From stool transplants to next-generation microbiota therapeutics

Elaine O. Petrof, Alexander Khoruts

Research output: Contribution to journalArticlepeer-review

134 Scopus citations


The epidemic of Clostridium difficile infection fueled by new virulent strains of the organism has led to increased use of fecal microbiota transplantation (FMT). The procedure is effective for even the most desperate cases after failure of multiple courses of antibiotics. The approach recognizes microbiota to be integral to normal human physiology, and microbiota being used in FMT represents a new class of therapeutics. Imbalance in the composition and altered activity of the microbiota are associated with many diseases. Consequently, there is growing interest in applying FMT to non-C difficile indications. However, this may succeed only if microbiota therapeutics are developed systematically, based on mechanistic understanding, and applying up-to-date principles of microbial ecology. We discuss 2 pathways in the development of this new therapeutic class: whole microbial communities separated from donor stool and an assembly of specific fecal microorganisms grown in vitro.

Original languageEnglish (US)
Pages (from-to)1573-1582
Number of pages10
Issue number6
StatePublished - May 2014

Bibliographical note

Funding Information:
Funding Supported, in part, by the Crohn’s and Colitis Foundation of Canada , Southeastern Ontario Academic Medical Association , the Canada Foundation for Innovation (E.O.P.), and by a National Institutes of Health grant ( R21 AI091907 to A.K.).


  • Defined Microbiota Ecosystems
  • Fecal Microbiota Transplantation
  • Full Spectrum Microbiota
  • Recurrent Clostridium difficile Infection


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