Potential alternative to FMT in bacteria may restore gut microbiome
Click Here to Manage Email Alerts
Researchers discovered a group of bacterial species and strains that may be used as an alternative to fecal microbiota transplantation to restore a patient’s gut microbiome, according to a study in Nature Microbiology.
“This study is another step in the evolution of FMT. The field is moving away from FMT and toward defined consortium of microbes that can restore a function of the gut microbiome that was lost — either from an antibiotic or from some disease state,” Ari Grinspan, MD, associate professor of medicine, division of gastroenterology, Icahn School of Medicine at Mount Sinai, told Healio Gastroenterology. “Engraftment of donor microbes into the recipient appears to be an important factor in determining whether or not the therapy will be effective. This study shows that long-term engraftment is achievable with a single dose of FMT.”
Jeremiah Faith, PhD, Grinspan and colleagues collected 1,008 bacterial strains that were cultured from fecal samples of 22 FMT donors and recipients. They developed Strainer, a statistical approach to detect and track bacterial strains from metagenomic sequencing data using strain collection combined with metagenomic sequencing data from these samples. Strainer was applied to a cohort of 13 recurrent Clostridium difficile infection FMT recipients and used to detect stable engraftment of 71% of donor microbiota strains in recipients up to 5 years after FMT.
Results showed FMT eliminated 80% of recipient gut bacterial strains before FMT. Grinspan and colleagues noted post-FMT strains persisted up to 5 years later, along with environmentally acquired strains.
After the initial and repeat FMT, researchers noted the qualification of donor bacterial strain engraftment in recipients independently explain clinical outcomes.
“The next step in our research is to see if a defined cocktail of the bacteria that transferred most frequently by fecal microbiota transplantation can be manufactured in the laboratory and used to treat recurrent C. difficile infection as a replacement to the costly, time-consuming job of finding human donors whose stool passes numerous safety screens, and an alternative to the messy process of blending their stool into a slurry,” Faith, associate professor, Precision Immunology Institute and Icahn School of Medicine at Mount Sinai, department of genetics and genomic sciences, told Healio Gastroenterology.
Perspective
Back to Top
Alison Schneider, MD, FACG, AGAF
This article highlights the importance of individual diversity of the gut microbiome and how we might capitalize on the therapeutic potential of its manipulation. The FMT is the administration of a solution of fecal matter from a healthy donor into the intestinal tract of a recipient in order to directly change the recipient’s microbial composition and confer a health benefit to that individual. This is well known for C. difficile infections but is also being studied in patients with inflammatory bowel disease, functional GI disorders and obesity and metabolic syndrome. Donor-recipient compatibility plays an important role in FMT. It is likely that there is existence of FMT super-donors or specific bacterial strains whose microbiomes are highly effective at engrafting in the recipient gut to treat disease. Conversely, host genetics and other environmental factors such as diet may have an effect on FMT engraftment success. Ongoing clinical trials will continue to provide insight into this exciting growing field.
Collapse
Click Here to Manage Email Alerts