Microbes Deserve a Closer Look in Lou Gehrig’s disease

Guest BloggerClinical Corner, Microbiome Environment

nervous system

Science isn’t hitting any home runs with Lou Gehrig’s disease.

Named after a famous baseball player, amyotrophic lateral sclerosis or ALS is a progressive disease that destroys nerve cells and causes disability.

ALS often begins with muscle twitching, weakness in a limb or slurred speech. Eventually, ALS affects control of the muscles needed to move, speak, eat and breathe. There is no cure for ALS; eventually the disease is fatal, most commonly from respiratory failure.

While 5 to 10 percent of cases are inherited, the cause is not known.

Other possible causes of ALS
  • Gene mutation
  • Chemical imbalance: Excess glutamate, a chemical messenger in the brain, can be toxic to some nerve cells.
  • Protein mishandling: Abnormal forms of proteins destroy nerve cells.
  • Disorganized immune response: Auto-immune attacks can lead to death of nerve cells.

Given the last suspect on the list, microbes may be involved. Recent studies suggest that gastrointestinal dysfunction may modify the gut-brain axis, playing a role in ALS development.

Researchers in Italy decided it was past time to look at microbiota in ALS.

Letizia Mazzini of the Department of Neurology and ALS Centre, University of Novara in Italy and colleagues published Potential Role of Gut Microbiota in ALS Pathogenesis and Possible Novel Therapeutic Strategies in May of 2018 in the Journal of Clinical Gastroenterology.

What they did: Fecal samples from 50 ALS patients and 50 healthy controls, matched for sex, age, and origin, were analyzed by total genomic DNA extraction.

Results showed differences between ALS subjects and healthy group: Patients with ALS had more Escherichia coli and enterobacteria and a low abundance of total yeast in patients. Whether or not dysbiosis existed was not clear.

In addition, subjects were treated with a probiotic mixture of Lactobacillus strains and randomized to double-blind treatment either with probiotics or placebo for 6 months. These results are not yet in.

Risk factors for ALS
  • Heredity
  • Age: most common between the ages of 40 and 60.
  • Sex. Slightly more men than women develop ALS, but this disparity disappears after age 70.
  • Genetics. Many similarities exist in the genetic variations of people with familial ALS and some people with noninherited ALS.
Possible triggers for ALS
  • Smoking
  • Environmental toxin exposure: Lead or other substances in the workplace or at home may be linked to ALS.
  • Military service: Triggers may include exposure to certain metals or chemicals, traumatic injuries, viral infections, and intense exertion.

Still for all the knowledge on ALS, its risk factors, triggers and possible causes, the disease continues to devastate and take many lives. If the gut-brain axis can lead us to new approaches in prevention or treatment, the road should be the one taken.