Fecal Microbiota Transplantation: Current Applications, Effectiveness, and Future Perspectives

Abstract

Fecal microbiota transplantation (FMT) is the infusion of liquid filtrate feces from a healthy donor into the gut of a recipient to cure a specific disease. A fecal suspension can be administered by nasogastric or nasoduodenal tube, colonoscope, enema, or capsule. The high success rate and safety in the short term reported for recurrent Clostridium difficile infection has elevated FMT as an emerging treatment for a wide range of disorders, including Parkinson’s disease, fibromyalgia, chronic fatigue syndrome, myoclonus dystopia, multiple sclerosis, obesity, insulin resistance, metabolic syndrome, and autism. There are many unanswered questions regarding FMT, including donor selection and screening, standardized protocols, long-term safety, and regulatory issues. This article reviews the efficacy and safety of FMT used in treating a variety of diseases, methodology, criteria for donor selection and screening, and various concerns regarding FMT.

Gleaning Insights from Fecal Microbiota Transplantation and Probiotic Studies for the Rational Design of Combination Microbial Therapies

“…(B) Disruption of the microbiota results in increased nutrients permissive for C. difficile growth (1) and high concentrations of primary bile salts relative to secondary bile salts (2). These changes promote C. difficile spore germination and growth to high concentrations within the intestine.…”

“…Reinforcing epithelial barriers and modulating inflammation may also promote healing and limit injurious host responses to infection. (C) Ulcerative colitis is characterized by an altered microbiota of decreased diversity (1), damage to the gastrointestinal epithelium (2), as well as aberrant, overly inflammatory host immune responses (3). By helping to maintain a normal microbiota and reinforce the barrier function of the epithelium, probiotics may limit exposure to inflammatory signals.…”

“…Techniques of FMT administration vary, with fecal preparations being given via oral capsules, nasogastric tubes, nasoduodenal tubes, colonoscopy, or enema (1,2). Both related and unrelated donors have been used.…”

The effect of intestinal microbiome on autism spectrum disorder

“…Moreover, an additional potential therapeutic aim of probiotics/synbiotics administration in this pediatric population could be the alleviation of gastrointestinal symptoms, as no effective treatments for these symptoms exist [31]. With regards to fecal microbiota transplantation, although the efficacy of this method has been investigated in other disorders (metabolic syndrome, inflammatory bowel disease), data in children with autism is poor [32,33].…”

Fecal microbiota transplantation in refractory or recurrent Clostridium difficile infection: a real-life experience in a non-academic center

“…of patients (1,(4)(5)(6). Nevertheless, recurrence rates range from 15 to 30% and these episodes are further treated with additional cycles of antibiotics.…”