Research feed 
Overview 
FAQs 
Research Feed 
Update History 
References 2025-02-06 08:19:04
Page Updates majorPage created by Karen Pendergrass
Did you know?
The creator of the Microbiome Signatures database was the first recorded person in the world to have undergone an FMT for Celiac Disease in 2012.
Fecal Microbiota Transplantation (FMT)
Researched by:
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Karen Pendergrass
ID
Karen Pendergrass
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.
Fecal Microbiota Transplantation (MT) involves transferring fecal bacteria from a healthy donor to a patient to restore microbiome balance.
-
Karen Pendergrass
Researched by:
-
Karen Pendergrass
ID
Karen Pendergrass
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Karen Pendergrass
Overview
Fecal Microbiota Transplantation (FMT) is a medical procedure that involves the transfer of fecal material from a healthy donor into the gastrointestinal tract of a recipient. This procedure aims to restore a healthy balance of gut microbiota in individuals with gastrointestinal disorders, such as recurrent Clostridioides difficile infection (CDI), inflammatory bowel disease (IBD), and irritable bowel syndrome (IBS). FMT has been shown to be effective in treating these conditions by introducing beneficial bacteria and reducing the presence of harmful pathogens. The procedure can be performed through various routes, including enema, colonoscopy, nasojejunal tube, and oral capsules. FMT is considered a promising treatment option for various gastrointestinal and non-gastrointestinal diseases, with ongoing research exploring its potential applications. [1][2]
Process of FMT
Fecal Microbiota Transplantation (FMT) begins with selecting a healthy donor whose microbiome is carefully analyzed to ensure suitability for the recipient. The donor’s fecal sample is then processed and prepared for transplantation, which may be administered via colonoscopy, enema, or oral capsules. After the transfer, the transplanted microbiota colonizes the recipient’s gut, replacing or augmenting the existing microbiome. Ultimately, the success of FMT is influenced by various factors, including the donor’s microbiome composition, the recipient’s overall health status, and the chosen transplantation method. [3][4][5][6]
Conditions
FMT is being investigated for various conditions, including cardiometabolic disorders, neurological disorders, psychiatric disorders, neoplastic disorders, autoimmune/inflammatory disorders, and gastrointestinal disorders. Research has shown promise in using FMT to treat conditions such as obesity, type 2 diabetes, Parkinson’s disease, and certain types of cancer. FMT has also been investigated as a potential treatment for psychiatric disorders, including mood disorders, substance use disorder, and eating disorders. Additionally, FMT has been explored as a treatment for autoimmune/inflammatory disorders, such as multiple sclerosis and inflammatory bowel disease. While more research is needed to confirm the effectiveness of FMT for these conditions, the current evidence suggests that it may be a promising treatment option. [8][9][10][11][12]
Success Rate of FMT
The success rate of FMT varies depending on the condition being treated and the method of administration. For recurrent Clostridium difficile infection (CDI), FMT has been shown to be effective in up to 90% of cases. In a study of 137 patients who received FMT for CDI, 82% had no recurrence of CDI at follow-up. For other conditions, such as irritable bowel syndrome (IBS), the success rate of FMT is less clear, with a meta-analysis of five studies showing a pooled odds ratio of improvement in IBS symptoms of 3.7 compared to placebo. However, the long-term durability and safety of FMT are still being studied and more research is needed to fully understand its effectiveness. [13][14]
Future Directions
Fecal Microbiota Transplantation (FMT)—recognized as a microbiome-based therapeutic intervention (MBTI)—holds a promising future, with ongoing research and clinical trials examining its potential to address diseases such as inflammatory bowel disease, autism spectrum disorder, and type 2 diabetes. However, several challenges remain, including the standardization of donor screening, sample preparation, and transplantation methods, as well as the development of effective storage and transportation protocols for frozen FMT products. Advances in microbiome analysis and sequencing technologies will help clarify the mechanisms that drive FMT’s therapeutic benefits and pave the way for more effective treatment strategies. Equally important is the establishment of a unified FMT registration system and clear, evidence-based guidelines to ensure safe and effective application of this therapy. Ultimately, these developments could lead to the advent of truly personalized medicine, where FMT-based interventions are tailored to an individual’s unique microbiome profile. [15][16]
FAQs
What conditions is FMT used for, and why is it performed?
What conditions is FMT used for, and why is it performed?
