Targeted Therapy for Gut Microbiota: Candidates for a Novel Strategy to Ameliorate Type 2 Diabetes MellitusIF:1.40

Faecal bacteria from patients with T2DM have been shown to 
cause abnormalities in glucose and lipid metabolism in normoglycemic mice (Hu 2016), impairing insulin tolerance and oral 
glucose tolerance while altering the composition of the gut microbiota, leading to a significant reduction in Prevotella at the genus 
level (Wang, Wang, et al. 2022). Furthermore, the gut microbiota of distal symmetric polyneuropathy in patients with diabetes 
induces a more severe peripheral neuropathy phenotype in db/
db mice (Yang et al. 2023). In a clinical trial, obese patients who 
received FMT from healthy, lean individuals demonstrated positive changes in insulin sensitivity (Aron-Wisnewsky et al. 2019). 
Notably, improvements in insulin sensitivity in patients with 
metabolic syndrome were observed exclusively in the group who 
received FMT from lean donors or their own gut microbiota 
(Vrieze et al. 2012). Similarly, impaired glucose tolerance and IR 
improved in individuals with exercise sensitivity to insulin and 
homeostatic glucose responses, as well as in patients with normal 
glucose tolerance (Zhang, Li, et al. 2020; Liu et al. 2020). Thus, 
donor health status plays a crucial role in determining FMT 
outcomes. After FMT, the similarity of the gut microbiota between the patient and the corresponding graft was significantly 
reduced; however, the composition of the gut microbiota of the 
patient remained closer to its baseline than that of the graft (Yang 
et  al.  2023). Additionally, one study found that among FMTtreated patients with T2DM, the family Rikenellaceae and genus 
Anaerotruncus (class Ruminalococcaceae) were more abundant 
in the gut microbiota of patients with good treatment outcomes 
than in those with poor outcomes. These findings suggest that 
Rikenellaceae and Anaerotruncus may serve as potential biomarkers in patients with T2DM undergoing FMT (Ding et al. 2022). 
Therefore, the status of the patient's gut microbiota is a critical 
factor influencing FMT treatment efficacy and warrants further investigation because of the study's small sample size. Some 
studies have indicated that when the intestinal type is matched 
between the donor and recipient, changes in the gut microbiota 
of patients are more pronounced after bacterial transplantation 
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感谢中国广东省微生物靶向治疗工程技术研究中心胃肠病学部，广东省药科大学第一附属医院，广州，2广东省药品制剂研究与评价重点实验室分享的文献！