• Immunology, Transplantation, and Regenerative Medicine (L Piemonti and V Sordi, Section Editors)
  • Published:

Fecal Microbiota Transplantation: a Future Therapeutic Option for Obesity/Diabetes?

Abstract

Purpose of Review

The aim of this review is to summarize the current data available on the metabolic effects of fecal microbiota transplantation (FMT) including obesity and glucose metabolism in humans.

Recent Findings

Gut microbiota dysbiosis is a frequent characteristic observed in obesity and related metabolic diseases. Pieces of evidence mostly generated in mouse models suggest that rescuing this dysbiosis associates with improved metabolism. In humans, dietary or bariatric surgery interventions are often accompanied by complete or partial restoration of this dysbiosis together with weight reduction and metabolic amelioration. FMT is an interesting option to modify gut microbiota and has been associated with improved clinical outcomes, albeit only used in routine care for Clostridium difficile infection. However, there are only limited data on using FMT in the metabolic context.

Summary

FMT from lean donors significantly improves insulin sensitivity in obese subjects with metabolic syndrome. However, there is a wide range of clinical responses. Interestingly in subjects with high microbial gene richness at baseline and when FMT donors that are metabolically compromised are used, no metabolic improvement is seen. Moreover, more studies evaluating the effect of FMT in patients with overt type 2 diabetes are warranted. Furthermore, interventions (in the receiver prior to FMT) aiming to enhance FMT response also need evaluation.

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Funding

Grant supports in this field were obtained by Ministry of Health and Solidarity (Assistance Publique-Hôpitaux de Paris: to JAW/PHRC-N Drifter, to KC/PHRC Micronaria), by European Union (Metacardis to KC HEALTH-F4-2012-305312, JPI MICRODIET Grant (5290510105) to KC and MN, EU Horizon 2020 grant (LITMUS 777377) to KC and MN) and by LeDucq Foundation consortium grant (17CVD01) to KC and MN. MN is also supported by a ZONMW-VIDI grant 2013 (016.146.327). JAW and KC are part of ICAN (Institute of Cardiometabolism and Nutrition Institute).

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Correspondence to Judith Aron-Wisnewsky.

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Judith Aron-Wisnewsky declares that she has no conflict of interest.

Karine Clément is on the Scientific Advisory Board of LNC Therapeutics, France.

Max Nieuwdorp is on the Scientific Advisory Board of Caelus Pharmaceuticals, the Netherlands.

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Aron-Wisnewsky, J., Clément, K. & Nieuwdorp, M. Fecal Microbiota Transplantation: a Future Therapeutic Option for Obesity/Diabetes?. Curr Diab Rep 19, 51 (2019). https://doi.org/10.1007/s11892-019-1180-z

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Keywords

  • Microbiota
  • Obesity
  • Type 2 diabetes
  • Fecal microbiota transplantation
  • Encapsulated feces