FMT is primarily used to treat recurrent Clostridioides difficile infections (rCDI) that do not respond to standard therapies. Researchers are also exploring its potential in a range of other conditions—such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and certain neurological and metabolic disorders like Parkinson’s disease and Multiple Sclerosis (MS)—due to its ability to restore a balanced gut microbiome. [17][18][19][20]
How safe is FMT, and what are the potential risks?
How safe is FMT, and what are the potential risks?
When conducted under medical supervision and with proper donor screening, FMT is generally considered safe. However, risks include infections from insufficiently screened donors, immune reactions, and, in very rare cases, unintended long-term microbiome shifts that may affect metabolism or other physiological functions. Common minor side effects can include diarrhea, abdominal discomfort, and transient bloating. [21]
How effective is FMT, and does it provide long-term benefits?
How effective is FMT, and does it provide long-term benefits?
FMT demonstrates high success rates (often 85%–90%) in resolving recurrent C. difficile infections. Its effectiveness in other conditions varies based on disease type and individual patient factors. Research is ongoing.[22]
Research Feed
Gut microbiota in heart failure and related interventions
July 10, 2023
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Cardiovascular Health •
Cardiovascular Health
Did you know?
Gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) is strongly linked to cardiovascular disease, potentially influencing atherosclerosis more than cholesterol, making the gut microbiome a key therapeutic target.
This review explores the gut-heart axis, highlighting how gut microbiota alterations and metabolites like TMAO and SCFAs contribute to heart failure (HF). It evaluates the gut hypothesis, emphasizing bacterial translocation and inflammation in HF, and discusses potential interventions.
What was reviewed?
The Gut Microbiota in Heart Failure and Related Interventions Review article examines the relationship between heart failure (HF) and the gut microbiota, exploring the gut hypothesis of HF, the role of gut microbiota metabolites, and potential microbiome-targeted interventions (MBTIs). The review provides a comprehensive overview of the current understanding of how changes in gut microbiota composition and its metabolites contribute to HF progression and discusses various interventions, including dietary changes, probiotic therapy, fecal microbiota transplantation (FMT), antibiotics, and other novel approaches.
Who was reviewed?
The review synthesizes findings from various studies involving HF patients and animal models to understand the connection between gut microbiota and HF. It also evaluates research on different interventions and their effects on gut microbiota and HF. Specific studies cited include investigations of bacterial species present in HF patients compared to healthy controls, the impact of gut microbiota metabolites like trimethylamine N-oxide (TMAO) and short-chain fatty acids (SCFAs) on HF, and the efficacy of interventions like the DASH diet, Mediterranean diet, probiotics, FMT, and antibiotics.
What were the most important findings of this review?
The review highlights the gut hypothesis of heart failure (HF), where reduced cardiac output and systemic congestion lead to diminished intestinal perfusion, ischemia, and barrier dysfunction. This allows bacterial translocation and endotoxin release, worsening inflammation and HF. HF patients show increased pathogenic bacteria (e.g., Bacteroides, Eubacterium rectale) and decreased beneficial bacteria (e.g., Lachnospiraceae, Ruminococcaceae). Key gut microbiota metabolites, such as TMAO, SCFAs, TMAVA, and PAGln, significantly impact HF. TMAO promotes cardiac fibrosis, hypertrophy, and inflammation, while SCFAs have protective effects, preventing cardiac hypertrophy and fibrosis, reducing inflammation, and providing energy to the failing heart.
What are the greatest implications of this review?
The greatest implications of the Gut Microbiota in Heart Failure and Related Interventions review are manifold. It highlights the therapeutic potential of targeting gut microbiota as a promising avenue for heart failure (HF) treatment, suggesting that a deeper understanding of the interactions between gut microbiota and HF could lead to novel strategies that complement existing therapies. Personalized medicine approaches, including dietary changes, probiotics, and potentially fecal microbiota transplantation (FMT), could be tailored to individual patients to address specific microbial imbalances contributing to HF. The review also underscores the importance of preventive strategies, such as adopting diets that support a healthy gut microbiota, in reducing the risk and progression of HF, which could have significant public health implications. Additionally, the review calls for further research to elucidate the mechanisms linking gut microbiota and HF, assess the long-term efficacy and safety of various interventions, and explore the roles of other metabolites and bacterial species in HF. Such research could pave the way for new diagnostic and therapeutic tools in HF management. Overall, the review emphasizes the critical role of gut microbiota in HF and suggests that targeting it could revolutionize HF treatment and prevention.
