A human microbiota-associated mouse model of early-life malnutrition reveals persistent microbiome immaturity and limited response to fecal viral transplantation

Malnutrition is a leading cause of child mortality worldwide and has long-lasting health and socio-economic consequences. Studies have established causal links between the gut microbiota and childhood malnutrition, with key microbial signatures including delayed microbiome development and an enrichment of bacterial pathogens. While current dietary interventions improve growth and developmental outcomes, post-therapy regression to an immature microbial state is common. Fecal virome transplants (FVTs) represent a promising approach to reshape gut microbial communities, yet their therapeutic potential in early life remains poorly described. In this work, we established a diet-inducible human microbiota-associated (HMA) mouse model of early-life stunting, where malnourished pups were 35% lighter and 25% shorter than healthy controls. We developed a predictive model to quantify gut bacteriome development, identifying Enterococcus and Clostridium as primary drivers of healthy maturation. Our model revealed that the malnourished HMA mouse gut remains significantly immature compared to healthy controls and decoupled from the mouse's chronological age. While a successful FVT from a healthy donor induced targeted changes in specific bacterial taxa, including a significant increase in Enterococcus species, it did not rescue physical growth or lead to broad community-level shifts. In contrast, a failed FVT from a different healthy donor revealed a significant mismatch between the donor virome and recipient bacteriome, indicating niche incompatibility that limits FVT efficacy. Our work establishes a robust human microbiota-associated mouse model for studying maturation of the gut in early life, suggesting that FVT alone is insufficient to reproducibly reshape the malnourished gut. These findings highlight the need for synergistic strategies, combining viral interventions with nutritional supplementation for maximum therapeutic effect.