AN OVERVIEW OF FAECAL MICROBIOTA TRANSPLANTATION
DOI:
https://doi.org/10.55197/qjmhs.v4i5.181Keywords:
faecal material, faecal microbiota transplant, clostridium difficile, gastrointestinal diseases, pathogen suppressionAbstract
Faecal Microbiota Transplant (FMT) is a medical intervention in which stool from a healthy person is transplanted into another individual’s large intestine. This method is meant to help restore the normal microbiota of the recipient’s gut, including cases with dysbiosis due to recurrent Clostridium difficile infection and other gastrointestinal diseases. Though the procedural detail of FMT is complex, it has some fundamental biological concepts such as replantation of reduced microbial balance, pathogenic microorganism inhibition, regulation of immunity, and metabolite production. Moreover, the current regulation and future studies by professional bodies regarding synthetic microbiota and individualised FMT have exciting potential for improved therapeutic use; there is a need for more standardisation and safety measures on the practice. To maximize its clinical potential, we also focused on data for developing uniform guidelines, enhancing donor screening procedures, and ensuring safety and efficacy through rigorous study. As FMT applications expand beyond recurrent Clostridium difficile infection to include inflammatory bowel disease, irritable bowel syndrome, and other microbiome-related conditions, advancements in personalized and synthetic microbiota therapies are expected to pave the way for their safer and more versatile use. Therefore, continuous exploration and strong regulatory frameworks are essential in unlocking the therapeutic potential of FMT while safeguarding patient outcomes.
References
[1] Afzal, M., Ilyas, K., Sarfraz, A., Sarfraz, Z. (2023): Treatment efficacy of fecal microbiota-based live biotherapeutics (RBX2660) for the prevention of recurring Clostridioides difficile infection. – European Journal of Internal Medicine 111: 130-132.
[2] Anderson, J.L., Edney, R.J., Whelan, K. (2012): Systematic review: faecal microbiota transplantation in the management of inflammatory bowel disease. – Alimentary Pharmacology & Therapeutics 36(6): 503-516.
[3] Aroniadis, O.C., Brandt, L.J. (2013): Fecal microbiota transplantation: past, present and future. – Current Opinion in Gastroenterology 29(1): 79-84.
[4] Bauer, M.P., Notermans, D.W., Van Benthem, B.H., Brazier, J.S., Wilcox, M.H., Rupnik, M., Monnet, D.L., Van Dissel, J.T., Kuijper, E.J. (2011): Clostridium difficile infection in Europe: a hospital-based survey. – The Lancet 377(9759): 63-73.
[5] Baunwall, S.M.D., Terveer, E.M., Dahlerup, J.F., Erikstrup, C., Arkkila, P., Vehreschild, M.J., Ianiro, G., Gasbarrini, A., Sokol, H., Kump, P.K., Satokari, R. (2021): The use of faecal microbiota transplantation (FMT) in Europe: a Europe-wide survey. – The Lancet Regional Health–Europe 9: 8p.
[6] Baxter, M., Colville, A. (2016): Adverse events in faecal microbiota transplant: a review of the literature. – Journal of Hospital Infection 92(2): 117-127.
[7] Blount, K.F., Shannon, W.D., Deych, E., Jones, C. (2019): Restoration of bacterial microbiome composition and diversity among treatment responders in a phase 2 trial of RBX2660: an investigational microbiome restoration therapeutic. – In Open Forum Infectious Diseases, US: Oxford University Press 6(4): 10p.
[8] Borody, T.J., Warren, E.F., Leis, S.M., Surace, R., Ashman, O., Siarakas, S. (2004): Bacteriotherapy using fecal flora: toying with human motions. – Journal of Clinical Gastroenterology 38(6): 475-483.
[9] Chen, D., Wu, J., Jin, D., Wang, B., Cao, H. (2019): Fecal microbiota transplantation in cancer management: Current status and perspectives. – International Journal of Cancer 145(8): 2021-2031.
