Table 1.
Summary of Preclinical and Clinical Studies Assessing the Effects of Fecal Microbiota Transplant (FMT) on Alcohol-Related Outcomes
| Study* | Subjects | Model | Main Finding |
|---|---|---|---|
| Ferrere et al. (2017)23 | Mice | Signs of ALD lesions after Lieber-DeCarli diet | FMT prevented the development of alcohol-induced liver lesions, but the effect depended on the host microbiome. |
| Wrzosek et al. (2021)30 | Mice | Signs of ALD after FMT from SAH patients | Pectin-FMT beneficially reshaped the GM, in an AhR-dependent manner. |
| Yu et al. (2020)31 | Mice | Signs of ALD lesions after Lieber-DeCarli diet with ethanol | FMT or LRP6-CRISPR improved GM diversity and composition to ameliorate ALD symptoms. |
| Yan et al. (2021)32 | Mice | Signs of ALD lesions after Lieber-DeCarli diet with ethanol | TQE supplementation or TQE-FMT alleviated chronic alcohol-induced liver injury and markers of gut barrier dysfunction. |
| Yan et al. (2021)33 | Mice | Signs of ALD lesions after Lieber-DeCarli diet with ethanol | UA had hepatoprotective effects and suppressed alcohol-induced oxidative stress and intestinal barrier disruption. |
| Guo et al. (2022)34 | Mice | Acute ALD signs by ethanol lavage | Goji berries restored intestinal epithelial cell integrity and prevented acute liver injury induced by alcohol intake. |
| Xiao et al. (2018)39 | Mice | FMT from noncontingent drinking mice | Alc-FMT transferred negative affective behaviors following withdrawal, altered brain gene expression, and reduced GM diversity. |
| Segovia-Rodriguez et al. (2022)40 | Rats | FMT from ethanol-exposed rats (10 g/kg for 10 days) | Alc-FMT increased drinking and reduced locomotor activity, but this was dependent on antibiotics pretreatment. |
| Ezquer et al. (2022)42 | Alcohol-preferring rats | Alcohol relapse drinking and LGG treatment | LGG modified the GM, reduced alcohol intake, and altered brain protein expression in a model of relapse drinking. |
| Bajaj et al. (2021)56 | Humans | Patients with alcohol-associated cirrhosis and AUD | FMT reduced alcohol consumption and cravings and increased microbial diversity. |
| Philips et al. (2022)58 | Humans | SAH hepatitis patients | FMT decreased alcohol relapse rates and increased time to relapse, increased beneficial GM diversity, and lowered rates of infections and hospitalizations with higher survival rates. |
| Philips et al. (2017)59 | Humans | Open-label study of patients ineligible for steroid therapy | FMT recipients had higher transplant-free survival associated with reduction in pathogenic bacteria. |
| Sharma et al. (2022)60 | Humans | Open-lab nonrandomized trial with severe alcohol-associated hepatitis with ACLF | FMT significantly reduced 28- and 90-day mortality and inflammatory cytokines. |
| Bajaj et al. (2017)62 | Humans | Open-label randomized trial: outpatient men with cirrhosis and recurrent HE received FMT enema | Improved cognition along with increased microbial diversity. |
| Bajaj et al. (2019)65 | Humans | Randomized, single-blind study: cirrhosis with recurrent HE receiving FMT capsules vs. placebo | FMT capsules were safe and improved duodenal mucosal diversity, dysbiosis, and objective measures of encephalopathy. |
| Philips et al. (2018)68 | Humans | Comparative study between pentoxifylline, corticosteroid, nutritional therapy, and FMT | FMT had highest survival rates at 3-month follow-up by modulating GM composition and function and decreasing inflammatory pathways. |
| Zhao et al. (2020)38 | Humans to mice | Cross-species Alc-FMT | Human to mouse Alc-FMT increased alcohol preference and negative affective behaviors and altered brain gene expression. |
| Wolstenholme et al. (2022)41 | Humans to mice | Cross-species Alc-FMT and treated Alc-FMT | Alcohol preference and intake were reduced in patients with AUD after receiving FMT, and this behavior was transmissible to mice; liver, intestine, and brain gene expression was altered in mice. |
| Leclercq et al. (2020)43 | Humans to mice | Cross-species Alc-FMT | Human-to-mouse Alc-FMT increased depression-like behavior and lowered sociability; brain neurotransmitter and myelin gene expression were altered. |
Studies are ordered by citation number within each subject type.
Note: ACLF, acute-on-chronic liver failure; AhR, aryl hydrocarbon receptor; Alc, alcohol; ALD, alcohol-associated liver disease; AUD, alcohol use disorder; CRISPR, clustered regularly interspaced short palindromic repeats; FMT, fecal microbiota transplant; GM, gut microbiota; HE, hepatic encephalopathy; LGG, Lactobacillus rhamnosus Gorbach-Goldin; LRP6, low-density lipoprotein-related protein 6; SAH, severe alcohol-associated hepatitis; TQE, Thymus quinquecostatus Celak extract; UA, ursolic acid.