Volume 3 · Issue 5 (2026)
Research Progress on Fecal Microbiota Transplantation in Regulating Neuroinflammation and Microglial Activation After Spinal Cord Injury
Daoyuan Jiang, Zhicheng Tang, Zhilai Zhou*
The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, Guangdong, 510317, China
Corresponding Author: Zhilai Zhou
Abstract: Spinal cord injury (SCI) causes neurological dysfunction and systemic complications, among which secondary neuroinflammation and gut-related immune alterations have increasingly been recognized as interrelated pathological processes. Beyond the initial mechanical insult, persistent neuroinflammation, microglial activation, disruption of the blood-spinal cord barrier (BSCB), and imbalance of the lesion microenvironment substantially influence neurological recovery and neuropathic pain development. Gut microbiota has recently been incorporated into the mechanistic framework of SCI because injury-induced autonomic dysfunction, bowel impairment, and antibiotic exposure may reshape intestinal microbial ecology. SCI-associated gut dysbiosis may further contribute to intestinal barrier dysfunction, altered microbial metabolite profiles, peripheral immune activation, and central neuroinflammatory responses through the gut-spinal cord axis. Fecal microbiota transplantation (FMT) introduces a complex donor-derived microbial ecosystem into the recipient intestine and aims to restore microbial diversity and functional balance. In preclinical SCI models, FMT has been associated with microbial reconstruction, improved gut barrier integrity, reduced inflammatory signaling, and a more permissive lesion microenvironment. However, the causal relationship among FMT, microbiota-derived metabolites, neuroinflammation, and microglial regulation remains insufficiently defined. This review summarizes current evidence linking FMT, gut microbiota, neuroinflammation, and microglial activation after SCI, with particular emphasis on the potential mechanisms connecting microbial remodeling with central immune regulation.
Keywords: Fecal microbiota transplantation; Spinal cord injury; Gut microbiota; Neuroinflammation; Microglial activation
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