In their recent publication in Gastroenterology, Rinott and Youngster et al. investigated whether autologous transplantation of diet-modified microbiota, delivered through oral capsules, prevented weight regain in abdominally obese individuals that were subjected to dietary regimens to induce weight loss. Transplantation of one’s own fecal microbiota collected after a calorie-restricted green Mediterranean diet (containing extra polyphenols) seemed to maintain metabolic improvements in comparison to placebo treatments during weight regain.

This study once more links alterations of the gut microbiome to changes in metabolic phenotype, and further identifies alterations of the gut microbiome as a causal factor in the development of cardiometabolic diseases such as diabetes. This study also provides some exciting prospects from a therapeutic point of view. The use of allogenic fecal microbiota transplantation has yielded considerable success in the treatment of recurrent Clostridioides difficile infections, and is now also considered in the context of a range of noninfectious diseases that are linked to an altered gut microbiome. However, practical concerns may limit the use of allogenic FMT on a large scale in clinical practice, as careful and repeated donor screening is needed to ensure the safety of this procedure. The current study in Gastroenterology provides another means of improving the composition of the gut microbiome by modifying the individual’s own microbiome and reusing it for autologous transplantation to prolong certain beneficial changes made to it.

Nordin M.J. Hanssen, MD, is in the department of internal medicine, school for cardiovascular diseases, faculty of health, medicine and life sciences, Maastricht University, Amsterdam. He has no conflicts of interest relevant to this publication.