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Faecal microbiota transplantation (FMT) has been initially used in medical centres to successfully treat recurrent or refractory intestinal infections with Clostridioides difficile. Eiseman et al published the first scientific paper describing the successful treatment using FMT to treat pseudomembranous enterocolitis.1 Nowadays, FMT is widely used in humans with the attempt to treat many non-gastrointestinal diseases (eg, obesity, diabetes, liver diseases, autism, neurodegenerative diseases) but still with controversial outcomes.
In preclinical studies, FMT is extensively used because it is possible to determine the contribution of the gut microbiota to a given pathology or condition since the composition of the transplanted microbiota is known. Interestingly, the development of germ-free (GF) animals started in the 1940s2 and in 1964, host energy metabolism has been comprehensively studied using GF mice, when studies on GF and conventional rats suggested that the gut microbiota was interfering with the absorption of fats.3
In the field of obesity and metabolic disorders, a 2006 seminal study by Turnbaugh et al unequivocally demonstrated that colonising GF mice with the gut microbiota obtained from ob/ob mice (ie, genetically obese mice) induced higher fat mass gain as compared with the gut microbes from lean mice and this effect was independent of food intake.4 Nowadays, this technique is widely used to allow researchers to better mimic human physiology by transplanting human faecal samples to GF mice or in conventional mice depleted of their gut microbiota using antibiotics and/or laxatives.5 However, it is also largely debated that …
PDC and CK contributed equally.
Contributors PDC and CK have equally contributed to the writing of this commentary.
Funding PDC is research director at FRS-FNRS (Fonds de la Recherche Scientifique).
Competing interests PDC is inventor on patent applications dealing with the use of specific bacteria and components in the treatment of different diseases. PDC is co-founder of The Akkermansia Company SA. PDC and CK are cofounders of Enterosys S.A. (Labège, France).
Provenance and peer review Commissioned; internally peer reviewed.