The role of the gut microbiome in human health and disease is being increasingly recognized. Gut microbes (including bacteria, fungi and viruses) can be genetically modified to diagnose (as biosensors) and treat (detoxification, controlled biosynthesis and precision targeting) the dysbiosis of the microbiome, which has been linked to several cancers and metabolic, autoimmune and infectious diseases. However, conventional manipulation of single microbial strains is often insufficient, and engineering a mutually supportive and collaborative network of gut microbes — ‘a keystone consortium’ — could be more effective. In this Review, we summarize gut microbiome engineering strategies against selected diseases and critically discuss their translational potential. We focus mainly on genetic engineering approaches, but we also discuss complementary strategies such as encapsulation, coupling with electronic devices, orthogonal diet engineering and faecal microbiota transplantation.
The role of the gut microbiome in human health and disease is being increasingly recognized. This Review discusses microbiome engineering strategies to treat the dysbiosis of the gut microbiota, which has been linked to the pathogenesis of multiple human diseases.
Key points: The human gastrointestinal (GI) tract contains thousands of microbial species, including bacteria, fungi and viruses, the dysbiosis of which has been linked to the pathogenesis of many diseases.The microbiome can be engineered to treat various pathologies including cancer, metabolic and autoimmune diseases.‘Holistic’ modulation of the gut microbiome through orthogonal approaches and/or engineering mutually supportive and collaborative networks of gut microbes is an emerging and promising alternative to engineering single microbes.Proper biocontainment and precision targeting are among the main challenges to be overcome for the clinical translation of gut microbiome engineering strategies.