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Current perspectives on fecal microbiota transplantation in inflammatory bowel disease

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Abstract

Fecal microbiota transplantation (FMT) has emerged as a promising therapeutic modality within the domain of inflammatory bowel disease (IBD). While FMT has secured approval and demonstrated efficacy in addressing recurrent and refractory Clostridioides difficile infection, its application in IBD remains an area of active exploration and research. The current status of FMT in IBD reflects a nuanced landscape, with ongoing investigations delving into its effectiveness, safety and optimal implementation. Early-stage clinical trials and observational studies have provided insights into the potential of FMT to modulate the dysbiotic gut microbiota associated with IBD, aiming to mitigate inflammation and promote mucosal healing. However, considerable complexities persist, including variations in donor selection, treatment protocols and outcome assessments. Challenges in standardizing FMT protocols for IBD treatment are compounded by the dynamic nature of the gut microbiome and the heterogeneity of IBD itself. Despite these challenges, enthusiasm for FMT in IBD emanates from its capacity to address gut microbial dysbiosis, signifying a paradigm shift towards more comprehensive approaches in IBD management. As ongoing research progresses, an enhanced understanding of FMT’s role in IBD therapy is anticipated. This article synthesizes the current status of FMT in IBD, elucidating the attendant challenges and aspiring towards the refinement of its application for improved patient outcomes.

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Authors and Affiliations

  1. Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, 141 001, India

    Arshdeep Singh & Ajit Sood

  2. Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, 141 001, India

    Vandana Midha

  3. Department of Biochemistry, Maharshi Dayanand University, Rohtak, 124 001, India

    Nar Singh Chauhan

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  2. Vandana Midha
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• ArS: the conception and design of the study, acquisition of data, interpretation of data, drafting the article, revising it critically for important intellectual content, final approval of the version to be submitted. • VM: the conception and design of the study, revising it critically for important intellectual content, final approval of the version to be submitted. • NSC: revising it critically for important intellectual content, final approval of the version to be submitted. • AS: the conception and design of the study, revising it critically for important intellectual content, final approval of the version to be submitted.

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Ajit Sood is on the advisory board of Janssen Pharmaceuticals (Asia–Pacific) and received honorarium for speaker events from Pfizer India and Takeda India. ArS, VM and NSC disclose no conflicts.

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Singh, A., Midha, V., Chauhan, N.S. et al. Current perspectives on fecal microbiota transplantation in inflammatory bowel disease. Indian J Gastroenterol 43, 129–144 (2024). https://doi.org/10.1007/s12664-023-01516-8

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