Fecal microbiota transplantation for ulcerative colitis: a prospective clinical study

Tian, Ye; Zhou, Yan; Huang, Sisi; Li, Jun; Zhao, Kui; Li, Xiaohui; Wen, Xiangchen; Li, Xiao-an

doi:10.1186/s12876-019-1010-4

Cited by 60 publications

(44 citation statements)

References 22 publications

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“…The present study demonstrated that three rounds of FMT (13,(28)(29)(30). The improved efficacy displayed in the present study may be explained by the modified FMT procedures used, including stool preparation (feces exposure to air for <30 min), microbiota resource (fresh; all FMTs for one patient were derived from the same donor), delivery route (via TET tube; remained in the right lateral position for 30 min to maintain the largest contact area between microbiota and intestines), dosage (150 ml to avoid inducing intestinal peristalsis) and intensity (three times within one week).…”

Section: Discussionsupporting

confidence: 57%

Fecal microbiota transplantation ameliorates active ulcerative colitis

Chen

Huang

et al. 2020

Exp Ther Med

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Ulcerative colitis (UC) is a complex chronic pathological condition of the gut in which microbiota targeted treatment, such as fecal microbiota transplantation (FMT), has shown an encouraging effect. The aim of the present study was to investigate the efficacy and safety of FMT in patients with mild or moderate UC. A single-center, open-label study was designed, including 47 patients with mild or moderate active UC who received three treatments of fresh FMT via colonic transendoscopic enteral tubing within 1 week. The inflammatory bowel disease questionnaire, partial Mayo scores, colonoscopy, erythrocyte sedimentation rate, C-reactive protein level and procalcitoin values were used to assess the efficacy of FMT and alteration in gut microbiota was detected by 16S ribosomal RNA-sequencing. Before FMT, microbiota Faecalibacterium prausnitzii (F. prausnitzii) levels were significantly decreased in patients with UC compared with healthy donors (P<0.01). At 4 weeks post-FMT, F. prausnitzii levels were significantly increased (P<0.05), and the Mayo score was significantly decreased (1.91±1.07 at baseline vs. 4.02±1.47 at week 4; P<0.001) in patients with UC compared with healthy donors. Steroid-free clinical responses were reported in 37 patients (84.1%), and steroid-free clinical remission was achieved in 31 patients (70.5%) at week 4 post-FMT, however, steroid-free remission was not achieved in any patient. No adverse events were reported in 41 (93.2%) patients after FMT or during the 12-week follow-up. Shannon's diversity index and Chao1 estimator were also improved in patients with UC receiving FMT. In conclusion, the results of the present study suggested that FMT resulted in clinical remission in patients with mild to moderate UC, and that the remission may be associated with significant alterations to the intestinal microbiota of patients with UC. Furthermore, F. prausnitzii may serve as a diagnostic and therapeutic biomarker for the use of FMT in UC.

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Section: Discussionsupporting

confidence: 57%

Fecal microbiota transplantation ameliorates active ulcerative colitis

Chen

Huang

et al. 2020

Exp Ther Med

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“…Both studies [ 16 , 17 ] used individual stool donation, which means that each donor provided a stool for one, at most two recipients. Tian et al [ 41 ] even described non-significantly decreased Shannon and Chao indices after FMTs, but still observed positive clinical outcomes and improved symptoms in the patient with UC. The same authors [ 41 ] did not find differences in beta diversity; however, in our study, statistically significant results were obtained from pairwise PERMANOVA analyses.…”

Section: Discussionmentioning

confidence: 99%

“…Tian et al [ 41 ] even described non-significantly decreased Shannon and Chao indices after FMTs, but still observed positive clinical outcomes and improved symptoms in the patient with UC. The same authors [ 41 ] did not find differences in beta diversity; however, in our study, statistically significant results were obtained from pairwise PERMANOVA analyses. Jaccard distances between samples revealed the separation of responders and non-responders after FMT treatment, however, the high variability of samples within the FMT group analyzed in this work has to be taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

Gut Microbiome Changes in Patients with Active Left-Sided Ulcerative Colitis after Fecal Microbiome Transplantation and Topical 5-aminosalicylic Acid Therapy

