[HTML][HTML] Targeted Restoration of the Intestinal Microbiota with a Simple, Defined Bacteriotherapy Resolves Relapsing Clostridium difficile Disease in Mice

TD Lawley, S Clare, AW Walker, MD Stares… - PLoS …, 2012 - journals.plos.org
TD Lawley, S Clare, AW Walker, MD Stares, TR Connor, C Raisen, D Goulding, R Rad
PLoS pathogens, 2012journals.plos.org
Relapsing C. difficile disease in humans is linked to a pathological imbalance within the
intestinal microbiota, termed dysbiosis, which remains poorly understood. We show that
mice infected with epidemic C. difficile (genotype 027/BI) develop highly contagious, chronic
intestinal disease and persistent dysbiosis characterized by a distinct, simplified microbiota
containing opportunistic pathogens and altered metabolite production. Chronic C. difficile
027/BI infection was refractory to vancomycin treatment leading to relapsing disease. In …
Relapsing C. difficile disease in humans is linked to a pathological imbalance within the intestinal microbiota, termed dysbiosis, which remains poorly understood. We show that mice infected with epidemic C. difficile (genotype 027/BI) develop highly contagious, chronic intestinal disease and persistent dysbiosis characterized by a distinct, simplified microbiota containing opportunistic pathogens and altered metabolite production. Chronic C. difficile 027/BI infection was refractory to vancomycin treatment leading to relapsing disease. In contrast, treatment of C. difficile 027/BI infected mice with feces from healthy mice rapidly restored a diverse, healthy microbiota and resolved C. difficile disease and contagiousness. We used this model to identify a simple mixture of six phylogenetically diverse intestinal bacteria, including novel species, which can re-establish a health-associated microbiota and clear C. difficile 027/BI infection from mice. Thus, targeting a dysbiotic microbiota with a defined mixture of phylogenetically diverse bacteria can trigger major shifts in the microbial community structure that displaces C. difficile and, as a result, resolves disease and contagiousness. Further, we demonstrate a rational approach to harness the therapeutic potential of health-associated microbial communities to treat C. difficile disease and potentially other forms of intestinal dysbiosis.
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