Serendipity in Refractory Celiac Disease: Full Recovery of Duodenal Villi and Clinical Symptoms after Fecal Microbiota Transfer
September 25, 2016
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Autoimmune Diseases •
Autoimmune Diseases
Did you know?
Americans are over three times more likely to suffer from autoimmune diseases compared to the global average, with approximately 16.67% of the U.S. population affected versus 5% worldwide.
A patient with refractory celiac disease type II achieved complete duodenal villi recovery and symptom resolution after fecal microbiota transfer. This unexpected outcome suggests that microbiome manipulation may offer a novel treatment for RCD II, providing an alternative to immunosuppressive therapies for this challenging condition.
What was studied?
This study examined the impact of fecal microbiota transfer (FMT) on a patient with refractory celiac disease type II (RCD II). The patient initially received FMT as treatment for recurrent Clostridium difficile infection (CDI), but the intervention unexpectedly resulted in full recovery of duodenal villi and resolution of celiac symptoms, suggesting a potential therapeutic role for microbiome manipulation in RCD II.
Who was studied?
A 68-year-old woman with a 10-year history of RCD II was the subject of this study. Despite adherence to a strict gluten-free diet, she experienced persistent villous atrophy and malabsorption. She had been receiving budesonide therapy and later underwent cladribine treatment, neither of which alleviated her condition. The patient was repeatedly hospitalized due to severe diarrhea, dehydration, and infections, and was ultimately treated with FMT for recurrent CDI.
What were the most important findings?
FMT not only resolved the patient’s CDI but also led to complete histological recovery of the duodenal mucosa. Before FMT, duodenal biopsies confirmed villous atrophy (Marsh IIIA) and an abnormal intraepithelial lymphocyte population (>80%). However, post-FMT, the patient experienced significant clinical improvement, gaining weight and becoming symptom-free. Follow-up biopsies at six months showed full villous recovery (Marsh 0), although 71% of intraepithelial lymphocytes remained aberrant.
Microbiome analysis of the FMT donor revealed a high Shannon diversity index (3.81), suggesting a diverse and resilient microbial community. Unfortunately, due to the lack of a pre-FMT stool sample from the patient, a direct comparison of microbiome shifts could not be conducted. However, the resolution of symptoms and histological improvement strongly indicate that microbiome alterations played a role in disease modulation. Given previous studies implicating gut dysbiosis in celiac disease pathogenesis, this case highlights a possible causal role of microbiota in maintaining the chronic inflammatory state of RCD II.
What are the greatest implications of this study?
This study provides compelling evidence that microbiome manipulation may be a viable therapeutic strategy for RCD II, a condition with limited treatment options and high mortality risk. The findings suggest that gut dysbiosis could be a key driver of persistent villous atrophy in RCD II and that FMT may help restore intestinal homeostasis. If confirmed in larger studies, this could shift the treatment paradigm for RCD II, potentially offering an alternative to immunosuppressive therapies or autologous stem cell transplantation. Given the poor prognosis associated with RCD II, the ability to restore mucosal integrity through microbiome-targeted interventions represents a significant advancement. Further research should explore optimal donor selection, microbial composition, and long-term effects of FMT in RCD II patients.
Update History
Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and altered bowel habits. Recent research has focused on the gut microbiota's role in IBS, aiming to identify specific microbial signatures associated with the condition.
Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and altered bowel habits. Recent research has focused on the gut microbiota's role in IBS, aiming to identify specific microbial signatures associated with the condition.
Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and altered bowel habits. Recent research has focused on the gut microbiota's role in IBS, aiming to identify specific microbial signatures associated with the condition.
References
- Fecal Microbiota Transplant.. Kao D, Surawicz C.. (Elsevier eBooks. 2019.)
- Fecal Transplant: The Benefits and Harms of Fecal Microbiota Transplantation.. Goldenberg, D., Melmed, G.Y.. (Clinical Understanding of the Human Gut Microbiome. Springer, Cham. 2023.)
- Understanding the Scope of Do-It-Yourself Fecal Microbiota Transplant.. Ekekezie C, Perler BK, Wexler A, Duff C, Lillis CJ, Kelly CR.. (Am J Gastroenterol. 2020.)
- Expanded Fecal Microbiota Transplantation use for the Treatment of Clostridioides difficile: A study of the Economic and Policy Implications.. Persing NM.. (Jhu.edu. 2021.)
- Recipient independent high accuracy FMT prediction and optimization in mice and humans.. Oshrit Shtossel, Sondra Turjeman, Alona Riumin et al.. (PREPRINT. 2022)
- Droplet-based high-throughput cultivation for accurate screening of antibiotic resistant gut microbes.. J. Watterson, M.Tanyeri, A.R. Watson, S. Tay et al.. (Microbiology and Infectious Disease. 2020.)
