ESPEYB17 14. The Year in Science and Medicine (1) (16 abstracts)
14.15. Fecal microbiota transplantation for the improvement of metabolism in obesity: The FMT-TRIM double-blind placebo-controlled pilot trial
Yu EW , Gao L , Stastka P , Cheney MC , Mahabamunuge J , Torres Soto M , Ford CB , Bryant JA , Henn MR & Hohmann EL
To read the full abstract: PLoS Med. 2020 Mar 9;17(3):e1003051. doi: 10.1371/journal.pmed.1003051.
The authors describe a 12-week long randomised controlled trial of weekly oral fecal microbiota transplantation capsules, derived from healthy lean donors, given to 24 adults with obesity and mild–moderate insulin resistance. Despite evidence of successful microbiota engraftment in recipients, there was no change in fasting insulin sensitivity, HbA1c, body weight, body composition or resting energy expenditure.
The premise for this approach was the widespread associations between microbiota and metabolism in human observational studies and consistently significant effects on body weight and glycaemia from microbiota transplantation in experimental animal studies.
However, the previous experimental evidence base seems suspiciously too positive. That was the conclusion of a recent review by Walter et al. (1), which found an implausible ‘exceedingly high (success) rate of inter-species transferable pathologies’ - all but two (36/38; 95%) studies found that fecal transfer from diseased human donors could create that disease phenotype in the recipient mice. Walter et al. (1) made several suggestions towards a more critical and rigorous experimental approach.
Reference:
1. Walter J et al. Establishing or Exaggerating Causality for the Gut Microbiome: Lessons from Human Microbiota-Associated Rodents. Cell. 2020 Jan 23;180(2):221–232. https://doi.org/10.1016/j.cell.2019.12.025.
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ESPE Yearbook of Paediatric Endocrinology
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