Schierová

Březina

Mrázek

et al. 2020

Cells

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Ulcerative colitis (UC) is an inflammatory bowel disease, and intestinal bacteria are implicated in the pathogenesis of this disorder. The administration of aminosalicylates (5-ASA) is a conventional treatment that targets the mucosa, while fecal microbial transplantation (FMT) is a novel treatment that directly targets the gut microbiota. The aim of this study was to identify changes in fecal bacterial composition after both types of treatments and evaluate clinical responses. Sixteen patients with active left-sided UC underwent enema treatment using 5-ASA (n = 8) or FMT (n = 8) with a stool from a single donor. Fecal microbiota were analyzed by 16S rDNA high-throughput sequencing, and clinical indices were used to assess the efficacy of treatments. 5-ASA therapy resulted in clinical remission in 50% (4/8) of patients, but no correlation with changes in fecal bacteria was observed. In FMT, remission was achieved in 37.5% (3/8) of patients and was associated with a significantly increased relative abundance of the families Lachnospiraceae, Ruminococcaceae, and Clostridiaceae of the phylum Firmicutes, and Bifidobacteriaceae and Coriobacteriaceae of the phylum Actinobacteria. At the genus level, Faecalibacterium, Blautia, Coriobacteria, Collinsela, Slackia, and Bifidobacterium were significantly more frequent in patients who reached clinical remission. However, the increased abundance of beneficial taxa was not a sufficient factor to achieve clinical improvement in all UC patients. Nevertheless, our preliminary results indicate that FMT as non-drug-using method is thought to be a promising treatment for UC patients.

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“…Mahajan et al described FMT efficacy in reducing adverse effects of corticosteroid therapy, for example weight loss (from BMI 28.0 kg /m 2 to 23.5 kg /m 2 without diet modifications), reducing hair loss, backache, morning stiffness and allergic rhinitis after 22 weeks of 7 FMT sessions [23]. Other studies demonstrated that FMT could reduce disease symptoms, for example diarrhea, stomach ache and blood in the stool, however decrease of C-reactive protein level was not observed [24]. The FMT method showed efficacy in treatment-resistant UC as well and clinical, endoscopic and laboratory remission was observed in 43.3% patients [25].…”

Section: The Use Of Fmt In Ulcerative Colitismentioning

confidence: 99%

The use of fecal microbiota transplantation in the treatment of intestinal diseases

Ręka¹,

Nowak²,

Psiuk³

et al. 2020

J Educ Health Sport

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Introduction and purpose Fecal microbiota transplantation (FMT) is a process of transferring gut microflora from a healthy donor to a recipient. It is indicated that the human distal gastrointestinal tract consists of more than 1000 species of bacteria, which have an impact on local and systemic processes related to immunity, nutrition and the gut-brain axis. The growth of new bacterial species, reduction of microbial variety or big changes in the ratio between them can lead to a dysbiosis. The relationship between intestinal microbiota and some systemic diseases is seen. The study aimed to present the state of knowledge on FMT in the treatment of intestinal diseases. Publications from the last 5 years from the Pubmed database were included. A brief description of the state of knowledge Intestinal diseases constitute the main group of indications for FMT. FMT can be delivered via upper or lower gastrointestinal routes. The review presents different studies concerning the usage of FMT. Among them, recurrent Clostridium difficile infection, colitis ulcerosa, Crohn's disease and irritable bowel syndrome are mainly indicated in the literature. FMT might find its application also in a treatment of multidrug-resistant organisms colonization, antibiotic-associated diarrhea, gut acute graft-versus-host disease and radiation enteritis. There is a possibility of the occurrence of adverse events from the digestive tract after FMT. However, the studies evaluate them as mostly mild and transient. In some cases it was necessary to repeat FMT to achieve a satisfactory final result. Conclusions Fecal microbiota transplantation gives hope for a safe and effective method of treatment of certain intestinal diseases. There is a need for conducting further analysis of the method.

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Fecal microbiota transplantation for ulcerative colitis: a prospective clinical study

Cited by 60 publications

References 22 publications

Fecal microbiota transplantation ameliorates active ulcerative colitis

Fecal microbiota transplantation ameliorates active ulcerative colitis

Gut Microbiome Changes in Patients with Active Left-Sided Ulcerative Colitis after Fecal Microbiome Transplantation and Topical 5-aminosalicylic Acid Therapy

The use of fecal microbiota transplantation in the treatment of intestinal diseases

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