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Review Article | Open Access | Online First

Therapeutic potential and clinical advances of fecal microbiota transplantation in disease management

Mei Liu1Ying Hu2Meng-Dai Xu1Yi Chen1Qing-Bin Meng1,3( )
Clinical Nutrition Department, Wuhan No. 1 Hospital, Wuhan 430022, China
Department of Pathology and Laboratory Medicine, University of California Davis Health, Sacrament 95817, USA
Department of Clinical Laboratory, Wuhan Center for Clinical Laboratory, Wuhan 430022, China
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Highlights

(1) Comprehensive review of FMT applications in multiple diseases, including IBD, IBS, metabolic disorders, neurological diseases, tumors, and cardiovascular conditions.

(2) In-depth discussion of key signaling pathways involved in FMT-mediated therapeutic effects.

(3) Analysis of various FMT administration methods and their clinical implications.

(4) Evaluation of challenges and future directions for FMT as a personalized therapeutic strategy.

Abstract

Fecal microbiota transplantation (FMT) has become an important method for treating various diseases. This review explores the relationship between FMT and various diseases such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), metabolic disorders, neurological disorders, tumors, and cardiovascular diseases, and analyzes the key mechanisms by which FMT exerts therapeutic effects. The mechanism of FMT involves signaling pathways such as Toll-like receptor 4 (TLR4)/NF-κB pathway, Aryl hydrocarbon receptor (AHR) pathway, NLR family pyrin domain containing 3 (NLRP3) inflammasome pathway, short chain fatty acid (SCFAs)-mediated pathway, and 5-hydroxytryptamine pathway. These pathways alleviate disease symptoms by synergistically regulating immune responses, inflammatory processes, and metabolic functions. In addition, this review also discusses different administration methods of FMT, including traditional colonoscopy or enema administration, oral FMT capsules, nasogastric/nasoduodenal tube administration, and rectal administration for pediatric patients. Although there are still technical and clinical challenges, FMT, as an individualized treatment strategy, has shown broad application prospects in the treatment of various diseases.

Graphical Abstract

This figure is an abstract example of how Fecal Microbiota Transplantation therapy works. Transplanting a healthy donor's microbial composition into a patient will assist in restoring the microbial diversity of the patient. The repaired microbiome will then create various metabolites (i.e., Short and Long Chain Fatty Acids, Bile Acids, Tryptophan Derivatives, & Histamine) which will subsequently interact with host signaling pathways such as TLR4/NF-κB, AHR, NLRP3 Inflammasome Pathway, and GCPRs (GPR41 GPR43). The result of these interactions creates an immunological response, promotes an inflammatory response, promotes metabolic processes, and regulates the health and function of several organs in the body including but not limited to the heart, kidneys, adipose tissue, pancreas, liver, skeletal muscle, and brain. As a result, Fecal Microbiota Transplantation has the potential to be beneficial in improving metabolic homeostasis, reducing inflammation, and restoring immune balance in patients with dysbiosis and other conditions that will benefit from the addition of functional intestinal flora.

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Cite this article:
Liu M, Hu Y, Xu M-D, et al. Therapeutic potential and clinical advances of fecal microbiota transplantation in disease management. Food & Medicine Homology, 2026, https://doi.org/10.26599/FMH.2027.9420146

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Web of Science

Received: 02 March 2025
Revised: 20 April 2025
Accepted: 22 April 2025
Published: 09 May 2026
© National R & D Center for Edible Fungus Processing Technology 2026. Published by Tsinghua University Press.

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).