Effective fecal microbiota transplantation for recurrent Clostridioides difficile infection in humans is associated with increased signalling in the bile acid-farnesoid X receptor-fibroblast growth factor pathway

Tanya Monaghan, Benjamin H. Mullish, Jordan Patterson, Gane K.S. Wong, Julian R. Marchesi, Huiping Xu, Tahseen Jilani, Dina Kao

Research output: Contribution to journalArticle

1 Scopus citations


The mechanisms of efficacy for fecal microbiota transplantation (FMT) in treating recurrent Clostridioides difficile infection (rCDI) remain poorly defined, with restored gut microbiota-bile acid interactions representing one possible explanation. Furthermore, the potential implications for host physiology of these FMT-related changes in gut bile acid metabolism are also not well explored. In this study, we investigated the impact of FMT for rCDI upon signalling through the farnesoid X receptor (FXR)-fibroblast growth factor (FGF) pathway. Herein, we identify that in addition to restoration of gut microbiota and bile acid profiles, FMT for rCDI is accompanied by a significant, sustained increase in circulating levels of FGF19 and reduction in FGF21. These FGF changes were associated with weight gain post-FMT, to a level not exceeding the pre-rCDI baseline. Collectively, these data support the hypothesis that the restoration of gut microbial communities by FMT for rCDI is associated with an upregulated FXR-FGF pathway, and highlight the potential systemic effect of FMT.

Original languageEnglish (US)
Pages (from-to)142-148
Number of pages7
JournalGut Microbes
Issue number2
StatePublished - Mar 4 2019



  • Microbiota
  • bile acid metabolism
  • fecal microbiota transplantation (FMT)
  • fibroblast growth factor (FGF)19
  • recurrent Clostridium difficile infection (rCDI)

ASJC Scopus subject areas

  • Microbiology
  • Gastroenterology
  • Microbiology (medical)
  • Infectious Diseases

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