Dissecting mechanisms of fecal microbiota transplantation efficacy in disease

Catherine M Andary; Kait F Al; John A Chmiel; Shaeley Gibbons; Brendan A Daisley; Seema Nair Parvathy; Saman Maleki Vareki; Dawn M E Bowdish; Michael S Silverman; Jeremy P Burton

doi:10.1016/j.molmed.2023.12.005

Dissecting mechanisms of fecal microbiota transplantation efficacy in disease

Trends Mol Med. 2024 Mar;30(3):209-222. doi: 10.1016/j.molmed.2023.12.005. Epub 2024 Jan 8.

Affiliations

¹ Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
² Department of Microbiology and Immunology, Western University, London, Ontario, Canada; Canadian Centre for Human Microbiome and Probiotics Research, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
³ Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario, Canada.
⁴ Division of Infectious Disease, St. Joseph's Health Care, London, Ontario, Canada.
⁵ Lawson Health Research Institute, London, Ontario, Canada; Department of Oncology, Western University, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
⁶ Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada; McMaster Immunology Research Centre and the Firestone Institute for Respiratory Health, McMaster University, Hamilton, Ontario, Canada.
⁷ Department of Microbiology and Immunology, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Division of Infectious Disease, St. Joseph's Health Care, London, Ontario, Canada.
⁸ Department of Microbiology and Immunology, Western University, London, Ontario, Canada; Canadian Centre for Human Microbiome and Probiotics Research, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada. Electronic address: jeremy.burton@lawsonresearch.com.

PMID: 38195358
DOI: 10.1016/j.molmed.2023.12.005

Abstract

Fecal microbiota transplantation (FMT) has emerged as an alternative or adjunct experimental therapy for microbiome-associated diseases following its success in the treatment of recurrent Clostridioides difficile infections (rCDIs). However, the mechanisms of action involved remain relatively unknown. The term 'dysbiosis' has been used to describe microbial imbalances in relation to disease, but this traditional definition fails to consider the complex cross-feeding networks that define the stability of the microbiome. Emerging research transitions toward the targeted restoration of microbial functional networks in treating different diseases. In this review, we explore potential mechanisms responsible for the efficacy of FMT and future therapeutic applications, while revisiting definitions of 'dysbiosis' in favor of functional network restoration in rCDI, inflammatory bowel diseases (IBDs), metabolic diseases, and cancer.

Keywords: bioenergetics; dysbiosis; fecal microbiota transplantation; gut microbiota.

Publication types

Review

MeSH terms

Clostridioides difficile*
Clostridium Infections* / therapy
Fecal Microbiota Transplantation
Gastrointestinal Microbiome*
Humans
Microbiota*
Treatment Outcome