Intestinal microbiota transplantation: do not forget the metabolites

Abstract

In The Lancet Gastroenterology & Hepatology, Siu Lam and colleagues 1 Lam S Bai X Shkoporov AN et al. Roles of the gut virome and mycobiome in faecal microbiota transplantation. Lancet Gastroenterol Hepatol. 2022; 7: 472-484 Summary Full Text Full Text PDF PubMed Scopus (3) Google Scholar highlight research demonstrating that sterile-filtered intestinal microbiota transplant (IMT; referred to as faecal microbiota transplant by Lam and colleagues) has comparable efficacy with conventional IMT in treating recurrent Clostridioides difficile infection, suggesting that soluble factors or those less than 0·2 μm in size within an IMT contribute to its efficacy. The authors provide a welcome review of the gut virome (and mycobiome) as potential mediators; however, the contribution of another group of soluble factors—gut metabolites arising from microbiome–host interactions—also merits highlighting. Roles of the gut virome and mycobiome in faecal microbiota transplantationFaecal microbiota transplantation (FMT) is an innovative approach to treat diseases that are associated with gut dysbiosis, by transferring a healthy stool microbiota to a recipient with disease. Beyond the bacteriome, the human gut also harbours diverse communities of viruses and fungi, collectively known as the virome and the mycobiome. The effect of the virome and the mycobiome on the success of FMT therapy has not been appreciated until recently. In this Review, we summarise the current literature on the effects of the gut virome and mycobiome on the treatment of various diseases with FMT. Full-Text PDF