Increased expression of activation antigens on CD8+ T lymphocytes in Myalgic Encephalomyelitis/chronic fatigue syndrome: inverse associations with lowered CD19+ expression and CD4+/CD8+ ratio, but no associations with (auto)immune, leaky gut, oxidative and nitrosative stress biomarkers | date = 2015 | url=https://pubmed.ncbi.nlm.nih.gov/26707044/|journal=Neuro Endocrinology Letters|volume=36|issue=5 | pages = 439–446 | last = Maes | first = Michael | authorlink = Michael Maes | last2 = Bosmans | first2 = Eugene | authorlink2 = | last3 = Kubera | first3 = Marta | authorlink3 = |doi=|pmc=|pmid=26707044|access-date=|issn=0172-780X|quote=|via=}}</ref> - [https://pubmed.ncbi.nlm.nih.gov/26707044/ (Abstract)] *2015, Changes in gut and plasma microbiome following exercise challenge in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)<ref name="Shukla2015">{{Cite journal | title = Changes in Gut and Plasma Microbiome following Exercise Challenge in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | date = 2015-12-18| url = https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0145453|journal=PLOS ONE|volume=10|issue=12| pages = e0145453 | last = Shukla | first = Sanjay K. | authorlink = | last2 = Cook | first2 = Dane | authorlink2 = Dane Cook | last3 = Meyer | first3 = Jacob | authorlink3 = | last4 = Vernon | first4 = Suzanne D. | authorlink4 = Suzanne Vernon | last5 = Le | first5 = Thao | authorlink5 = | last6 = Clevidence | first6 = Derek | author-link6 = | last7 = Robertson | first7 = Charles E. | last8 = Schrodi | first8 = Steven J. | last9 = Yale | first9 = Steven | last10 = Frank | first10 = Daniel N.|doi=10.1371/journal.pone.0145453|pmc=PMC4684203|pmid=26683192|access-date=|issn=1932-6203|quote=|via=}}</ref> - [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0145453 (Full text)] * 2016, The role of microbiota and intestinal permeability in the pathophysiology of autoimmune and neuroimmune processes with an emphasis on inflammatory bowel disease type 1 diabetes and chronic fatigue syndrome<ref name="Morris2016">{{Cite journal | title = The Role of Microbiota and Intestinal Permeability in the Pathophysiology of Autoimmune and Neuroimmune Processes with an Emphasis on Inflammatory Bowel Disease Type 1 Diabetes and Chronic Fatigue Syndrome | date = 2016 | url=https://pubmed.ncbi.nlm.nih.gov/27634186/|journal=Current Pharmaceutical Design|volume=22|issue=40 | pages = 6058–6075 | last = Morris | first = Gerwyn | authorlink = Gerwyn Morris | last2 = Berk | first2 = Michael | authorlink2 = Michael Berk | last3 = Carvalho | first3 = André F. | authorlink3 = | last4 = Caso | first4 = Javier R. | authorlink4 = | last5 = Sanz | first5 = Yolanda | authorlink5 = | last6 = Maes | first6 = Michael | author-link6 = Michael Maes|doi=10.2174/1381612822666160914182822|pmc=|pmid=27634186|access-date=|issn=1873-4286|quote=|via=}}</ref> - [https://www.researchgate.net/publication/308201841_The_Role_of_Microbiota_and_Intestinal_Permeability_in_the_Pathophysiology_of_Autoimmune_and_Neuroimmune_Processes_with_an_Emphasis_on_Inflammatory_Bowel_Disease_Type_1_Diabetes_and_Chronic_Fatigue_Syn (Full text)] *2016, A role for the intestinal microbiota and virome in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)<ref name="Vavaneetharaja2016">{{Cite journal | title = The Role of Microbiota and Intestinal Permeability in the Pathophysiology of Autoimmune and Neuroimmune Processes with an Emphasis on Inflammatory Bowel Disease Type 1 Diabetes and Chronic Fatigue Syndrome | date = 2016 | url=https://pubmed.ncbi.nlm.nih.gov/27634186/|journal=Current Pharmaceutical Design|volume=22|issue=40 | pages = 6058–6075 | last = Morris | first = Gerwyn | authorlink = Gerwyn Morris | last2 = Berk | first2 = Michael | authorlink2 = Michael Berk | last3 = Carvalho | first3 = André F. | authorlink3 = | last4 = Caso | first4 = Javier R. | authorlink4 = | last5 = Sanz | first5 = Yolanda | authorlink5 = | last6 = Maes | first6 = Michael | author-link6 = Michael Maes|doi=10.2174/1381612822666160914182822|pmc=|pmid=27634186|access-date=|issn=1873-4286|quote=|via=}}</ref> - [https://www.mdpi.com/142986 (Full text)] *2016, The association of fecal microbiota and fecal, blood serum and urine metabolites in myalgic encephalomyelitis/chronic fatigue syndrome<ref name="Anderson2016">{{Cite journal | title = The association of fecal microbiota and fecal, blood serum and urine metabolites in myalgic