Do early dysbiosis events cause cumulative long-term effects via cascading processes in ME/CFS?

Establish whether microbial dysbiosis observed in short-term ME/CFS leads to cumulative and long-term downstream effects initiated by an early trigger, consistent with cascading pathophysiological events over the disease course.

Background

Although long-term ME/CFS patients showed a gut microbiome more similar to controls, they displayed more severe clinical symptoms and metabolic dysregulation. This observation motivated a conjecture that early dysbiosis may initiate persistent, cascading effects.

Testing this hypothesis will require temporal data linking early microbiome disruptions to later metabolic and clinical outcomes to clarify causality and mechanisms.