Fecal Microbiota Transplantation in Allogeneic Hematopoietic Stem Cell Transplantation Recipients: A Systematic Review

Pession, Andrea; Zama, Daniele; Muratore, Edoardo; Leardini, Davide; Gori, Davide; Guaraldi, Federica; Prete, Arcangelo; Turroni, Silvia; Brigidi, Patrizia; Masetti, Riccardo

doi:10.3390/jpm11020100

Cited by 23 publications

(19 citation statements)

References 68 publications

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“…Fecal microbiota transplantation (FMT) represents an alternative, more direct modulatory intervention using live microorganisms. The infusion of donor fecal matter is aimed at restoring GM eubiosis by replacing the bacterial communities harbored by the gut mucosa 72 . Bluestone et al reported the use of FMT to treat refractory Clostridioides difficile in 3 pediatric patients undergoing HSCT with no adverse effects, even if they achieved only one remission 73 .…”

Section: Gut Microbiome Modifications During Hematopoietic Stem Cell Transplantationmentioning

confidence: 99%

Gut microbiome in pediatric acute leukemia: from predisposition to cure

et al. 2021

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The gut microbiome (GM) has emerged as a key factor in the genesis and progression of many diseases. The intestinal bacterial composition is also able to influence treatment-related side effects and even efficacy of oncological therapies. Acute leukemia (AL) is the most common cancer among children and the most frequent cause of death from cancer during childhood. Outcome has improved considerably over the past four decades, with the current long-term survival for acute lymphoblastic leukemia being approximately 90%. However, several acute toxicities and long-term sequela are associated with the multimodal therapy-protocols applied in these patients. Specific GM configurations could contribute in the multistep developmental hypothesis for leukemogenesis. Moreover, GM alterations occur during the AL therapeutic course and are associated with treatment-related complications, especially during hematopoietic stem cell transplantation. The GM perturbation could last even after the removal of microbiome-modifying factors, like antibiotics, chemotherapeutic drugs or allo-immune reactions, contributing to several health-related issues in AL survivors. The aim of this paper is to provide a comprehensive review of the chronological changes of GM in children with AL, from predisposition to cure. The underpinning biological processes and the potential interventions to modulate the GM towards a potentially health-promoting configuration are also highlighted.

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Section: Gut Microbiome Modifications During Hematopoietic Stem Cell Transplantationmentioning

confidence: 99%

Gut microbiome in pediatric acute leukemia: from predisposition to cure

et al. 2021

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“…Given the impact of intestinal microbiota diversity loss in the course of aGvHD, interventions to maintain intestinal diversity might contribute to improved outcomes. Numerous studies evaluated FMT as a treatment for steroid-resistant gut aGvHD, providing encouraging preliminary data regarding feasibility and efficacy that need to be confirmed in larger prospective studies [ 46 ]. van Lier et al reported that the response after FMT was accompanied by an increase in gut microbial α-diversity and an increased abundance of butyrate-producing bacteria, including the Clostridiales and Blautia species [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Ulcerative Colitis in Response to Fecal Microbiota Transplantation via Modulation of Gut Microbiota and Th17/Treg Cell Balance

Huang

Mei

Lou

et al. 2022

Cells

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Background: Fecal microbiota transplantation (FMT) may contribute to disease remission in ulcerative colitis (UC). We studied the microbiota change and its regulation on T cells after FMT. Methods: Patients with mild to moderately active UC were included to receive FMT. The intestinal histopathological changes and barrier function were evaluated. The fecal samples of donors and patients were analyzed by 16S rRNA gene-based microbiota analysis, and the colon Th17 and Treg cells were assessed. Results: Fifteen patients completed the 8-week-follow-up. A total of 10 patients (66.7%) were in the responders (RE) group and five in the non-responders (NR) group. The Nancy histological index and fecal calprotectin decreased (p < 0.001, p = 0.06, respectively) and Occludin and Claudin1 increased in the RE group. The abundance of Faecalibaterium increased significantly by 2.3-fold in the RE group at week 8 (p = 0.043), but it was suppressed in the NR group. Fecal calprotectin (r = −0.382, p = 0.003) and Nancy index (r = −0.497, p = 0.006) were correlated inversely with the abundance of Faecalibacterium, respectively. In the RE group the relative mRNA expression of RORγt decreased and Foxp3 increased. Significantly decreased CD4+ RORγt+ Th17 and increased CD4+ Foxp3+ Treg were also observed in the RE group. The relative abundance of Faecalibacterium correlated with CD4+ RORγt+ Th17 (r = −0.430, p = 0.018) and CD4+ Foxp3+ Treg (r = 0.571, p = 0.001). Conclusions: The long-term Faecalibaterium colonization following FMT plays a crucial role in UC remission by alleviating intestinal inflammation. This anti-inflammatory effect of Faecalibacterium may be achieved by regulating the imbalance of Th17/Treg levels in UC.

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“…Infection control measures and regional epidemiology possess a significant role in the prevalence of CDI among individual medical centers, and our pooled estimation does not reduce the need for local centers to understand local prevalence. The meta-analysis showed that fecal microbiota transplantation, as an innovative strategy to reduce CDI occurrence, was recommended in patients with recurrent CDI in whom appropriate antibiotic treatments failed ( Pession et al., 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Clostridium difficile Infection in the Hematopoietic Transplantation Setting: Update of Systematic Review and Meta-Analysis

Luo

Su-mei

Shang

et al. 2022

Front. Cell. Infect. Microbiol.

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Hematopoietic stem cell transplant (HSCT) recipients are vulnerable to Clostridium difficile infection (CDI) due to risk factors such as immunosuppression, antimicrobial use, and frequent hospitalization. We systematically searched PubMed and Embase to screen relevant studies from April 2014 to November 2021. A meta-analysis was performed to identify the association between CDI and hematopoietic transplantation based on the standard mean difference and 95% confidence intervals (CIs). Among the 431 retrieved citations, we obtained 43 eligible articles, which included 15,911 HSCT patients at risk. The overall estimated prevalence of CDI was 13.2%. The prevalence of CDI among the 10,685 allogeneic transplantation patients (15.3%) was significantly higher than that among the 3,840 autologous HSCT recipients (9.2%). Different incidence rates of CDI diagnosis over the last 7 years were found worldwide, of which North America (14.1%) was significantly higher than Europe (10.7%) but not significantly different from the prevalence among Asia (11.6%). Notably, we found that the estimated prevalence of CDI diagnosed by polymerase chain reaction (PCR) (17.7%) was significantly higher than that diagnosed by enzyme immunoassay (11.5%), indicating a significant discrepancy in the incidence rate of CDI owing to differences in the sensibility and specificity of the detection methods. Recurrence of CDI was found in approximately 15% of the initial patients with CDI. Furthermore, 20.3% of CDI cases were severe. CDI was found to be a common complication among HSCT recipients, displaying an evident increase in the morbidity of infection.

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Fecal Microbiota Transplantation in Allogeneic Hematopoietic Stem Cell Transplantation Recipients: A Systematic Review

Cited by 23 publications

References 68 publications

Gut microbiome in pediatric acute leukemia: from predisposition to cure

Gut microbiome in pediatric acute leukemia: from predisposition to cure

Ulcerative Colitis in Response to Fecal Microbiota Transplantation via Modulation of Gut Microbiota and Th17/Treg Cell Balance

Prevalence of Clostridium difficile Infection in the Hematopoietic Transplantation Setting: Update of Systematic Review and Meta-Analysis

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