encephalomyelitis/chronic fatigue syndrome | date = 2016-12-12| url = https://doi.org/10.1007/s11306-016-1145-z|journal=Metabolomics|volume=13|issue=1 | pages = 8 | last = Armstrong | first = Christopher W. | authorlink = Christopher Armstrong | last2 = McGregor | first2 = Neil R. | authorlink2 = Neil McGregor | last3 = Lewis | first3 = Donald P. | authorlink3 = Donald Lewis | last4 = Butt | first4 = Henry L. | authorlink4 = Henry Butt | last5 = Gooley | first5 = Paul R. | authorlink5 = Paul Gooley|doi=10.1007/s11306-016-1145-z|pmc=|pmid=|access-date=|issn=1573-3890|quote=|via=}}</ref> - [https://link.springer.com/article/10.1007/s11306-016-1145-z (Full text)] *2016, Reduced Diversity and Altered Composition of the Gut Microbiome in Individuals With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome<ref name="Giloteaux2016">{{Cite journal | title = Reduced diversity and altered composition of the gut microbiome in individuals with myalgic encephalomyelitis/chronic fatigue syndrome | date = 2016-06-23| url = https://doi.org/10.1186/s40168-016-0171-4|journal=Microbiome|volume=4|issue=1 | pages = 30 | last = Giloteaux | first = Ludovic | authorlink = Ludovic Giloteaux | last2 = Goodrich | first2 = Julia K. | authorlink2 = | last3 = Walters | first3 = William A. | authorlink3 = | last4 = Levine | first4 = Susan M. | authorlink4 = Susan Levine | last5 = Ley | first5 = Ruth E. | authorlink5 = Ruth Ley | last6 = Hanson | first6 = Maureen R. | author-link6 = Maureen Hanson|doi=10.1186/s40168-016-0171-4|pmc=PMC4918027|pmid=27338587|access-date=|issn=2049-2618|quote=|via=}}</ref> - [https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-016-0171-4 (Full text)] *2017, Fecal Metagenomic Profiles in Subgroups of Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome<ref name="Nagy2017">{{Cite journal | title = Fecal metagenomic profiles in subgroups of patients with myalgic encephalomyelitis/chronic fatigue syndrome | date = 2017-04-26| url = https://doi.org/10.1186/s40168-017-0261-y|journal=Microbiome|volume=5|issue=1 | pages = 44 | last = Nagy-Szakal | first = Dorottya | authorlink = | last2 = Williams | first2 = Brent L. | authorlink2 = | last3 = Mishra | first3 = Nischay | authorlink3 = | last4 = Che | first4 = Xiaoyu | authorlink4 = | last5 = Lee | first5 = Bohyun | authorlink5 = | last6 = Bateman | first6 = Lucinda | author-link6 = Lucinda Bateman | last7 = Klimas | first7 = Nancy G. | author-link8 = Nancy Klimas | last8 = Komaroff | first8 = Anthony L. | author-link8 = Anthony Komaroff | last9 = Levine | first9 = Susan | last10 = Montoya | first10 = Jose G. | author-link10 = Joseph Breen | last11 = Peterson | first11 = Daniel L. | author-link11 = Daniel Peterson|doi=10.1186/s40168-017-0261-y|pmc=PMC5405467|pmid=28441964|access-date=|issn=2049-2618|quote=|via=}}</ref> - [https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-017-0261-y (Full text)] *2018, The Emerging Role of Gut Microbiota in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Current Evidence and Potential Therapeutic Applications<ref name="microbiota2018">{{Cite journal | title = The Emerging Role of Gut Microbiota in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Current Evidence and Potential Therapeutic Applications | date = 2021-10-29| url = https://doi.org/10.3390/jcm10215077|journal=Journal of Clinical Medicine|volume=10|issue=21 | pages = 5077 | last = Varesi | first = Angelica | last2 = Deumer | first2 = Undine-Sophie | last3 = Ananth | first3 = Sanjana | last4 = Ricevuti | first4 = Giovanni|doi=10.3390/jcm10215077|pmc=PMC8584653|pmid=34768601|issn=2077-0383}}</ref> - [https://doi.org/10.3390/jcm10215077 (Full text)] *2018, A role for a leaky gut and the intestinal microbiota in the pathophysiology of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)<ref name="Vipond2018">{{Cite web | title = A role for a leaky gut and the intestinal microbiota in the pathophysiology of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) | date = 2018| url = https://ueaeprints.uea.ac.uk/id/eprint/70522/ | last = Vipond | first = Daniel | authorlink = Daniel Vipond|work=University of East Anglia|volume=|issue= | pages = |access-date=}}</ref> - [https://ueaeprints.uea.ac.uk/id/eprint/70522/1/DV_thesis_final2019.pdf (Thesis - Full text)] *2020, The “Leaky Gut”: Tight Junctions but Loose Associations?