The Super-Donor Phenomenon in Fecal Microbiota Transplantation (Jan 2019, review) FMT

[Michael Harrop]

https://www.frontiersin.org/articles/10.3389/fcimb.2019.00002/full

An important paper to have submitted here.

Fecal microbiota transplantation (FMT) has become a highly effective bacteriotherapy for recurrent Clostridium difficile infection. Meanwhile the efficacy of FMT for treating chronic diseases associated with microbial dysbiosis has so far been modest with a much higher variability in patient response.

Notably, a number of studies suggest that FMT success is dependent on the microbial diversity and composition of the stool donor, leading to the proposition of the existence of FMT super-donors.

The identification and subsequent characterization of super-donor gut microbiomes will inevitably advance our understanding of the microbial component of chronic diseases and allow for more targeted bacteriotherapy approaches in the future.

Here, we review the evidence for super-donors in FMT and explore the concept of keystone species as predictors of FMT success. Possible effects of host-genetics and diet on FMT engraftment and maintenance are also considered. Finally, we discuss the potential long-term applicability of FMT for chronic disease and highlight how super-donors could provide the basis for dysbiosis-matched FMTs.

Click to shrink...

Unfortunately, the authors of this review didn't bother to attempt to find a super-donor for their FMT trial: https://forum.humanmicrobiome.info/threads/effects-of-fecal-microbiome-transfer-in-adolescents-with-obesity-the-g.474/

 

[Michael Harrop]

Comment from a previous thread:

Another user mentioned that this should be common sense, which I agree with, and have been surprised at the amount of people arguing against it. Personally I would think it would also be common sense for the universities doing FMT studies and other microbiome studies to turn to their athletics departments for donor recruitment.

I'm not sure if there are problems there or why it hasn't been done so far, but college athletes are probably one of the best groups of people to recruit donors from.

Despite the multi-donor and intensive dosing approach, Paramsothy et al. achieved post-FMT remission rates (FMT, 27% vs. placebo, 8%, p = 0.02) that were similar to those reported previously

Click to shrink...

This is inline with what I said/discovered before: You cannot combine multiple low quality donors to create one high quality donor. Low quality donors all seem to be missing the same thing(s).