title: Transplanting a Microbial Organ: the Good, the Bad, and the Unknown.
abstract: Fecal microbiota transplantation (FMT) has received increased attention as a therapy for correcting intestinal dysbiosis and restoring a state of health in patients suffering from either recalcitrant infection by Clostridium difficile or more complex disease states, such as inflammatory bowel disease (IBD). The "gut microbial organ" from the donor that is used in these transplants may serve to transfer genetic material between donor and recipient via virus-like particles, specifically bacteriophages, that infect the bacterial component of the microbiota. The recently published study by Chehoud et al. provides evidence for not only the transfer of bacteriophages during FMT but also the transfer of multiple populations of bacteriophages to recipients from the donor microbiota used (C. Chehoud et al., mBio 7:e00322-16, 2016, http://dx.doi.org/10.1128/mBio.00322-16). While the clinical significance of these findings remains unclear, nothing short of a diligent and persistent effort is needed to define the intended and unintended consequences of FMT.
authors.affiliation: Department of Medicine, University of Chicago, Chicago, Illinois, USA Biosciences Division, Argonne National Laboratory, Argonne, Illinois, USA.
authors.forename: Dionysios A
authors.initials: DA
authors.lastname: Antonopoulos
authors.affiliation: Department of Medicine, University of Chicago, Chicago, Illinois, USA echang@medicine.bsd.uchicago.edu.
authors.forename: Eugene B
authors.initials: EB
authors.lastname: Chang
mesh_terms: D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000382:microbiology*; D064806:Dysbiosis; D005243:Feces / Q000382:microbiology*; D006801:Humans; D064307:Microbiota