- Droplet-based high-throughput cultivation for accurate screening of antibiotic resistant gut microbes.. J. Watterson, M.Tanyeri, A.R. Watson, S. Tay et al..
- Abstract CT258: Phase II trial of fecal microbiota transplantation in combination with ipilimumab and nivolumab in patients with advanced cutaneous melanoma (FMT-LUMINate trial).. Sreya Duttagupta, Meriem Messaoudene, Jamal R, et al.. (Cancer Research. 2024.)
- The Potential Role of Fecal Microbiota Transplant in the Reversal or Stabilization of Multiple Sclerosis Symptoms: A Literature Review on Efficacy and Safety.. Laeeq T, Vongsavath T, Tun KM, Hong AS.. (Microorganisms. 2023.)
- Fecal Microbiota Transplantation to Prevent and Treat Chronic Disease: Implications for Dietetics Practice.. Opoku-Acheampong I, McLaud T, Anderson OS.. (J Acad Nutr Diet. 2022)
- Recipient-independent, high-accuracy FMT-response prediction and optimization in mice and humans.. Shtossel O, Turjeman S, Riumin A, Goldberg MR, Elizur A, Bekor Y, Mor H, Koren O, Louzoun Y.. (Microbiome. 2023.)
- Recipient-independent, high-accuracy FMT-response prediction and optimization in mice and humans.. Shtossel O, Turjeman S, Riumin A, Goldberg MR, Elizur A, Bekor Y, Mor H, Koren O, Louzoun Y.. (Microbiome. 2023.)
- Durability and Long-term Clinical Outcomes of Fecal Microbiota Transplant Treatment in Patients With Recurrent Clostridium difficile Infection. Mamo Y, Woodworth MH, Wang T, Dhere T, Kraft CS.. (Clin Infect Dis. 2018.)
- German Clinical Microbiome Study Group (GCMSG). Fecal Microbiota Transplant in Patients With Recurrent Clostridium Difficile Infection.. Hagel S, Fischer A, Ehlermann P, Vehreschild M. et al.. (Dtsch Arztebl Int. 2016)
- Understanding the Scope of Do-It-Yourself Fecal Microbiota Transplant.. Ekekezie C, Perler BK, Wexler A, Duff C, Lillis CJ, Kelly CR.. (Am J Gastroenterol. 2020)
- Fecal microbiota transplantation: Current status and challenges in China.. Shi YC, Yang YS.. (JGH Open. 2018.)
- The Potential Role of Fecal Microbiota Transplant in the Reversal or Stabilization of Multiple Sclerosis Symptoms: A Literature Review on Efficacy and Safety.. Laeeq T, Vongsavath T, Tun KM, Hong AS.. (Microorganisms. 2023.)
- Fecal Microbiota Transplantation to Prevent and Treat Chronic Disease: Implications for Dietetics Practice.. Opoku-Acheampong I, McLaud T, Anderson OS.. (J Acad Nutr Diet. 2022)
- Recipient-independent, high-accuracy FMT-response prediction and optimization in mice and humans.. Shtossel O, Turjeman S, Riumin A, Goldberg MR, Elizur A, Bekor Y, Mor H, Koren O, Louzoun Y.. (Microbiome. 2023.)
- Recipient-independent, high-accuracy FMT-response prediction and optimization in mice and humans.. Shtossel O, Turjeman S, Riumin A, Goldberg MR, Elizur A, Bekor Y, Mor H, Koren O, Louzoun Y.. (Microbiome. 2023.)
- Durability and Long-term Clinical Outcomes of Fecal Microbiota Transplant Treatment in Patients With Recurrent Clostridium difficile Infection. Mamo Y, Woodworth MH, Wang T, Dhere T, Kraft CS.. (Clin Infect Dis. 2018.)
- Durability and Long-term Clinical Outcomes of Fecal Microbiota Transplant Treatment in Patients With Recurrent Clostridium difficile Infection. Mamo Y, Woodworth MH, Wang T, Dhere T, Kraft CS.. (Clin Infect Dis. 2018.)
Goldenberg, D., Melmed, G.Y.
Fecal Transplant: The Benefits and Harms of Fecal Microbiota Transplantation.Clinical Understanding of the Human Gut Microbiome. Springer, Cham. 2023.
