The Liggins Institute, University of Auckland, Auckland, New Zealand.
The Broad Institute of MIT and Harvard, Cambridge, MA, United States.
Front Cell Infect Microbiol. 2019 Jan 21;9:2. doi: 10.3389/fcimb.2019.00002. eCollection 2019.
Fecal microbiota transplantation (FMT) has become a highly effective bacteriotherapy for recurrent infection. Meanwhile the efficacy of FMT for treating chronic diseases associated with microbial dysbiosis has so far been modest with a much higher variability in patient response. Notably, a number of studies suggest that FMT success is dependent on the microbial diversity and composition of the stool donor, leading to the proposition of the existence of FMT super-donors. The identification and subsequent characterization of super-donor gut microbiomes will inevitably advance our understanding of the microbial component of chronic diseases and allow for more targeted bacteriotherapy approaches in the future. Here, we review the evidence for super-donors in FMT and explore the concept of keystone species as predictors of FMT success. Possible effects of host-genetics and diet on FMT engraftment and maintenance are also considered. Finally, we discuss the potential long-term applicability of FMT for chronic disease and highlight how super-donors could provide the basis for dysbiosis-matched FMTs.
粪便微生物移植(FMT)已成为治疗复发性感染的一种非常有效的细菌疗法。同时,FMT 治疗与微生物失调相关的慢性疾病的疗效迄今为止一直较为温和,患者反应的变异性也更高。值得注意的是,一些研究表明,FMT 的成功与否取决于供体粪便中的微生物多样性和组成,这导致了存在 FMT 超级供体的假设。对超级供体肠道微生物组的鉴定和后续特征描述,必将促进我们对慢性疾病微生物成分的理解,并为未来更有针对性的细菌疗法方法提供依据。在这里,我们回顾了 FMT 中超级供体的证据,并探讨了关键种作为 FMT 成功预测因子的概念。还考虑了宿主遗传和饮食对 FMT 定植和维持的可能影响。最后,我们讨论了 FMT 治疗慢性疾病的潜在长期适用性,并强调了超级供体如何为菌群失调匹配的 FMT 提供基础。
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