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Donor fecal microbiota transplantation (FMT) is an investigational microbiome-based therapy being evaluated in the Phase 2 PRAGMAT trial for the treatment of irritable bowel syndrome (IBS). Led by researchers at the Mayo Clinic, the intervention involves the transfer of fecal microbiota from healthy donors—specifically those with low proteolytic activity and the presence of *Alistipes putredinis*—into patients with IBS and high luminal proteolytic activity. The goal is to restore microbial diversity and introduce species capable of inactivating proteases that contribute to IBS pathophysiology, particularly in post-infection IBS (PI-IBS).
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