Fecal Microbiota-based Therapeutics for Recurrent Clostridium difficile Infection, Ulcerative Colitis and Obesity

Abstract

The human gut microbiome is a complex ecosystem of fundamental importance to human health. Our increased understanding of gut microbial composition and functional interactions in health and disease states has spurred research efforts examining the gut microbiome as a valuable target for therapeutic intervention. This review provides updated insight into the state of the gut microbiome in recurrent Clostridium difficile infection (CDI), ulcerative colitis (UC), and obesity while addressing the rationale for the modulation of the gut microbiome using fecal microbiota transplant (FMT)-based therapies. Current microbiome-based therapeutics in pre-clinical or clinical development are discussed. We end by putting this within the context of the current regulatory framework surrounding FMT and related therapies.

Association between the gut microbiota and mineral metabolism

“…New study directions on mineral metabolism and the intestinal microbiota should cover fields such as: the optimization of the minerals supplied in the diet of patients suffering from diseases for which microflora could be therapeutically applied; the effects of frequently overused mineral supplements on the intestinal microbiota; the impact of probiotics on the bioavailability of minerals and their metabolism; and the full identification of all human intestinal microbes undetectable by existing methods. Moreover, gut microbiota–host interactions serve as an essential target for development of new therapeutic strategies such as: fecal microbiota transplant (FMT) in the therapy of C. difficile infection, hepatic encephalopathy and gastrointestinal and behavioral symptoms of autism spectrum disorders; stool‐substitute therapies in the treatment of C. difficile infection; and the implementation of FMT, non‐traditional probiotics (e.g. F. prausnitzii and Clostridium butyricum ) and postbiotics (bacterial products and metabolic byproducts of probiotic organisms) in the therapy of inflammatory diseases .…”

Gut Microbiome and Bone: to Build, Destroy, or Both?

“…More than a dozen randomized clinical trials have been completed assessing microbiome based therapies in a variety of disease states. 54 With the rising popularity of probiotics and medical use of probiotics and fecal microbiota transplant (FMT) to treat disease, understanding whether these manipulations have unintended consequences for bone health is increasingly important.…”

A soy-based probiotic drink modulates the microbiota and reduces body weight gain in diet-induced obese mice

“…This imbalance in the composition of the intestinal microbiota, known as dysbiosis, seems to promotes an increase in energy absorption capacity from the diet, modulating the individual's immune response and leading to a state of obesity (Koliada et al, 2017;Krajmalnik-Brown, Ilhan, Kang, & DiBaise, 2012;Sweeney & Morton, 2013). Some studies indicate that a shift in diversity of intestinal microbiota and specific microrganism genera are also associated with the development of obesity (Carlucci, Petrof, & Allen-Vercoe, 2016;Le Chatelier et al, 2013;Million et al, 2012;Million, Lagier, Yahav, & Paul, 2013).…”