Gut Revolution: Fecal Transplants vs. Live Biotherapeutic Products

An article published in Gut Microbes (2024) introduces a groundbreaking class of drugs known as Live Biotherapeutic Products (LBPs), which are making waves in the biotechnology world. These “super bugs” are based on live microorganisms—such as bacteria, viruses, and fungi—engineered to treat or prevent diseases. Representing a true innovation, LBPs offer a promising alternative to traditional antibiotics and synthetic drugs.

The secret to their effectiveness lies in their ability to modulate the gut microbiota—the diverse community of microorganisms residing in our intestines that influence everything from physical health to mood. When this delicate balance is disrupted, it can lead to problems such as recurrent Clostridioides difficile infections, inflammatory diseases like colitis or Crohn’s disease, and metabolic disorders like obesity. By targeting specific imbalances, LBPs can restore harmony and improve overall health.

Unlike conventional treatments that simply introduce beneficial bacteria, LBPs are designed to actively interact with the body, enhancing immune system function, combating infections, and even influencing behavior and mood, as recent research into the gut-brain axis has shown.

But LBPs are not the only innovative approach making headlines. Fecal Microbiota Transplantation (FMT), which involves transferring fecal microbiota from a healthy donor to a patient, has demonstrated remarkable success in treating C. difficile infections and shows potential in addressing autism spectrum disorders. However, LBPs offer a safer, more controlled, and standardized alternative. While FMT transfers a complex mixture of microorganisms, LBPs utilize carefully selected and targeted strains for greater precision.

Despite their promise, both LBPs and FMT face challenges, including treatment standardization and a deeper understanding of how these microorganisms interact with the human body. Nevertheless, the outlook is highly encouraging.

In summary, LBPs are shaping up to be a revolutionary force in the treatment of complex diseases, providing more natural and precise solutions compared to conventional therapies. With regulatory approvals from authorities like the FDA and EMA, LBPs are poised to become an integral part of future medical treatments. While FMT remains a viable option, LBPs appear ready to take center stage in the biotechnology arena.

By Silvia Diviccaro, Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, University of Milan