Ekekezie C, Perler BK, Wexler A, Duff C, Lillis CJ, Kelly CR.
Understanding the Scope of Do-It-Yourself Fecal Microbiota Transplant.Am J Gastroenterol. 2020.
Oshrit Shtossel, Sondra Turjeman, Alona Riumin et al.
Recipient independent high accuracy FMT prediction and optimization in mice and humans.PREPRINT. 2022
J. Watterson, M.Tanyeri, A.R. Watson, S. Tay et al.
Droplet-based high-throughput cultivation for accurate screening of antibiotic resistant gut microbes.Microbiology and Infectious Disease. 2020.
J. Watterson, M.Tanyeri, A.R. Watson, S. Tay et al.
Droplet-based high-throughput cultivation for accurate screening of antibiotic resistant gut microbes.Sreya Duttagupta, Meriem Messaoudene, Jamal R, et al.
Abstract CT258: Phase II trial of fecal microbiota transplantation in combination with ipilimumab and nivolumab in patients with advanced cutaneous melanoma (FMT-LUMINate trial).Cancer Research. 2024.
Laeeq T, Vongsavath T, Tun KM, Hong AS.
The Potential Role of Fecal Microbiota Transplant in the Reversal or Stabilization of Multiple Sclerosis Symptoms: A Literature Review on Efficacy and Safety.Microorganisms. 2023.
Opoku-Acheampong I, McLaud T, Anderson OS.
Fecal Microbiota Transplantation to Prevent and Treat Chronic Disease: Implications for Dietetics Practice.J Acad Nutr Diet. 2022
Shtossel O, Turjeman S, Riumin A, Goldberg MR, Elizur A, Bekor Y, Mor H, Koren O, Louzoun Y.
Recipient-independent, high-accuracy FMT-response prediction and optimization in mice and humans.Microbiome. 2023.
Shtossel O, Turjeman S, Riumin A, Goldberg MR, Elizur A, Bekor Y, Mor H, Koren O, Louzoun Y.
Recipient-independent, high-accuracy FMT-response prediction and optimization in mice and humans.Microbiome. 2023.
Mamo Y, Woodworth MH, Wang T, Dhere T, Kraft CS.
Durability and Long-term Clinical Outcomes of Fecal Microbiota Transplant Treatment in Patients With Recurrent Clostridium difficile InfectionClin Infect Dis. 2018.
Hagel S, Fischer A, Ehlermann P, Vehreschild M. et al.
German Clinical Microbiome Study Group (GCMSG). Fecal Microbiota Transplant in Patients With Recurrent Clostridium Difficile Infection.Dtsch Arztebl Int. 2016
Ekekezie C, Perler BK, Wexler A, Duff C, Lillis CJ, Kelly CR.
Understanding the Scope of Do-It-Yourself Fecal Microbiota Transplant.Am J Gastroenterol. 2020
Shi YC, Yang YS.
Fecal microbiota transplantation: Current status and challenges in China.JGH Open. 2018.
Laeeq T, Vongsavath T, Tun KM, Hong AS.
The Potential Role of Fecal Microbiota Transplant in the Reversal or Stabilization of Multiple Sclerosis Symptoms: A Literature Review on Efficacy and Safety.Microorganisms. 2023.
Opoku-Acheampong I, McLaud T, Anderson OS.
Fecal Microbiota Transplantation to Prevent and Treat Chronic Disease: Implications for Dietetics Practice.J Acad Nutr Diet. 2022
Shtossel O, Turjeman S, Riumin A, Goldberg MR, Elizur A, Bekor Y, Mor H, Koren O, Louzoun Y.
Recipient-independent, high-accuracy FMT-response prediction and optimization in mice and humans.Microbiome. 2023.
Shtossel O, Turjeman S, Riumin A, Goldberg MR, Elizur A, Bekor Y, Mor H, Koren O, Louzoun Y.
Recipient-independent, high-accuracy FMT-response prediction and optimization in mice and humans.Microbiome. 2023.
Mamo Y, Woodworth MH, Wang T, Dhere T, Kraft CS.
Durability and Long-term Clinical Outcomes of Fecal Microbiota Transplant Treatment in Patients With Recurrent Clostridium difficile InfectionClin Infect Dis. 2018.
Mamo Y, Woodworth MH, Wang T, Dhere T, Kraft CS.
Durability and Long-term Clinical Outcomes of Fecal Microbiota Transplant Treatment in Patients With Recurrent Clostridium difficile InfectionClin Infect Dis. 2018.