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On THE one hand, microbial metabolites such as short-chain fatty acids (SCFAs) stimulate endogenous GLP-1 secretion by activating G-protein-coupled receptors GPR43 (FFAR2) and GPR41 (FFAR3) on enteroendocrine L cells

In contrast, available clinical evidence is limited and does not demonstrate therapeutic benefit in ALS, while raising important safety concerns, particularly related to weight loss, lean mass reduction, and altered glucose regulation, factors associated with a worse prognosis in ALS

Future research should focus on precise patient stratification, optimizing dosage and treatment timing, and exploring their potential for combination with ART

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