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Review
. 2023 May 10;31(5):712-733.
doi: 10.1016/j.chom.2023.03.020.

Key determinants of success in fecal microbiota transplantation: From microbiome to clinic

Serena Porcari  1 , Nicolas Benech  2 , Mireia Valles-Colomer  3 , Nicola Segata  4 , Antonio Gasbarrini  1 , Giovanni Cammarota  1 , Harry Sokol  5 , Gianluca Ianiro  6
Affiliations
Free article
Review

Key determinants of success in fecal microbiota transplantation: From microbiome to clinic

Serena Porcari et al. Cell Host Microbe. .
Free article

Abstract

Fecal microbiota transplantation (FMT) has achieved satisfactory results in preventing the recurrence of Clostridioides difficile infection, but these positive outcomes have only been partially replicated in other diseases. Several factors influence FMT success, including those related to donors and recipients (including diversity and specific composition of the gut microbiome, immune system, and host genetics) as well as to working protocols (fecal amount and number of infusions, route of delivery, and adjuvant treatments). Moreover, initial evidence suggests that the clinical success of FMT may be related to the degree of donor microbial engraftment. 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. Here, we review the key determinants of FMT success and insights and strategies that will enable a close integration of lab-based and clinical approaches for increasing FMT success.

Keywords: engraftment; fecal microbiota transplantation; host immunity; microbiome.

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Conflict of interest statement

Declaration of interests A.G. reports personal fees for consultancy for Eisai S.r.l., 3PSolutions, Real Time Meeting, Fondazione Istituto Danone, Sinergie S.r.l. Board MRGE, and SanofiS.p.A; personal fees for acting as a speaker for Takeda S.p.A, AbbVie, and Sandoz S.p.A; and personal fees for acting on advisory boards for VSL3 and Eisai. G.C. has received personal fees for acting as an advisor for Ferring Therapeutics. H.S. reports lecture fees, board membership, or consultancy from Amgen, Fresenius, IPSEN, Actial, Astellas, Danone, THAC, biose, BiomX, Eligo, Immusmol, Adare, Nestle, Ferring, MSD, Bledina, Pfizer, Biocodex, BMS, Bromatech, Gilead, Janssen, Mayoli, Roche, Sanofi, Servier, Takeda, Abbvie, has stocks from Enterome bioscience, and is co-founder of Exeliom Biosciences. G.I. has received personal fees for acting as a speaker for Biocodex, Danone, Sofar, Malesci, Metagenics, and Tillotts Pharma and for acting as consultant/advisor for Ferring Therapeutics, Giuliani, Metagenics, and Tillotts Pharma.

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