Gut virome remodeling after fecal microbiota transplantation is associated with virus-bacteria co-variation and metabolic response in obesity and type 2 diabetes.
Hui Jiang, Ye Peng, Brian Lam et al.
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In 30 seconds
This randomized controlled trial examined longitudinal fecal virome and bacteriome changes after fecal microbiota transplantation (FMT) in people with obesity and type 2 diabetes. Post-FMT virome changes distinguished LDL responders from non-responders with 84.8% accuracy, comparable to 81.4% for bacteriome changes. Donor-derived viral contigs were detected in 64.7% (11/17) of recipients given FMT alone and 58.8% (10/17) given FMT with lifestyle intervention, compared with 5.6% (1/18) after sham with lifestyle intervention. FMT was also associated with greater virome diversity and coordinated virus-bacteria associations.
Key findings
- Virome changes classified LDL responders versus non-responders with 84.8% accuracy, compared with 81.4% for bacteriome changes.
- Donor-derived viral contigs were detected in 64.7% (11/17) after FMT alone and 58.8% (10/17) after FMT with lifestyle intervention, versus 5.6% (1/18) after sham with lifestyle intervention.
- FMT was associated with increased virome diversity, shifts toward the donor virome, and coordinated virus-bacteria associations.
Why it matters
The findings suggest that gut viruses may provide information about metabolic response to FMT beyond bacterial composition alone. Characterising virus-bacteria relationships could help explain variation in response and inform future studies of the gut ecosystem in obesity and type 2 diabetes. The reported associations do not establish that viral changes cause clinical improvement.
What to keep in mind
The findings are based on longitudinal fecal samples from a trial, and the reported virus-bacteria links and predicted viral hosts do not establish causal mechanisms.