Microbiota Transplantation, Health Implications, and the Way Forward

Alteration of gut microbiome homeostasis has been linked to many diseases, like hypertension, various metabolic syndromes and gastrointestinal disorders like ulcerative colitis, vaginosis, recurrent Clostridium difficile infection (CDI), and inflammatory bowel disease (IBD). Although fecal microbiota transplantation (FMT) is currently an approved therapy for many chronic gastrointestinal disorders, intensive research into fundamental genomics, ecological interactions, and culture of the members of human gut microbiomes has become priority around the world. Transplanting fecal microbial biomass is able to restore the dynamic equilibrium of the community, structure, and diversity of the normal gut microbiome. In spite of the successes recorded, FMT application is faced with numerous challenges such as donor recruitment difficulties, inadequate donation facilities, adverse unintended versus host outcomes, and complex regulatory and safety guidelines. Mitigation efforts include stool banking and stool encapsulation which allows for consistent, suitable, and unbiased access to FMT for individuals with gastrointestinal disorders. The mechanisms of action of FMT are extremely complex, and are reported to involve reduction of gut inflammation through modulatory activities on the inflammatory genes, mucins and antimicrobial peptides. In addition, FMT helps to correct dysbiosis by replenishing the gut microbiota communities which in turn mediates brain signaling, nutritional enhancement, and immune regulation to resolve colonic inflammatory disorders. This chapter reviews the various applications of microbiota transplantation, examines the limitations of the approach, and underscores the need for developing countries, where rural populations host the most valuable gut microbiomes, to invest in metagenomics and novel culture techniques to power the future of this revolutionary science. This chapter reviews the various applications of microbiota transplantation, examines the limitations of the approach, and underscores the need for developing countries, where rural populations host the most valuable gut microbiomes, to invest in metagenomics and novel culture techniques to power the future of this revolutionary science. A recent study revealed that duodenal injection of feces of a healthy donor into a diseased is as efficient administering treatment via the colon for the treatment of Clostridium difficile infection (CDI). Maximum clinical application of FMT has concen