Gut microbiome (GM) composition and function are linked to human health and disease, and routes for manipulating the GM have become an area of intense research. Due to its high treatment efficacy, the use of fecal microbiota transplantation (FMT) is generally accepted as a promising experimental treatment for patients suffering from GM imbalances (dysbiosis), e.g. caused by recurrent Clostridioides difficile infections (rCDI). Mounting evidence suggests that bacteriophages (phages) play a key role in successful FMT treatment by restoring the dysbiotic bacterial GM. As a refinement to FMT, removing the bacterial component of donor feces by sterile filtration, also referred to as fecal virome transplantation (FVT), decreases the risk of invasive infections caused by bacteria. However, eukaryotic viruses and prophage-encoded virulence factors remain a safety issue. Recent in vivo studies show how cascading effects are initiated when phage communities are transferred to the gut by e.g. FVT, which leads to changes in the GM composition, host metabolome, and improve host health such as alleviating symptoms of obesity and type-2-diabetes (T2D). In this review, we discuss the promises and limitations of FVT along with the perspectives of using FVT to treat various diseases associated with GM dysbiosis.

中文翻译：

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噬菌体介导的肠道微生物组的操纵-并存在局限性。

肠道微生物组（GM）的组成和功能与人类健康和疾病相关，操纵GM的途径已成为研究的热点。由于其高治疗效率，粪便微生物群移植（FMT）的使用被普遍接受为患有GM失衡（营养不良）（例如由艰难梭状芽胞杆菌引起）的患者的有希望的实验治疗方法感染（rCDI）。越来越多的证据表明，噬菌体（噬菌体）通过恢复营养不良的细菌GM在成功的FMT治疗中起关键作用。作为FMT的改进，通过无菌过滤去除供体粪便中的细菌成分（也称为粪便病毒移植（FVT））可降低细菌引起的侵袭性感染的风险。但是，真核病毒和原噬菌体编码的毒力因子仍然是安全问题。近期体内研究表明，当噬菌体群落通过FVT转移到肠道时如何引发级联效应，从而导致GM组成，宿主代谢组学改变以及改善宿主健康，例如减轻肥胖和2型糖尿病（T2D）症状。在这篇综述中，我们讨论了FVT的前景和局限性，以及使用FVT来治疗与GM营养不良相关的各种疾病的观点。