<ref name="Hollander2020">{{Cite journal | title = The “Leaky Gut”: Tight Junctions but Loose Associations? | date = May 2020| url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193723/|journal=Digestive diseases and sciences|volume=65|issue=5 | pages = 1277–1287 | last = Hollander | first = Daniel | authorlink = | last2 = Kaunitz | first2 = Jonathan D. | authorlink2 = |doi=10.1007/s10620-019-05777-2|pmc=7193723|pmid=31471860|access-date=|issn=0163-2116|quote=|via=}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193723/ (Full text)] *2020, Mitochondria and immunity in chronic fatigue syndrome<ref name="Anderson2020">{{Cite journal | title = Mitochondria and immunity in chronic fatigue syndrome | date = 2020-12-20| url = https://www.sciencedirect.com/science/article/pii/S027858462030292X|journal=Progress in Neuro-Psychopharmacology and Biological Psychiatry|volume=103|issue= | pages = 109976 | last = Anderson | first = G. | authorlink = George Anderson | last2 = Maes | first2 = M. | authorlink2 = Michael Maes|doi=10.1016/j.pnpbp.2020.109976|pmc=|pmid=32470498|access-date=|issn=0278-5846|quote=|via=}}</ref> - [https://www.sciencedirect.com/science/article/pii/S027858462030292X (Full text)] *2021, The Emerging Role of Gut Microbiota in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Current Evidence and Potential Therapeutic Applications<ref name="Varesi2021">{{Cite journal | title = The Emerging Role of Gut Microbiota in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Current Evidence and Potential Therapeutic Applications | date = 2021-10-29| url = https://doi.org/10.3390/jcm10215077|journal=Journal of Clinical Medicine|volume=10|issue=21 | pages = 5077 | last = Varesi | first = Angelica | last2 = Deumer | first2 = Undine-Sophie | last3 = Ananth | first3 = Sanjana | last4 = Ricevuti | first4 = Giovanni|doi=10.3390/jcm10215077|pmc=PMC8584653|pmid=34768601|issn=2077-0383}}</ref> - [https://doi.org/10.3390/jcm10215077 (Full text)] *2021, Tryptophan Metabolites, Cytokines, and Fatty Acid Binding Protein 2 in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome<ref name="Simonato2021">{{Cite journal | title = Tryptophan Metabolites, Cytokines, and Fatty Acid Binding Protein 2 in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2021-11-19| url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8615774/|journal=Biomedicines|volume=9|issue=11 | pages = 1724 | last = Simonato | first = Manuela | last2 = Dall’Acqua | first2 = Stefano | last3 = Zilli | first3 = Caterina | last4 = Sut | first4 = Stefania | last5 = Tenconi | first5 = Romano | last6 = Gallo | first6 = Nicoletta | last7 = Sfriso | first7 = Paolo | last8 = Sartori | first8 = Leonardo | last9 = Cavallin | first9 = Francesco | last10 = Fiocco | first10 = Ugo | last11 = Cogo | first11 = Paola|doi=10.3390/biomedicines9111724|pmc=8615774|pmid=34829952|issn=2227-9059}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8615774/ (Full text)] *2022, The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS)<ref name="Konig2022">{{Cite journal | title = The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) | date = 2022 | url=https://www.frontiersin.org/article/10.3389/fimmu.2021.628741|journal=Frontiers in Immunology|volume=12|issue= | pages = | last = König | first = Rahel S. | authorlink = | last2 = Albrich | first2 = Werner C. | authorlink2 = | last3 = Kahlert | first3 = Christian R. | authorlink3 = | last4 = Bahr | first4 = Lina Samira | authorlink4 = | last5 = Löber | first5 = Ulrike | authorlink5 = | last6 = Vernazza | first6 = Pietro | author-link6 = | last7 = Scheibenbogen | first7 = Carmen | author-link8 = Carmen Scheibenbogen | last8 = Forslund | first8 = Sofia K.|doi=10.3389/fimmu.2021.628741/full|pmc=PMC8761622|pmid=35046929|access-date=|issn=1664-3224|quote=|via=}}</ref> - [https://www.frontiersin.org/articles/10.3389/fimmu.2021.628741/full (Full text)] == See also == * [[Intestinal permeability]] (leaky gut) * [[Dr Markov's chronic bacterial intoxication syndrome (CBIS) theory of ME/CFS]] (Dr Markov has evidence that ME/CFS is caused by a dysbiosis in the kidneys) == Learn more == *2017, [https://www.virology.ws/2017/04/27/intestinal-dysbiosis-in-mecfs-patients/ Intestinal dysbiosis in ME/CFS patients] - Vincent Racaniello, [[Virology blog]] ==References== {{Reflist}} [[Category:Signs and symptoms]] [[Category:Digestive signs and symptoms]]
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This page is a member of 5 hidden categories:
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