[10] Chen, J., Vitetta, L. (2021): Modulation of Gut Microbiota for the Prevention and Treatment of COVID-19. – Journal of Clinical Medicine 10(13): 17p.
[11] Cohen, S.H., Gerding, D.N., Johnson, S., Kelly, C.P., Loo, V.G., McDonald, L.C., Pepin, J., Wilcox, M.H. (2010): Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). – Infection Control & Hospital Epidemiology 31(5): 431-455.
[12] Costello, S.P., Day, A., Yao, C.K., Bryant, R.V. (2020): Faecal microbiota transplantation (FMT) with dietary therapy for acute severe ulcerative colitis. – BMJ Case Reports CP 13(8): 3p.
[13] Dubberke, E.R., Lee, C.H., Orenstein, R., Khanna, S., Hecht, G., Gerding, D.N. (2018): Results from a randomized, placebo-controlled clinical trial of a RBX2660-a microbiota-based drug for the prevention of recurrent Clostridium difficile infection. – Clinical Infectious Diseases 67(8): 1198-1204.
[14] Gupta, S., Allen-Vercoe, E., Petrof, E.O. (2016): Fecal microbiota transplantation: in perspective. – Therapeutic Advances in Gastroenterology 9(2): 229-239.
[15] Johnson, S., Louie, T.J., Gerding, D.N., Cornely, O.A., Chasan-Taber, S., Fitts, D., Gelone, S.P., Broom, C., Davidson, D.M., Polymer Alternative for CDI Treatment (PACT) investigators (2014): Vancomycin, metronidazole, or tolevamer for Clostridium difficile infection: results from two multinational, randomized, controlled trials. – Clinical Infectious Diseases 59(3): 345-354.
[16] Kassam, Z., Lee, C.H., Yuan, Y., Hunt, R.H. (2013): Fecal microbiota transplantation forClostridium difficileInfection: systematic review and meta-analysis. – Official Journal of the American College of Gastroenterology, ACG 108(4): 500-508.
[17] Khanna, S., Assi, M., Lee, C., Yoho, D., Louie, T., Knapple, W., Aguilar, H., Garcia-Diaz, J., Wang, G.P., Berry, S.M., Marion, J. (2022): Efficacy and safety of RBX2660 in PUNCH CD3, a phase III, randomized, double-blind, placebo-controlled trial with a Bayesian primary analysis for the prevention of recurrent Clostridioides difficile infection. – Drugs 82(15): 1527-1538.
[18] Kwak, S., Choi, J., Hink, T., Reske, K.A., Blount, K., Jones, C., Bost, M.H., Sun, X., Burnham, C.A.D., Dubberke, E.R., Dantas, G. (2020): Impact of investigational microbiota therapeutic RBX2660 on the gut microbiome and resistome revealed by a placebo-controlled clinical trial. – Microbiome 8(1): 16p.
[19] Louie, T.J., Miller, M.A., Mullane, K.M., Weiss, K., Lentnek, A., Golan, Y., Gorbach, S., Sears, P., Shue, Y.K. (2011): Fidaxomicin versus vancomycin for Clostridium difficile infection. – New England Journal of Medicine 364(5): 422-431.
[20] Martin-Gallausiaux, C., Marinelli, L., Blottière, H.M., Larraufie, P., Lapaque, N. (2021): SCFA: mechanisms and functional importance in the gut. – Proceedings of the Nutrition Society 80(1): 37-49.
[21] McDonald, L.C., Gerding, D.N., Johnson, S., Bakken, J.S., Carroll, K.C., Coffin, S.E., Dubberke, E.R., Garey, K.W., Gould, C.V., Kelly, C., Loo, V. (2018): Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). – Clinical Infectious Diseases 66(7): e1-e48.
[22] Nakov, R., Velikova, T. (2020): Chemical metabolism of xenobiotics by gut microbiota. – Current Drug Metabolism 21(4): 260-269.
