Fecal Microbiota Transplantation in Healthy Aging: Challenges and Prospects in Personalized Medicine

As organisms age, the gut microbiome experiences pronounced shifts in both its composition and function, resulting in a state of dysbiosis. In order to mitigate the detrimental consequences of aging and promote healthier aging trajectories, it has been suggested that the modulation of the gut microbiome through the implementation of fecal microbiota transplantation may constitute a promising strategy to enhance healthspan and delay age-related decline. This narrative review examines the role of the gut microbiome in aging, with a specific focus on the therapeutic potential of fecal microbiota transplantation in promoting healthy aging. In older adults, the presence of gut microbiome dysbiosis has been linked to a heightened susceptibility to various age-related disorders, as well as to oxidative stress, diminished bioavailability of essential nutrients, persistent systemic inflammation, and insulin resistance. Preclinical studies have evidenced that the administration of fecal microbiota transplantation from young donors to aged recipients can effectively restore the donor’s gut microbiome, thereby enhancing the overall health of the host. In clinical studies, the efficacy of fecal microbiota transplantation in restoring a healthy gut microbiome has been demonstrated in the treatment of numerous conditions, including not only chronic gastrointestinal disorders but also a range of extra-intestinal disorders and symptoms. However, several factors limit its widespread clinical use, including mechanisms of action, treatment costs, application timing and route, efficacy, tolerability, and safety. Therefore, fecal microbiota transplantation shows promise as a microbial approach for addressing aging-related effects, but its full viability and effectiveness are still under investigation, requiring further development and optimization to reach a more refined stage of therapeutic application.