Gilbert Jack A, Azad Meghan B, Bäckhed Fredrik, Blaser Martin J, Byndloss Mariana, Chiu Charles Y, Chu Hiutung, Dugas Lara R, Elinav Eran, Gibbons Sean M, Gilbert Katharine E, Henn Matthew R, Ishaq Suzanne L, Ley Ruth E, Lynch Susan V, Segal Eran, Spector Tim D, Strandwitz Philip, Suez Jotham, Tropini Carolina, Whiteson Katrine, Knight Rob
Department of Pediatrics, University of California San Diego, La Jolla, CA, USA.
Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, USA.
Nat Med. 2025 Apr;31(4):1099-1113. doi: 10.1038/s41591-025-03615-9. Epub 2025 Apr 11.
The landscape of clinical microbiome research has dramatically evolved over the past decade. By leveraging in vivo and in vitro experimentation, multiomic approaches and computational biology, we have uncovered mechanisms of action and microbial metrics of association and identified effective ways to modify the microbiome in many diseases and treatment modalities. This Review explores recent advances in the clinical application of microbiome research over the past 5 years, while acknowledging existing barriers and highlighting opportunities. We focus on the translation of microbiome research into clinical practice, spearheaded by Food and Drug Administration (FDA)-approved microbiome therapies for recurrent Clostridioides difficile infections and the emerging fields of microbiome-based diagnostics and therapeutics. We highlight key examples of studies demonstrating how microbiome mechanisms, metrics and modifiers can advance clinical practice. We also discuss forward-looking perspectives on key challenges and opportunities toward integrating microbiome data into routine clinical practice, precision medicine and personalized healthcare and nutrition.
在过去十年中，临床微生物组研究领域发生了巨大的演变。通过利用体内和体外实验、多组学方法和计算生物学，我们已经揭示了作用机制和微生物关联指标，并确定了在许多疾病和治疗方式中改变微生物组的有效方法。本综述探讨了过去5年微生物组研究临床应用的最新进展，同时承认存在的障碍并突出机会。我们专注于将微生物组研究转化为临床实践，这一过程由美国食品药品监督管理局（FDA）批准的用于复发性艰难梭菌感染的微生物组疗法以及基于微生物组的诊断和治疗新兴领域引领。我们重点介绍了一些研究的关键实例，展示了微生物组机制、指标和调节剂如何推动临床实践。我们还讨论了关于将微生物组数据整合到常规临床实践、精准医学以及个性化医疗保健和营养中的关键挑战和机遇的前瞻性观点。