[23] Orenstein, R., Dubberke, E.R., Khanna, S., Lee, C.H., Yoho, D., Johnson, S., Hecht, G., DuPont, H.L., Gerding, D.N., Blount, K.F., Mische, S. (2022): Durable reduction of Clostridioides difficile infection recurrence and microbiome restoration after treatment with RBX2660: results from an open-label phase 2 clinical trial. – BMC Infectious Diseases 22(1): 13p.
[24] Patel, N.C., Griesbach, C.L., DiBaise, J.K., Orenstein, R. (2013): Fecal microbiota transplant for recurrent Clostridium difficile infection: Mayo Clinic in Arizona experience. – In Mayo Clinic Proceedings, Elsevier 88(8): 7p.
[25] Paredes-Sabja, D., Shen, A., Sorg, J.A. (2014): Clostridium difficile spore biology: sporulation, germination, and spore structural proteins. – Trends in Microbiology 22(7): 406-416.
[26] Petrof, E.O., Gloor, G.B., Vanner, S.J., Weese, S.J., Carter, D., Daigneault, M.C., Brown, E.M., Schroeter, K., Allen-Vercoe, E. (2013): Stool substitute transplant therapy for the eradication of Clostridium difficile infection:‘RePOOPulating’the gut. – Microbiome 1(1): 12p.
[27] Quigley, E.M., Gajula, P. (2020): Recent advances in modulating the microbiome. – F1000Research 9(F1000-Faculty): 12p.
[28] Rao, K., Safdar, N. (2016): Fecal microbiota transplantation for the treatment of Clostridium difficile infection. – Journal of Hospital Medicine 11(1): 56-61.
[29] Simões, C.D., Maganinho, M., Sousa, A.S. (2022): FODMAPs, inflammatory bowel disease and gut microbiota: updated overview on the current evidence. – European Journal of Nutrition 61(3): 1187-1198.
[30] Smits, L.P., Bouter, K.E., De Vos, W.M., Borody, T.J., Nieuwdorp, M. (2013): Therapeutic potential of fecal microbiota transplantation. – Gastroenterology 145(5): 946-953.
[31] Sunkara, T., Rawla, P., Ofosu, A., Gaduputi, V. (2018): Fecal microbiota transplant–a new frontier in inflammatory bowel disease. – Journal of Inflammation Research 8p.
[32] Surawicz, C.M., Brandt, L.J., Binion, D.G., Ananthakrishnan, A.N., Curry, S.R., Gilligan, P.H., McFarland, L.V., Mellow, M., Zuckerbraun, B.S. (2013): Guidelines for diagnosis, treatment, and prevention ofclostridium difficileInfections. – Official Journal of the American College of Gastroenterology, ACG 108(4): 478-498.
[33] Terrier, M.C.Z., Simonet, M.L., Bichard, P., Frossard, J.L. (2014): Recurrent Clostridium difficile infections: the importance of the intestinal microbiota. – World Journal of Gastroenterology: WJG 20(23): 9p.
[34] Van Nood, E., Vrieze, A., Nieuwdorp, M., Fuentes, S., Zoetendal, E.G., de Vos, W.M., Visser, C.E., Kuijper, E.J., Bartelsman, J.F., Tijssen, J.G., Speelman, P. (2013): Duodenal infusion of donor feces for recurrent Clostridium difficile. – New England Journal of Medicine 368(5): 407-415.
[35] Wortelboer, K., Nieuwdorp, M., Herrema, H. (2019): Fecal microbiota transplantation beyond Clostridioides difficile infections. – EBioMedicine 44: 716-729.
[36] Youngster, I., Mahabamunuge, J., Systrom, H.K., Sauk, J., Khalili, H., Levin, J., Kaplan, J.L., Hohmann, E.L. (2016): Oral, frozen fecal microbiota transplant (FMT) capsules for recurrent Clostridium difficile infection. – BMC Medicine 14(1): 4p.
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Copyright (c) 2025 SOLOMON MATTHIAS GAMDE, ASIBOR DAVID OLUMESE, ODU STEPHEN IYEJE, ENEUDE TOCHUKWU FAITH, ABIGAIL BIYA
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