RT Journal Article SR Electronic T1 Reconstitution of the gut microbiota of antibiotic-treated patients by autologous fecal microbiota transplant JF Science Translational Medicine FD American Association for the Advancement of Science SP eaap9489 DO 10.1126/scitranslmed.aap9489 VO 10 IS 460 A1 Taur, Ying A1 Coyte, Katharine A1 Schluter, Jonas A1 Robilotti, Elizabeth A1 Figueroa, Cesar A1 Gjonbalaj, Mergim A1 Littmann, Eric R. A1 Ling, Lilan A1 Miller, Liza A1 Gyaltshen, Yangtsho A1 Fontana, Emily A1 Morjaria, Sejal A1 Gyurkocza, Boglarka A1 Perales, Miguel-Angel A1 Castro-Malaspina, Hugo A1 Tamari, Roni A1 Ponce, Doris A1 Koehne, Guenther A1 Barker, Juliet A1 Jakubowski, Ann A1 Papadopoulos, Esperanza A1 Dahi, Parastoo A1 Sauter, Craig A1 Shaffer, Brian A1 Young, James W. A1 Peled, Jonathan A1 Meagher, Richard C. A1 Jenq, Robert R. A1 van den Brink, Marcel R. M. A1 Giralt, Sergio A. A1 Pamer, Eric G. A1 Xavier, Joao B. YR 2018 UL http://stm.sciencemag.org/content/10/460/eaap9489.abstract AB Patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) receive antibiotics to prevent and treat bacterial infections. Antibiotics, however, also damage the intestinal microbiota by killing beneficial commensal bacteria that inhibit pathogens and promote immune defenses. Loss of gut microbiota diversity increases the risk of adverse outcomes, including infections and graft-versus-host disease. Taur and colleagues conducted a randomized clinical trial to demonstrate the effectiveness of collecting and freezing feces before allo-HSCT, followed by fecal thawing and autologous fecal microbiota transplantation (auto-FMT) after stem cell engraftment. The authors show that auto-FMT reconstitutes major commensal bacterial populations, thereby reestablishing the patient’s gut microbiota diversity and composition.Antibiotic treatment can deplete the commensal bacteria of a patient’s gut microbiota and, paradoxically, increase their risk of subsequent infections. In allogeneic hematopoietic stem cell transplantation (allo-HSCT), antibiotic administration is essential for optimal clinical outcomes but significantly disrupts intestinal microbiota diversity, leading to loss of many beneficial microbes. Although gut microbiota diversity loss during allo-HSCT is associated with increased mortality, approaches to reestablish depleted commensal bacteria have yet to be developed. We have initiated a randomized, controlled clinical trial of autologous fecal microbiota transplantation (auto-FMT) versus no intervention and have analyzed the intestinal microbiota profiles of 25 allo-HSCT patients (14 who received auto-FMT treatment and 11 control patients who did not). Changes in gut microbiota diversity and composition revealed that the auto-FMT intervention boosted microbial diversity and reestablished the intestinal microbiota composition that the patient had before antibiotic treatment and allo-HSCT. These results demonstrate the potential for fecal sample banking and posttreatment remediation of a patient’s gut microbiota after microbiota-depleting antibiotic treatment during allo-HSCT.