Fecal microbiota

Fecal microbiota refers to the complex community of microorganisms, including bacteria, viruses, fungi, and archaea, that reside in the human gastrointestinal tract and are excreted in feces [25, 27]. It plays a critical role in host health by maintaining intestinal homeostasis, modulating the immune system, and synthesizing essential nutrients and metabolites like short-chain fatty acids (SCFAs) [13, 21]. Dysbiosis, or an imbalance in this ecosystem, is strongly associated with various diseases, most notably recurrent Clostridioides difficile infection (CDI), where the loss of microbial diversity allows for pathogen overgrowth [4, 16]. Beyond infection, alterations in fecal microbiota are linked to inflammatory bowel disease (IBD), metabolic disorders, and even the efficacy of cancer immunotherapies [10, 15, 22]. Therapeutic interventions targeting the fecal microbiota aim to restore a healthy microbial balance through Fecal Microbiota Transplantation (FMT) or the administration of live biotherapeutic products (LBPs) [26, 29]. FDA-approved products such as Rebyota and Vowst utilize screened donor-derived microbiota to treat recurrent CDI by re-establishing colonization resistance and normal metabolic pathways, such as secondary bile acid metabolism [2, 3, 16]. While highly effective for specific indications, the use of fecal microbiota as a therapeutic target presents challenges, including the risk of transmitting multi-drug resistant organisms (MDROs) and the inherent variability of donor-derived materials [6, 11].

Other names

Gut microbiotaGut microbiomeIntestinal floraFecal floraGastrointestinal microbiota

Restoration of gut microbial diversity and functional homeostasis to provide colonization resistance against pathogens and modulate host immune and metabolic pathways.