Co-cultivation is a powerful approach to produce a robust functionally designed synthetic consortium as a live biotherapeutic product (LBP)

The successes of fecal microbiota transplants (FMT) have provided the necessary proof-of-concept for microbiome therapeutics. Because of the many risks and uncertainties associated with feces-based therapies, defined microbial consortia that modify the microbiome in a targeted manner have emerged as a promising safer alternative to FMT. The development of such live biotherapeutic products has important challenges, including the selection of appropriate strains and the production of the consortia at scale. Here, we report on an ecology and biotechnology-based approach to microbial consortium design that overcomes these issues. We designed a nine-strain consortium that emulates the central metabolic pathways of carbohydrate fermentation in the healthy human gut microbiota. We show that continuous co-culturing the bacteria produce a stable consortium whose activity is distinct from an equivalent mix of individually cultured strains. Further, we showed that our function-based consortium is as effective as FMT in counteracting dysbiosis in a dextran sodium sulfate mouse model of acute colitis. We propose that combining a bottom-up functional design with continuous co-cultivation is a powerful strategy to produce robust, functionally designed synthetic consortia for therapeutic use.