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Manrique et al. Microbiome Res Rep 2024;3:23 Microbiome Research
DOI: 10.20517/mrr.2023.80
Reports

Review Open Access

Past, present, and future of microbiome-based
therapies

Pilar Manrique , Ignacio Montero , Marta Fernandez-Gosende, Noelia Martinez, Claudio Hidalgo
Cantabrana , David Rios-Covian
Department of R&D, Microviable Theapeutics S.L., Gijón 33203, Spain.

Correspondence to: Dr. David Rios-Covian, Department of R&D, Microviable Theapeutics S.L., Calle los Prados 133, Gijón 33203,
Spain. E-mail: david.rios@microviable.com

How to cite this article: Manrique P, Montero I, Fernandez-Gosende M, Martinez N, Cantabrana CH, Rios-Covian D. Past,
present, and future of microbiome-based therapies. Microbiome Res Rep 2024;3:23. https://dx.doi.org/10.20517/mrr.2023.80

Received: 26 Dec 2023 First Decision: 23 Feb 2024 Revised: 7 Mar 2024 Accepted: 12 Mar 2024 Published: 18 Mar 2024

Academic Editor: Maria L. Marco Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

Abstract
Technological advances in studying the human microbiome in depth have enabled the identification of microbial
signatures associated with health and disease. This confirms the crucial role of microbiota in maintaining
homeostasis and the host health status. Nowadays, there are several ways to modulate the microbiota composition
to effectively improve host health; therefore, the development of therapeutic treatments based on the gut
microbiota is experiencing rapid growth. In this review, we summarize the influence of the gut microbiota on the
development of infectious disease and cancer, which are two of the main targets of microbiome-based therapies
currently being developed. We analyze the two-way interaction between the gut microbiota and traditional drugs
in order to emphasize the influence of gut microbial composition on drug effectivity and treatment response. We
explore the different strategies currently available for modulating this ecosystem to our benefit, ranging from 1st
generation intervention strategies to more complex 2nd generation microbiome-based therapies and their
regulatory framework. Lastly, we finish with a quick overview of what we believe is the future of these strategies,
that is 3rd generation microbiome-based therapies developed with the use of artificial intelligence (AI) algorithms.

Keywords: Microbiome-based therapies, microbiota, LBP, MBP, biological drugs

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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