Development of a protocol with concentrated bacteria for fecal microbiota transplantation and impact on the equine fecal microbiota after antibiotic-induced dysbiosis

The equine gut microbiota plays an important role in maintaining the health of the host. The gut microbiota is composed of many microorganisms such as bacteria, viruses, fungi, and archaea. However, the majority of these microbial cells are bacterial cells, and consequently, many studies, including the present one, focus on exploring bacterial communities in the gut. An imbalance of the gut microbiota, termed dysbiosis, has been observed in several conditions such as colitis, colic, after antibiotic administration, or diet modification. Restoration of the gut to a healthy state can be performed through fecal microbiota transplantation (FMT). Studies using current recommendations for FMT have shown clinical recovery in horses with diarrhea, but the microbiota remains largely unchanged after FMT and no controlled studies have been performed.  The hypotheses of this project were that treatment with concentrated FMT will correct dysbiosis faster than conventional FMT and the vehicle, and that the gut microbiota of horses treated with concentrated FMT will resemble the gut microbiota of the donor. The objective of this project was to develop an improved protocol for FMT in horses, by increasing the concentration of bacteria found in the donor stool using centrifugation, and to test it in horses with antibiotic-induced intestinal dysbiosis.   The antibiotic trimethoprim sulfadiazine (TMS) was administered to nine horses to induce intestinal dysbiosis. Horses were separated into three groups: horses receiving concentrated FMT (cFMT) (n=3); horses receiving fresh FMT (fFMT), as per current recommendations (n=3); horses receiving a vehicle (VEH) with 10% glycerol in 0.9% saline (n=3). Fecal samples were collected before and after antibiotic administration, as well as before, during, and after transplantation. Sequencing was performed using the Illumina MiSeq platform and data analysed using the software Mothur.  As expected, the antibiotic TMS significantly decreased the richness in all horses (P < 0.05). Unexpectedly, the membership of the cFMT and fFMT donor fecal suspensions was significantly different from cFMT and fFMT recipients’ baseline membership, respectively. The membership of the cFMT and fFMT recipient horses was significantly different after transplantation, while the vehicle recipients were not. In addition, the Escherichia genus was found in significantly higher relative abundances in the cFMT donor fecal suspensions when compared to the fFMT donor fecal suspensions.  The main limitations of this study are the small sample size and exposure of cFMT donor stool to oxygen and freeze-thawing. In addition, the dysbiosis model may not be optimal to test the efficacy of FMT, and studies performing FMT in horses with diarrhea are warranted. This study contributed to the search for novel approaches to improve FMT in horses. The weak effect of both FMT protocols on the gut microbiota and the increase in Escherichia suggest that further clinical studies are needed before FMT can be recommended to treat and prevent dysbiosis in horses.

Keyphrases: Fecal Microbiota Transplantation, Microbiota Manipulation, Intestinal Dysbiosis, Equine Gut Microbiota, Next Generation Sequencing, Microbiome, Intestinal Flora, Antibiotics