1Medicine and Surgery School, Faculty of Medical Sciences, University of Cuenca, Cuenca, Ecuador, 2Pharmacology and Nutritional Sciences Interdisciplinary Research Group, Faculty of Medical Sciences, University of Cuenca, Cuenca, Ecuador, 3Nutrition and Dietetics School, Faculty of Medical Sciences, University of Cuenca, Cuenca, Ecuador.
Background and objective: Amyotrophic lateral sclerosis (ALS) is a progressive, multifactorial neurodegenerative disease. Although there is no clear understanding of its risk or progression factors, a potential relationship between gut microbiota and neurodegenerative diseases has been suggested. Consequently, probiotics, prebiotics, and postbiotics could be therapeutic alternatives for ALS prevention and evolution. To date, there is no review on the role of this nutritional immunomodulatory intervention as a potential ALS modifier. This literature review aimed to select, analyze, and discuss the available scientific evidence regarding the action of probiotics, prebiotics, and postbiotics in ALS to promote further research on this topic. Methods: An extensive search was performed, selecting the most relevant articles on cellular, animal, and human models of ALS published in the PubMed and Scholar Google databases between 2000 and 2022. Results: Gut dysbiosis plays a role in the pathogenesis of ALS models by triggering molecular changes associated with neuronal function and disease progression. Escherichia coli and Ruminococcus torques negatively affect ALS-related neurodegeneration. On the other hand, a positive influence of Akkermansia muciniphila, Lactobacillus spp., Bifidobacterium spp., and Butyrivibrio fibrisolvens has been described. Consequently, a nutritional immunomodulatory intervention could modify the course of ALS. Conclusions: Due to the multifactorial nature of ALS, further preclinical and clinical research is required to scientifically determine the effect of the nutritional intervention with probiotics, prebiotics, and postbiotics on the gut-brain axis, and, consequently, its influence on ALS symptoms amelioration and progression.
Keywords: nutritional intervention; probiotics; prebiotics; postbiotics; amyotrophic lateral sclerosis; ALS; treatment; gut microbiota; gut-brain axis.