Over the last two decades, advancements in sequencing technologies have significantly deepened our understanding of the human microbiome's complexity, leading to increased concerns about the detrimental effects of antibiotics on these intricate microbial ecosystems. Concurrently, the rise in antimicrobial resistance has intensified the focus on how beneficial microbes can be harnessed to treat diseases and improve health and offer potentially promising alternatives to traditional antibiotic treatments. Here, we provide a comprehensive overview of both established and emerging microbe-centric therapies, from probiotics to advanced microbial ecosystem therapeutics, examine the sophisticated ways in which microbes are used medicinally, and consider their impacts on microbiome homeostasis and health outcomes through a microbial ecology lens. In addition, we explore the concept of rewilding the human microbiome by reintroducing “missing microbes” from nonindustrialized societies and personalizing microbiome modulation to fit individual microbial profiles—highlighting several promising directions for future research. Ultimately, the advancements in sequencing technologies combined with innovative microbial therapies and personalized approaches herald a new era in medicine poised to address antibiotic resistance and improve health outcomes through targeted microbiome management.

中文翻译：

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 微生物作为药物


在过去的二十年里，测序技术的进步大大加深了我们对人类微生物组复杂性的理解，导致人们越来越担心抗生素对这些错综复杂的微生物生态系统的有害影响。与此同时，抗菌素耐药性的上升加剧了人们对如何利用有益微生物来治疗疾病和改善健康的关注，并为传统抗生素治疗提供可能有前途的替代品。在这里，我们全面概述了从益生菌到先进的微生物生态系统疗法的成熟和新兴的以微生物为中心的疗法，研究了微生物的药用复杂方式，并通过微生物生态学的角度考虑了它们对微生物组稳态和健康结果的影响。此外，我们通过从非工业化社会重新引入“缺失的微生物”并个性化微生物组调节以适应个体微生物特征来探索人类微生物组再野化的概念——突出了未来研究的几个有前途的方向。最终，测序技术的进步与创新的微生物疗法和个性化方法相结合，预示着医学的新时代即将到来，通过有针对性的微生物组管理来解决抗生素耐药性问题并改善健康结果。