Does the ME/CFS gut microbiome stabilize toward a control-like state over time?

Establish whether the gut microbiome in ME/CFS patients stabilizes over time and reverts toward a composition resembling healthy controls, including reacquisition of low-abundance species and normalization of alpha diversity metrics.

Background

Cross-sectional comparisons in the paper suggest that short-term ME/CFS patients exhibit marked dysbiosis (loss of diversity and high heterogeneity), whereas long-term patients appear more similar to controls in overall composition, despite notable differences in low-abundance taxa.

The authors conjecture a temporal trajectory in which the microbiome converges toward a more control-like ecosystem, a hypothesis that would benefit from longitudinal validation.