Microbiome and virome of a C. difficile patient cured by fecal transfer 5 years ago
Karin Moelling
University of Zurich, Switzerland
: Expert Opin Environ Biol
Abstract
Fecal transplantation (FT) is a promising therapeutic option for antibiotic-refractory Clostridium difficile infection. FT utilizes donor feces with complex bacterial and viral communities to limit C. difficile and inflammation. Ultimately, bacterial communities were donor similar, suggesting sustainable stool engraftment. A central rather unexplored role in FT is played by phages, the most abundant viruses, which largely influence bacterial communities in response to environmental changes. They are activated during obesity and inflammation and promote bacterial lysis and reduction of microbiota complexity as indicators of disease. In light of the fact that phages behave differently in the intestine than under laboratory conditions, more research is needed. Here, we describe the dynamic microbiota changes of a C. difficile patient cured by FT since five years, the longest follow-up period so far. We reported on the microbiome and recently also analyzed the virome by deep sequencing and observed that low abundance of phages correlated with recovery of the patient and absence of inflammation. Thus, healthy microbiota appears to be characterized by low phage abundance. This has been described to correlate with high microbiome complexity. In accordance, the cured patient’s microbiota had similar complexity as the donor’s. Although viruses were likely transferred, the patient established a virome distinct from the donor. Surprisingly, we detected Chlorella virus-related sequence, an algae-specific giant virus, for the first time in the human intestine. Similarities of the phage-bacterial interplay in the intestine and the better understood marine ecosystems as reported by the TARA Oceans-EMBO expedition participants in 2016 are striking. Based on these findings, we will discuss technical difficulties encountered with virome analyses possible implications of intestinal viruses on future microbiota and other phage therapies.
Biography
Email: moelling@molgen.mpg.de
