Microbiome dynamics: from life course changes to dysbiosis in cancer

This review focuses on the evolution of the human microbiome in health and disease across the lifespan. In recent years, research on the microbiome has made significant progress, making it timely to synthesize current knowledge and review emerging microbiome therapies, with attention to clinical applications as well. The paper considers the transformations of the microbiome at different stages of life, from childhood to old age, and explores its interactions with the immune system, metabolism, and mental health. A central theme is the pathological impact of microbial alterations (dysbiosis), which have been linked to a wide variety of diseases, including cancers. Particular emphasis is placed on therapies that modulate the microbiome, including probiotics, prebiotics, synbiotics, postbiotics, antibiotics, and fecal microbiota transplantation. While probiotics and prebiotics are known to have a positive effect, synbiotics and postbiotics are emerging as promising alternatives that are more adaptable to individual variations in the microbiome. Moreover, fecal transplantation represents one of the most advanced innovations, with applications ranging from Clostridium difficile infections to potential treatments for autoimmune and metabolic diseases. Modulation of the microbiome, from the perspective of personalized medicine, offers prospects for tailored therapies aimed at restoring microbial balance according to the specificities of each patient. Metabolomics looms as a key avenue of investigation that can support the evolution of personalized therapeutic approaches in the near future.