Can donor gut bacteria reshape the immune system in ALS?
NCT ID NCT03766321
First seen Sep 10, 2026 · Last updated Sep 11, 2026 · Updated 1 time
Summary
Researchers are testing whether fecal microbiota transplantation, which transfers stool from a healthy donor into the gut, can change the immune system in people with amyotrophic lateral sclerosis (ALS). The trial enrolls 42 adults aged 18 to 70 who were diagnosed within the past 18 months and are taking a stable dose of riluzole. Participants receive either the transplant or a placebo procedure through an endoscope at the start and again at six months. The main goal is to see whether the transplant increases the number of regulatory T cells, a type of immune cell that may influence how quickly ALS progresses.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- fecal microbiota transplantation, a procedure that transfers stool from a healthy donor into the patient's small intestine
- What this could lead to
- If it works, this could point toward a way to steer the immune system in ALS and possibly slow how fast the disease progresses.
- What could go wrong
- The trial is small, with 42 participants, and it tests a biomarker rather than a proven clinical benefit. FMT can cause digestive upset and carries a small risk of infection from donor material, and the approach may not change the course of ALS.
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Study facts
What this study's own registry entry says, in plain language.
- Phase
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Not a phased trial
Phase numbers describe drug development. The registry uses this when they do not apply, as it does for trials of devices, procedures or behaviour changes, and for observational studies.
- Participants
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42 people
The number who actually took part.
- Started
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Jul 2020
- Finished
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Jun 2025
- Lead sponsor
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Other sponsor
The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 to 70 years
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: * Patients diagnosed with a laboratory supported, clinically "probable" or "definite" amyotrophic lateral sclerosis according to the Revised El Escorial criteria (Brooks, 2000) * Sporadic or familial ALS * Female or male patients aged between 18 and 70 years old * Disease duration from symptoms onset no longer than 18 months at the screening visit * Patients treated with a stable dose of Riluzole (100 mg/day) for at least 30 days prior to screening * Patients with a weight \> 50 kg and a BMI ≥18 * Patients with a FVC (Forced Vital Capacity) equal or more than 70% predicted normal value for gender, height, and age at the screening visit * Patients able and willing to comply with study procedures as per protocol * Patients able to understand, and capable of providing informed consent at screening visit prior to any protocol-specific procedures * Use of effective contraception both for males and females Exclusion Criteria: * Known organic gastrointestinal disease * History of gastrointestinal malignancy; ongoing malignancies * Use of immunosuppressive or chemotherapy within the past 2 years * Celiac disease and/or food (e.g.lactose) intolerance * Previous gastrointestinal surgery * Any condition that would make endoscopic procedures contraindicated * Acute infections requiring antibiotics * Antimicrobial treatment or probiotics 4 weeks prior to screening * Severe comorbidities (heart, renal, liver failure); severe renal (eGFR\< 30ml/min/1.73m2), or liver failure or liver aminotransferase (ALT/AST \> 2x Upper limit of normal), * Autoimmune diseases, inflammatory disorders (SLE, Rheumatoid arthritis, connective tissue disorder) or chronic infections (HIV, hepatitis B or C infection) * Abuse of alcohol or drugs * HIV, tuberculosis, hepatitis * Participation in clinical trials \<30 days before screening * Existing blood dyscrasia (e.g., myelodysplasia) * White blood cells\<4,000/mm³, platelets count\<100,000/mm³, hematocrit\<30% * Patients who underwent non-invasive ventilation, tracheotomy and /or gastrostomy * Women who are pregnant or breastfeeding
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
Contacts and locations
Locations
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Azienda Ospedaliero Universitaria di Modena
Modena, Italy
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Catholic University of Sacred Heart - Fondazione Policlinico "A. Gemelli"
Roma, Italy, Italy
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Clinica Neurologica, Ospedale Clinicizzato "SS Annunziata"
Chieti, Italy
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NEuroMuscular Omnicentre Centre (NeMO), Fondazione Serena Onlus-Fondazione Policlinico A. Gemelli
Roma, Italy
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UO Neurofisiopatologia, Azienda Ospedaliera dì Perugia
Perugia, Italy
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