Fecal microbiota transplantation: in perspective

Abstract

There has been increasing interest in understanding the role of the human gut microbiome to elucidate the therapeutic potential of its manipulation. Fecal microbiota transplantation (FMT) is the administration of a solution of fecal matter from a donor into the intestinal tract of a recipient in order to directly change the recipient's gut microbial composition and confer a health benefit. FMT has been used to successfully treat recurrent Clostridium difficile infection. There are preliminary indications to suggest that it may also carry therapeutic potential for other conditions such as inflammatory bowel disease, obesity, metabolic syndrome, and functional gastrointestinal disorders.

Keywords: Clostridium difficile infection; bacteriotherapy; fecal microbiota transplantation; gut microbiome; inflammatory bowel disease.

Figure 1.

(a), (b) Schematic to indicate the events that contribute to Clostridium difficile infection: (a) the contributions of the pathogen to disease driven by reduced gut microbiota diversity; (b) how these contributions are minimized when a more diverse microbiota is present. (c), (d) Schematic to indicate the events that contribute to the proliferation of pathobionts (resident bacteria that can contribute to disease pathology under the appropriate altered environmental conditions) in the gut microbiota. The potential contribution of the gut microbiota, and the reduction of diversity in the microbiota in particular, is highlighted as a driver for disease to draw a comparison against C. difficile infection, using C. difficile infection as a model for disease caused by reduction in host gut-microbiota diversity.