Advances in capsule-based fecal microbiota transplantation: clinical applications and innovations

Dec 2, 2025Journal of translational medicine

Improved capsule methods for fecal microbiota transplantation: new uses and developments

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Abstract

(cFMT) effectively restores microbial balance in infections like Clostridioides difficile with outcomes comparable to traditional methods.

cFMT is associated with significant restoration of microbial diversity in conditions such as infections, inflammatory bowel disease, and small intestinal bacterial overgrowth.
Clinical benefits of cFMT are inconsistent in individuals with irritable bowel syndrome and functional constipation, despite some changes in gut microbial diversity.
Emerging applications suggest cFMT may influence metabolic disorders and neuropsychiatric conditions through modulation of gut-derived metabolites and gut–brain signaling.
Challenges impacting cFMT adoption include donor variability, gaps in standardization, and transient adverse effects.
Advancements like targeted colon-release formulations and synthetic microbial consortia could enhance the precision and scalability of cFMT.

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(cFMT) has emerged as a vital tool for modulating gut dysbiosis for therapeutic intervention. This noninvasive alternative to traditional avoids procedural invasiveness while offering logistical advantages in terms of storage, administration, and patient compliance. This review evaluates cFMT as a transformative approach across diverse diseases. Notably, cFMT demonstrates robust efficacy in restoring the microbial balance ininfection (CDI), inflammatory bowel disease (IBD), and multidrug-resistant infections, with outcomes comparable to those of conventional methods. It also alleviates symptoms and enhances microbiota diversity in small intestinal bacterial overgrowth (SIBO). However, the clinical benefits remain inconsistent for individuals with in irritable bowel syndrome (IBS) and functional constipation (FC), despite alterations in gut microbial diversity. Emerging applications highlight the potential of cFMT metabolic disorders (e.g., obesity and hypertension) via the modulation of gut-derived metabolites and neuropsychiatric conditions (e.g., depression and autism) through gut–brain axis signaling, in addition to chronic kidney disease and hepatic encephalopathy. Challenges such as donor variability, standardization gaps, and transient adverse effects hinder widespread adoption. Further advancements, including targeted colon-release formulations, synthetic microbial consortia, and single-cell delivery systems, could improve precision and scalability. Despite its transformative potential, the clinical adoption of cFMT hinges on rigorous quality control, mechanistic insights, and long-term safety data. In recent years, the United States Food and Drug Administration (FDA) has officially approved the oral microbiome therapy Vowst for marketing. This marked the gradual transition of fecal microbiota transplantation (FMT)-related therapies from clinical research to standardized clinical application, and at the same time, Vowst has become the world's first oral fecal microbiome therapy approved by the FDA. This review highlights the role of cFMT in microbiota-targeted therapies while advocating for innovation to address current limitations and expand its therapeutic scope. Clostridioides difficile

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Advances in capsule-based fecal microbiota transplantation: clinical applications and innovations

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