Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2023; 11(21): 4975-4988
Published online Jul 26, 2023. doi: 10.12998/wjcc.v11.i21.4975
Manipulation of the intestinal microbiome-a slow journey to primetime
Ofra Kriger-Sharabi, Stephen D H Malnick, David Fisher
Ofra Kriger-Sharabi, Institute of Gastroenterology, Assuta Medical Center, Ashdod 7747629, Israel
Stephen D H Malnick, Department of Internal Medicine, Kaplan Medical Center, Rehovot 76100, Israel
David Fisher, Department of Endocrinology, Soroka Medical Center, Beer Sheva POB 151, Israel
Author contributions: Each author contributed equally to the writing of the manuscript.
Conflict-of-interest statement: David Fisher and Stephen Malnick have no conflicts of interest to declare. Ofra Kriger-Sharabi has sat on advisory boards with Abbvie, Janssen and Takeda pharmaceutical companies.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Stephen D H Malnick, MD, Doctor, Department of Internal Medicine, Kaplan Medical Center, Derech Pasternak 1, Rehovot 76100, Israel. steve_m@clalit.org.il
Received: March 23, 2023
Peer-review started: March 23, 2023
First decision: April 20, 2023
Revised: May 17, 2023
Accepted: June 30, 2023
Article in press: June 30, 2023
Published online: July 26, 2023
Processing time: 125 Days and 8.6 Hours
Abstract

The gut microbiota has important functions in the regulation of normal body functions. Alterations of the microbiota are being increasingly linked to various disease states. The microbiome has been manipulated via the administration of stool from animals or humans, for more than 1000 years. Currently, fecal microbiota transplantation can be performed via endoscopic administration of fecal matter to the duodenum or colon or via capsules of lyophilized stools. More recently fecal microbial transplantation has been shown to be very effective for recurrent Clostridoides difficile infection (CDI). In addition there is some evidence of efficacy in the metabolic syndrome and its hepatic manifestation, metabolic associated fatty liver disease (MAFLD), irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). We review the current literature regarding the microbiome and the pathogenesis and treatment of CDI, MAFLD, IBS and IBD.

Keywords: Gut microbiota; Fecal microbiota transplantation; Clostridoides difficile; Metabolic associated fatty liver disease; Irritable bowel syndrome; Inflammatory bowel disease

Core Tip: We review the current literature regarding the microbiome and the pathogenesis and treatment of Clostridoides difficile infection (CDI), metabolic associated fatty liver disease (MAFLD), irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Fecal microbial transplantation is an established treatment option in recurrent CDI. There is also promising evidence of efficacy in MAFLD, IBS and IBD which require further work to establish its role in managing these conditions.