Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA.
Texas Children's Microbiome Center, Department of Pathology, Texas Children's Hospital, Houston, TX, USA.
NPJ Biofilms Microbiomes. 2023 Aug 3;9(1):54. doi: 10.1038/s41522-023-00421-4.
Fecal microbiota transplantation (FMT) has proven to be an effective treatment for recurrent Clostridioides difficile infection (rCDI) in both adult and pediatric patients. However, as microbiome development is a critical factor in children, it remains unclear whether adult fecal donors can provide age-appropriate functional restoration in pediatric patients. To address this issue, we conducted an integrated systems approach and found that concordant donor strain engraftment, along with metabolite restoration, are associated with FMT outcomes in both adult and pediatric rCDI patients. Although functional restoration after FMT is not strain-specific, specialized metabolic functions are retained in pediatric patients when adult fecal donors are used. Furthermore, we demonstrated broad utility of high-resolution variant-calling by linking probiotic-strain engraftment with improved gastrointestinal symptoms in adults with irritable bowel syndrome and in children with autism spectrum disorder. Our findings emphasize the importance of strain-level identification when assessing the efficacy of probiotics and microbiota-based therapeutics.
粪便微生物群移植（FMT）已被证明可有效治疗成人和儿科患者的复发性艰难梭菌感染（rCDI）。然而，由于微生物组的发展是儿童的关键因素，目前尚不清楚成人粪便供体是否能为儿科患者提供适合年龄的功能恢复。为了解决这个问题，我们采用了一种综合系统方法，发现供体菌株的嵌合以及代谢物的恢复与成人和儿科 rCDI 患者的 FMT 结果相关。尽管 FMT 后的功能恢复不是菌株特异性的，但当使用成人粪便供体时，儿科患者保留了专门的代谢功能。此外，我们通过将益生菌菌株的嵌合与成人肠易激综合征和儿童自闭症谱系障碍患者的胃肠道症状改善联系起来，证明了高分辨率变异调用的广泛实用性。我们的研究结果强调了在评估益生菌和基于微生物组的治疗效果时，进行菌株水平鉴定的重要性。
