Microbiota Transplant in the Treatment of Obesity and Diabetes: Current and Future Perspectives

Abstract

A wealth of evidence has revealed the critical role of the gut microbiota in health and disease. Many chronic diseases have been associated with gut microbiota imbalance in its composition, diversity and functional capacity. Several types of interventions have been shown to correct microbiota imbalance and restore the beneficial metabolic outcomes of a normal microbiota. Among them, fecal microbiota transplantation (FMT) is an emergent, promising technology employed to improve clinical outcomes of various pathological conditions through modifications in the gut microbiota composition. FMT has been used successfully as a treatment option in recurrent Clostridium difficile infection , a condition characterized by severe gut microbiota dysbiosis. However, the potential usage of FMT in other microbiota-associated conditions different from C. difficile such as metabolic syndrome or obesity that are also marked by gut dysbiosis is still under investigation. Furthermore, the contribution of the gut microbiota as a cause or consequence in metabolic disease is still largely debated. This review provides critical information on the methodological approaches of FMT and its technological innovation in clinical applications. This review sheds light on the current findings and gaps in our understanding of how FMT can be used as a future biotherapeutic to restore microbial homeostasis in amelioration of obesity and diabetes.

Polydextrose Alleviates Adipose Tissue Inflammation and Modulates the Gut Microbiota in High-Fat Diet-Fed Mice

“…Moreover, we found that PDX treatment significantly modulated the gut microbiota structure in obese mice. Previous studies have indicated that gut microbiota dysbiosis is one of the reasons for obesity and related disorders, and fecal microbial transplantation (FMT) is considered a potential source of novel therapeutics (Napolitano and Covasa, 2020;He et al, 2021;Voland et al, 2021). FMT from the obesity-associated human gut microbiota to mice can induce vascular dysfunction and glucose intolerance, and FMT from lean donors to patients with obesity can promote metabolic benefits (Mocanu et al, 2021;Russo et al, 2021).…”

Current Status and Future Therapeutic Options for Fecal Microbiota Transplantation

“…Preliminary studies showed a promising beneficial effect of FMT, manifested by improved insulin sensitivity, glycemic control, and reduced chronic systemic inflammation [159]. However, high-quality well-powered RCTs with longer follow-up are urgently needed to highlight the benefits of FMT as a viable option for patients with obesity and metabolic syndrome in the future.…”

Fecal Microbiota Transplant for Hematologic and Oncologic Diseases: Principle and Practice

“…Outside the context of hematologic and oncologic conditions, FMT has been used to regulate host metabolism in both animal models of obesity [18,19] and in obese humans [20,21]. FMT from lean donors resulted in variable improvements in the insulin-sensitivity in obese recipients [22,23] and in patients with metabolic syndromes [22,23]. Improvement was associated with an increased abundance of butyrate-producing intestinal microbes.…”