Effects of fecal microbiota transplantation in subjects with irritable bowel syndrome are mirrored by changes in gut microbiome

Abstract

Irritable bowel syndrome (IBS) is a common disorder of the lower gastrointestinal tract. The pathophysiology is far from settled, but a gut microbial dysbiosis is hypothesized to be a contributing factor. We earlier published a randomized double-blind placebo-controlled clinical trial on fecal microbiota transplantation (FMT) for IBS – the REFIT trial. The present data set describes the engraftment and includes participants from the study who received active FMT; 14 participants with effect of FMT ( Effect ) and 8 without ( No effect ). Samples were collected at baseline, after 6 and 12 months. Samples from the transplants ( Donor ) served as a comparator. In total 66 recipient samples and 17 donor samples were subjected to deep metagenomic sequencing, and taxonomic and functional analyses were performed. Alpha diversity measures showed a significantly increased diversity and evenness in the IBS groups compared to the donors. Taxonomic profiles showed higher relative abundance of phylum Firmicutes, and lower relative abundance of phylum Bacteroidetes, compared to donors at baseline. This profile was shifted toward the donor profile following FMT. Imputed growth rates showed that the resulting growth pattern was a conglomerate of donor and recipient activity. Thirty-four functional subclasses showed distinct differences between baseline samples and donors, most of which were shifted toward a donor-like profile after FMT. All of these changes were less pronounced in the No effect group. We conclude that FMT induces long-term changes in gut microbiota, and these changes mirror the clinical effect of the treatment. The study was registered in ClinicalTrials.gov (NCT02154867).

Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D

“… 13 On the other hand, Goll et al recently reported that responders to FMT had a trend of convergence toward donor microbiome profile after FMT while this trend was less clear for non-responders. 26 El-Salhy et al did not find any improvement in ‘dysbiosis index’ with FMT in IBS patients despite finding FMT was effective in improving IBS symptoms. 14 Our study was designed to detect the effect of antibiotic pretreatment on post-FMT bacterial engraftment and not the association between bacterial engraftment and clinical response.…”

Engraftment of strictly anaerobic oxygen-sensitive bacteria in irritable bowel syndrome patients following fecal microbiota transplantation does not improve symptoms

“…18,42,43 However, many studies have used autologous FMT as placebo treatment and hence the true effect of the donor derived allogenic FMT is difficult to distinguish. As we report no beneficial effects of increasing gut microbiome diversity and Goll et al- 44 reported response only in patients, that did not increase their diversity, based on microbiome data from a study of FMT treatment to IBS patients delivered through colonoscopy, 45 simply to increase gut microbiome diversity following FMT cannot be used as a marker of beneficial effects.…”

Fecal Microbiota Transplantation for Patients With Irritable Bowel Syndrome: A Meta-Analysis of Randomized Controlled Trials

“…However, FMT only induced a transient relief for 3 months in accordance with Lahtinen's research, coinciding with the result of Johnsen's study ( 17 , 21 ). Interestingly, relatively long-term conversions of the composition of gut microbiota were also detected in their studies ( 21 , 29 ). It may attribute to the complex integrated effects of multiple factors.…”