Current Trends and Challenges of Fecal Microbiota Transplantation-An Easy Method That Works for All?

Abstract

The gut microbiota refers to bacteria lodges in the gastrointestinal tract (GIT) that interact through various complex mechanisms. The disturbance of this ecosystem has been correlated with several diseases, such as neurologic, respiratory, cardiovascular, and metabolic diseases and cancer. Therefore, the modulation of the gut microbiota has emerged as a potential therapeutic tool; of the various forms of gut microbiota modulation, fecal microbiota transplantation (FMT) is the most approached. This recent technique involves introducing fecal material from a healthy donor into the patient's gastrointestinal tract, aiming to restore the gut microbiota and lead to the resolution of symptoms. This procedure implies a careful donor choice, fine collection and handling of fecal material, and a balanced preparation of the recipient and consequent administration of the prepared content. Although FMT is considered a biological therapy with promising effects, side effects such as diarrhea and abdominal pain have also been claimed, making this a significant challenge in the application of FMT. Bearing this in mind, the present review aims to summarize the recent advances in understanding FMT mechanisms, their impact across different pathological conditions, and the associated side effects, emphasizing the most recent published data.

Keywords: cancer; cardiometabolic disorders; fecal microbiota transplantation; gastrointestinal disorders; gut microbiota; neurological disorders.

Figure 1

PRISMA flow diagram for the scoping review.

Figure 2

Examining the role of gut microbiota in neurological, respiratory, gastrointestinal, and cardiometabolic disorders and cancer under FMT procedures. From the application point of view, FMT is recognized for reducing intestinal permeability in dysbiotic situations, by increasing the production of butyrate, acetate, and propionate. Such increased levels have been associated with an increase in epithelial barrier integrity and lessened disease severity, especially in brain-gut axis, lungs-gut axis, heart-gut axis, and gastrointestinal axis. In addition, and considering lungs-gut axis in specific, FMT was found to enhance the preservation of alveolar structures and to modulate inflammation through the reduction of IL-6 and IFN- γ levels.