Fecal Microbiota Transplants: Two Reviews Explore What's Worked, What Hasn't, and Where Do We Go From Here
Published:30 May2023 Source:Cell Press
Fecal microbiota transplants are the most effective and affordable treatment for recurrent infections with Clostridioides difficile, an opportunistic bacterium and the most common cause of hospital-acquired intestinal infections. However, attempts to treat chronic noncommunicable diseases such as ulcerative colitis and metabolic syndrome via fecal microbiota transplantation (FMT) have yielded mixed results. Two review articles publishing May 10 in the journal Cell Host and Microbe discuss what we do and don't know about why FMTs work (when they do).
Both research teams agree that we need to know more about how various under-explored factors -- -- such as the patient's diet and genetic background, how closely the donor's microbial composition matches the patient's existing microbiome, and the presence of non-bacterial gut inhabitants like fungi and viruses -- impact FMT success.
"To deepen our understanding of FMT mechanisms and to establish causality, human intervention trials using not just stool, but stool derivatives with defined compositions and characteristics, or with defined consortium of bacterial, viral, and metabolic components alone or in combination will serve as an important experimental platform," writes Abbas Yadegar, a microbiologist at the Shahid Beheshti University of Medical Sciences in Iran and lead author of the first review.
"The application of cutting-edge technologies for microbiome assessment, along with changes in the current vision of fecal transplants, are expected to improve FMT protocols and outcomes," writes Serena Porcari, a gastroenterologist at the Fondazione Policlinico Universitario Gemelli and Università Cattolica del Sacro Cuore, who led the second review.