Overview
- A Nature Microbiology paper published January 8 details the largest ABS cohort to date, comparing 22 patients with 21 household partners and 22 healthy controls.
- During symptomatic flares, stool from ABS patients produced significantly more ethanol than samples from partners and controls, supporting development of a stool-based diagnostic assay.
- Escherichia coli and Klebsiella pneumoniae were identified among bacterial drivers of intestinal ethanol, with elevated fermentation enzymes pointing to pathway-level mechanisms.
- Patient responses varied; antibiotics reduced ethanol production in some cases, and the authors emphasize targeting fermentation enzymes or pathways rather than single species.
- One patient remained symptom-free for more than 16 months after a second fecal microbiota transplant, and a phase 1 study is now evaluating FMT in eight ABS patients.