The microbiome varies from person to person, making it unique to each individual. This requires that the therapies targeting the microbiome as a therapeutic approach be tailored specifically for an individual to get more precise and effective treatment outcomes. The concept of customized therapies, tailored specifically to an individual’s needs based on their clinical features, genetics, biomarker-based, psychological, and lifestyle factors, is referred to as personalized or precision medicine. In contrast to the traditional treatment approach of ‘one treatment for all,’ personalized medicine is a novel and individualized targeted approach, allowing for more patient- and disease-specific treatments. Personalized microbiome-based therapies aim to modulate the gut microbiome by enriching beneficial microorganisms, suppressing harmful ones, and restoring the gut microbial balance. As discussed previously, the gut microbiome plays a crucial role in maintaining the host’s overall well-being, including metabolic health, as well as in the development of metabolic syndromes. Treatment strategies targeting the gut microbiome to treat metabolic syndrome and reduce the risk of cardiometabolic diseases are being explored.

The interindividual variability in the microbiome can render traditional treatment approaches less effective or ineffective and may not be sufficient to address the complexities introduced by the microbiome. For instance, in obesity, the prevention and treatment of metabolic syndrome through weight loss by dietary changes can help improve glucose levels, cholesterol levels, and hypertension. However, the rates of nutrient metabolization differ among people and depend on various determinants, including age and genetics. People with slower metabolic rates might not have the same weight loss as those with relatively active metabolism, despite following the same diet recommendations. Moreover, dietary modifications that solely focus on calorie intake reduction without considering other factors might lead to weight regain after a temporary weight loss. This might be due to the adaptation of the gut microbiome to limited calorie intake by enhancing its energy-conserving processes.

Currently, microbiome profiling and omics technologies are essential tools for understanding the microbiome and its roles. Microbiome profiling involves analyzing the composition, diversity, and function of the microbial communities residing within a specific environment, such as the gut. It includes techniques like 16S rRNA sequencing for bacteria, internal transcribed spacer (ITS) sequencing for fungi, metagenomics, metatranscriptomics, proteomics, metabolomics, and culturomics. The 16S rRNA sequence and ITS regions are marker genes, with highly conserved sequences and hypervariable regions that evolve rapidly and allow for microbial identification. These gene markers serve as molecular barcodes for species identification. Personalized microbiome-based therapies (PMT) for the management of metabolic syndromes would involve the integration of omics technologies and biomarker validation. Firstly, through omics studies, detailed information on the DNA, RNA, proteins, and metabolites is collected to gain insights into the unique bio-signatures associated with metabolic syndromes. Secondly, the collected data are used to identify the biomarkers associated with disease occurrence and progression.

Microbiome-based therapeutic approaches include probiotics, prebiotics, symbiotics, microbiota transplants, and dietary interventions. These therapies can be personalized based on the patient’s specific treatment needs. Probiotics, prebiotics, and synbiotics aim to enrich the beneficial commensal bacteria, while microbiota transplantation is designed to restore the normal microbiota, and phage therapy aims to eliminate the pathogenic microbes. PMT also requires regular assessments of the microbiome to fine-tune treatments and eliminate unintended changes in the microbiota.