Beneficial effects of fecal microbiota transplantation in recurrent Clostridioides difficile infection

Abbas Yadegar; Sepideh Pakpoor; Fathima F Ibrahim; Ali Nabavi-Rad; Laura Cook; Jens Walter; Anna M Seekatz; Karen Wong; Tanya M Monaghan; Dina Kao

doi:10.1016/j.chom.2023.03.019

Beneficial effects of fecal microbiota transplantation in recurrent Clostridioides difficile infection

Cell Host Microbe. 2023 May 10;31(5):695-711. doi: 10.1016/j.chom.2023.03.019.

Authors

Affiliations

¹ Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² School of Engineering, University of British Columbia, Kelowna, BC, Canada.
³ National Institute for Health Research Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK; Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK.
⁴ Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Parkville, VIC, Australia.
⁵ School of Microbiology, Department of Medicine and APC Microbiome Ireland, University College Cork, Cork, Ireland.
⁶ Department of Biological Sciences, Clemson University, Clemson, SC, USA.
⁷ Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
⁸ National Institute for Health Research Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK; Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK. Electronic address: tanya.monaghan@nottingham.ac.uk.
⁹ Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada. Electronic address: dkao@ualberta.ca.

Abstract

Fecal microbiota transplantation (FMT) is highly effective in preventing recurrent Clostridioides difficile infection (rCDI). However, the mechanisms underpinning its clinical efficacy are incompletely understood. Herein, we provide an overview of rCDI pathogenesis followed by a discussion of potential mechanisms of action focusing on the current understanding of trans-kingdom microbial, metabolic, immunological, and epigenetic mechanisms. We then outline the current research gaps and offer methodological recommendations for future studies to elevate the quality of research and advance knowledge translation. By combining interventional trials with multiomics technology and host and environmental factors, analyzing longitudinally collected biospecimens will generate results that can be validated with animal and other models. Collectively, this will confirm causality and improve translation, ultimately to develop targeted therapies to replace FMT.

Keywords: fecal microbiota transplantation; host-microbial interactions; intestinal microbial transfer; recurrent Clostridioides difficile infection.

Publication types

Review

MeSH terms

Animals
Clostridioides difficile*
Clostridium Infections* / therapy
Fecal Microbiota Transplantation / methods
Recurrence
Treatment Outcome

Abstract

Publication types

MeSH terms

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