Department of Microbiome Research and Applied Bioinformatics, University of Hohenheim, Stuttgart, Germany.
Institute of Pathology, Medical University of Graz, Graz, Austria; Theodor Escherich Laboratory for Medical Microbiome Research, Medical University of Graz, Graz, Austria.
Cell Rep Med. 2022 Aug 16;3(8):100711. doi: 10.1016/j.xcrm.2022.100711. Epub 2022 Aug 4.
Fecal microbiota transplantation (FMT) is a promising therapeutic approach for microbiota-associated pathologies, but our understanding of the post-FMT microbiome assembly process and its ecological and clinical determinants is incomplete. Here we perform a comprehensive fecal metagenome analysis of 14 FMT trials, involving five pathologies and >250 individuals, and determine the origins of strains in patients after FMT. Independently of the underlying clinical condition, conspecific coexistence of donor and recipient strains after FMT is uncommon and donor strain engraftment is strongly positively correlated with pre-FMT recipient microbiota dysbiosis. Donor strain engraftment was enhanced through antibiotic pretreatment and bowel lavage and dependent on donor and recipient ɑ-diversity; strains from relatively abundant species were more likely and from predicted oral, oxygen-tolerant, and gram-positive species less likely to engraft. We introduce a general mechanistic framework for post-FMT microbiome assembly in alignment with ecological theory, which can guide development of optimized, more targeted, and personalized FMT therapies.
粪便微生物群移植（FMT）是一种有前途的治疗与微生物群相关的疾病的方法，但我们对 FMT 后微生物组组装过程及其生态和临床决定因素的理解还不完整。在这里，我们对 14 项 FMT 试验进行了全面的粪便宏基因组分析，涉及五种疾病和超过 250 个人，并确定了 FMT 后患者中菌株的来源。独立于潜在的临床状况，同种供体和受体菌株在 FMT 后的共存并不常见，并且供体菌株的定植与 FMT 前受者微生物失调呈强烈正相关。通过抗生素预处理和肠道灌洗增强了供体菌株的定植，并且依赖于供体和受体的 α-多样性；来自相对丰富物种的菌株更有可能定植，而来自预测的口腔、耐氧和革兰氏阳性物种的菌株则不太可能定植。我们引入了一个与生态理论一致的 FMT 后微生物组组装的通用机制框架，该框架可以指导优化、更有针对性和个性化的 FMT 治疗的发展。
