Fecal Microbiota Transplantation and Other Gut Microbiota Manipulation Strategies

Abstract

The gut microbiota is composed of bacteria, archaea, phages, and protozoa. It is now well known that their mutual interactions and metabolism influence host organism pathophysiology. Over the years, there has been growing interest in the composition of the gut microbiota and intervention strategies in order to modulate it. Characterizing the gut microbial populations represents the first step to clarifying the impact on the health/illness equilibrium, and then developing potential tools suited for each clinical disorder. In this review, we discuss the current gut microbiota manipulation strategies available and their clinical applications in personalized medicine. Among them, FMT represents the most widely explored therapeutic tools as recent guidelines and standardization protocols, not only for intestinal disorders. On the other hand, the use of prebiotics and probiotics has evidence of encouraging findings on their safety, patient compliance, and inter-individual effectiveness. In recent years, avant-garde approaches have emerged, including engineered bacterial strains, phage therapy, and genome editing (CRISPR-Cas9), which require further investigation through clinical trials.

Prostate and gut: Any relationship? A narrative review on the available evidence and putative mechanisms

“…While nonspecific interventions affect the general composition and functions of the GM, aiming at reestablishing the eubiosis, specific manipulations modify selected bacterial species or metabolic patterns. 23 Dietary intervention showed to be the most effective modulators of GM in a long-term perspective. So far, we have an evidence of diets rich in fiber and vegetables along with energy restrictions to be beneficial for the host microbiome.…”

“…The dysregulation of GM, namely dysbiosis, is an alteration in the normal composition of the microbiota, and is linked to a number of pathologic conditions, including depression, metabolic disorders, cardiovascular diseases, and so forth. 23,24 The intestinal epithelial barrier (IEB) plays a critical role in maintaining the integrity of the gastrointestinal tract and represents the first line of defense of our body against external noxious agents including toxins and pathogens. IEB is a well-regulated structure, and the integrity of the mucous surface and of the epithelial lining is responsible of its permeability which in turn may influence intestinal homeostasis.…”

Gut microbiota and irritable bowel syndrome

“…Modulations of the alimentary regimen might alter the intestinal microbiota and, in turn, affect the clinical outcomes of intestinal diseases. 87 Several dietary strategies are considered for the management of IBS, including healthy eating strategies, gluten-free diets, low-FODMAP diets, etc. 88,89 A diet low in FODMAP has shown promising results in relieving IBS symptoms and has been increasingly recommended for IBS patients.…”

“…During the last decade, innovative approaches targeting specific subsets of gut microbiota directly or indirectly have emerged, including engineered bacterial strains, bacteriophage therapy, stem cell-based intestine-on-a-chip, and CRISPR/Cas9-based therapy. 62,87 Although these strategies have yet to be explored in IBS, they offer promising avenues for further investigation. Figure 1 illustrates the framework of gut microbiota manipulation strategies for IBS.…”

“…As omics analyses become more affordable and more readily available, there is now an increasing emphasis on developing precision medicine for individual patients. During the last decade, innovative approaches targeting specific subsets of gut microbiota directly or indirectly have emerged, including engineered bacterial strains, bacteriophage therapy, stem cell‐based intestine‐on‐a‐chip, and CRISPR/Cas9‐based therapy 62,87 . Although these strategies have yet to be explored in IBS, they offer promising avenues for further investigation.…”