Microbiome mismatches from microbiota transplants lead to persistent off-target metabolic and immunomodulatory effects, 2025, DeLeon et al.

SNT Gatchaman

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Microbiome mismatches from microbiota transplants lead to persistent off-target metabolic and immunomodulatory effects
Orlando DeLeon; Mora Mocanu; Alan Tan; Ashley M. Sidebottom; Jason Koval; Hugo D. Ceccato; Sarah Kralicek; John J. Colgan; Marissa M. St. George; Joash M. Lake; Michael Cooper; Jingwen Xu; Julia Moore; Qi Su; Zhilu Xu; Siew C. Ng; Francis K.L. Chan; Hein M. Tun; Candace M. Cham; Cambrian Y. Liu; David T. Rubin; Kristina Martinez-Guryn; Eugene B. Chang

Fecal microbiota transplant (FMT) is an increasingly used intervention, but its suitability to restore regional gut microbiota, particularly in the small bowel (SB), must be questioned because of its predominant anaerobic composition. In human subjects receiving FMT by upper endoscopy, duodenal engraftment of anaerobes was observed after 4 weeks. We hypothesized that peroral FMTs create host-microbe mismatches that impact SB homeostasis.

To test this, antibiotic-treated specific-pathogen-free (SPF) mice were given jejunal, cecal, or fecal microbiota transplants (JMTs, CMTs, or FMTs, respectively) and studied 1 or 3 months later.

JMT and FMT altered regional microbiota membership and function, energy balance, and intestinal and hepatic transcriptomes; JMT favored host metabolic pathways and FMT favored immune pathways. MTs drove regional intestinal identity (Gata4, Gata6, and Satb2) and downstream differentiation markers. RNA sequencing (RNA-seq) of metabolite-exposed human enteroids and duodenal biopsies post-FMT confirmed transcriptional changes in mice.

Thus, regional microbial mismatches after FMTs can lead to unintended consequences and require rethinking of microbiome-based interventions.

HIGHLIGHTS
• Microbes alter regional intestinal environments to enhance fitness and engraftment

• Mismatches alter metabolic and immune states of host tissues and regional microbiomes

• Engraftment of FMT (anaerobic) microbes in the small bowel is persistent

• Regionally matched microbiota in the small and large bowel restore homeostasis

Link | PDF (Cell)
 
Much more complex than marketing claims for probiotics or FMTs. "Take this product and it will fix your microbiome!" I wonder how the results would have looked if the mice had as varied diets as typical humans. I'm guessing that lab mice have much less genetic variation and variation in microbial exposure before and after birth than typical humans.
 
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