Fecal microbiome transplant in food allergy in humans and mice identifies a role for bile acid metabolites in oral tolerance.

Authors

Rima Rachid, Monica Martinez-Blanco, Gavin A Kuziel, Emmanuel Stephen-Victor, Mathieu Groussin, Askarbek Orakov, George Russell, Le Thanh Tu Nguyen, Mathilde Poyet, Zhussipbek Mukhatayev, Christina S K Yee, Sultan Albuhairi, Rayan Kteish, Ebla Abdel Rahman, Farida Abi Farraj, Ziwei Wang, Suzanne Dahlberg, Morgan Ryan, Meghan Fitzgerald, Wendy Elverson, John J Lee, Lynda Schneider, Andrew MacGinnitie, Elena Crestani, Dianna Queheillalt, Elizabeth Burke-Roberts, Jonathan Watson, Ryan J Elliott, Wing Fei Wong, Majdi Osman, Robert Voyksner, Elizabeth Hohmann, Curtis Huttenhower, Eric Alm, Seth Rakoff-Nahoum, Talal A Chatila

Published in

Science translational medicine. Volume 18. Issue 861. Pages eaee3263. Aug 05, 2026. Epub Aug 05, 2026.

Abstract

The gut microbiome has been implicated in the pathogenesis of food allergy (FA), prompting microbiome-focused interventions. We evaluated, in a phase 1 open-label trial (NCT02960074), the safety and efficacy of oral encapsulated fecal microbiome transplantation (FMT) in 15 adults with peanut allergies. An increase in the peanut reactivity threshold was noted in 3 of 10 participants not pretreated with antibiotics and 3 of 5 participants pretreated with antibiotics, without safety issues. In responders, FMT increased tolerogenic RORγt⁺ regulatory T cells (T_reg cells) and decreased T helper 2 cells (T_H2 cells). Mice transplanted with the microbiomes of post-FMT responders were protected from FA in association with increased RORγt⁺ T_reg cell percentages and increased colonization with members of the gut Bacteroides. In both humans and mice, protection by FMT was associated with increased bile acid metabolites. Deletion of a bile salt hydrolase in a candidate protective Bacteroides abrogated FA suppression in mice. These results suggest that FMT is a safe and potentially promising therapeutic modality for treating FA.

PMID:
42555752
Bibliographic data and abstract were imported from PubMed on 06 Aug 2026.

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