Fecal Microbiota Transplantation (FMT): Historical Perspectives, Expanding Therapeutic Applications, and Future Prospects in Human Health

Fecal microbiota transplantation (FMT) has evolved from ancient Chinese medicine to a modern therapeutic intervention, gaining recognition in 1958 for treating pseudomembranous colitis. Today, recurrent Clostridioides difficile infection (rCDI) treatment is highly effective, and it has more than 90% success rate. Beyond rCDI, FMT shows promise in addressing metabolic disorders, autoimmune diseases, skin diseases, glaucoma and autism spectrum disorder, where it may enhance immune checkpoint inhibitor efficacy. However, challenges remain, including the lack of standardized protocols, donor-recipient matching complexities, long-term safety concerns, and ethical issues. Future advancements in personalized FMT, computational tools, and large-scale clinical trials are essential to overcome these limitations and expand its applications. This review highlights FMT’s transformative potential in modern medicine while emphasizing the need for rigorous research, standardized protocols, and innovative strategies to optimize its therapeutic benefits across diverse diseases.