Fecal microbiota transplantation (FMT) has become a popular, alternative therapy to treat recurrent Clostridium difficile infections by restoring gut microbial diversity and function. FMT has also been used to treat inflammatory bowel diseases, autism, depression, and obesity with varying degrees of success. The Microbiota Therapeutics Program at UMN have been international leaders in exploring the efficacy and underlying mechanisms of this treatment.
Recently, we developed an encapsulated FMT preparation (a pill) that could be administered orally and resulted in a similar degree of clinical success compared to traditional routes of FMT administration (colonoscopy). We have comprehensively characterized shifts in the microbiota following capsule FMT (cFMT), and observed that while the clinical success is similar, the kinetics of microbiota engraftment are delayed. This delay has allowed us to develop a highly accurate, predictive model for recurrence which has, in part, helped inform our on-going efforts to improve cFMT efficacy and microbiota engraftment kinetics. Our on-going projects are focused on improving the capsule formulation to expedite engraftment as well as evaluating how different routes of administration impact engraftment.
Staley C, Kaiser T, Vaughn BP, Graizig C, Hamilton MJ, Kabage AJ, Khoruts A, Sadowsky MJ. 2019. Durable long-term bacterial engraftment following encapsulated fecal microbiota transplantation to treat Clostridium difficile. mBIO. 10(4), e01586-19 doi:10.1128/mBio.01586-19
Staley C, Kaiser T, Vaughn BP, Graiziger CT, Hamilton MJ, Khoruts A, Sadowsky MJ. 2018. Predicting recurrence of Clostridium difficile infection following encapsulated fecal microbiota transplantation. Microbiome 6, 166. doi:10.1186/s40168-018-0549-6
Smillie CS, Sauk J, Gevers D, Friedman J, Sung J, Youngster I, Hohmann EL, Staley C, Khoruts A, Sadowsky MJ, Allegretti JR, Smith MB, Xavier RJ, Alm EJ. 2018. Strain tracking reveals the determinants of bacterial engraftment in the human gut following fecal microbiota transplantation. Cell Host Microbe. 23, 229-240. doi:10.1016/j.chom.2018.01.003
Staley C, Khoruts A, Sadowsky MJ. 2017. Contemporary applications of fecal microbiota transplantation to treat intestinal diseases in humans. Arch. Med. Res. 48(8), 766-773. doi:10.1016/j.arcmed.2017.11.006
Staley C, Vaugh BP, Graiziger CT, Singroy S, Hamilton MJ, Yao D, Chen C, Khoruts A, Sadowsky MJ. 2017. Community dynamics drive punctuated engraftment of the fecal microbiome following transplantation using freeze-dried, encapsulated fecal microbiota. Gut Microbes 8(3), 276-288. doi:10.1080/19490976.2017.1299310
Staley C, Hamilton MJ, Vaughn BP, Graiziger CT, Newman KM, Kabage AJ, Sadowsky MJ, Khoruts A. 2017. Successful resolution of recurrent Clostridium difficile infection using freeze-dried, encapsulated microbiota. Am. J. Gastroenterol. 112(6), 940-947 doi:10.1038/ajg.2017.6