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

Abstract

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.

A Novel Combination Therapy Using Rosuvastatin and Lactobacillus Combats Dextran Sodium Sulfate-Induced Colitis in High-Fat Diet-Fed Rats by Targeting the TXNIP/NLRP3 Interaction and Influencing Gut Microbiome Composition

“…This abundance was restored in the groups subjected to treatment with LB, particularly with RSVT/LB combination therapy. Consistent with our findings, a reduction of Bifidobacterium was previously detected when UC was chemically induced [ 45 ]. Lactobacillus has a significant role in attenuating IBD.…”

An Immunologic Compatibility Testing Was Not Useful for Donor Selection in Fecal Microbiota Transplantation for Ulcerative Colitis

“…The first FMT studies on UC pointed to limited efficacy, although recent revisions (11, 23) observed higher remission when using high fecal dosage, regardless of the donor, and the previous administration of antibiotics; however, certain other variables might also be involved (24), as the duration and severity of the disease (11). None of our 4 patients showed relevant clinical improvement after FMT, which contrast with previous reports (25)(26)(27); however, the beneficial effects reported in those studies were not long lasting. Conversely, a recent study (28) provided evidence for the long-term efficacy of FMT in patients with UC, particularly associated with the increase in Proteobacteria and the decrease in Bacteroidota phyla.…”

Atractylodin Attenuates Dextran Sulfate Sodium-Induced Colitis by Alleviating Gut Microbiota Dysbiosis and Inhibiting Inflammatory Response Through the MAPK Pathway

“…An increase in the relative abundance of Firmicutes using fecal microbial transplantation resulted in alleviation of the symptoms of UC in patients, as increased microbial groups of Firmicutes are mostly related to healthy intestines (Schierová et al, 2020). Proteobacteria is one of the larger bacterial communities, which includes several pathogenic bacteria, such as Escherichia coli, Salmonella, Vibrio cholerae, and Helicobacter pylori among others.…”