Low Level Engraftment and Improvement following a Single Colonoscopic Administration of Fecal Microbiota to Patients with Ulcerative Colitis

Abstract

ObjectiveFecal microbiota transplantation (FMT) is an investigational treatment for diseases thought to involve alterations in the intestinal microbiota including ulcerative colitis (UC). Case reports have described therapeutic benefit of FMT in patients with UC, possibly due to changes in the microbiota. We measured the degree to which the transplanted microbiota engraft following FMT in patients with UC using a donor similarity index (DSI).MethodsSeven patients with mild to moderate UC (UC disease activity index scores 3–10) received a single colonoscopic administration of FMT. Metagenomic sequence data from stool were analyzed using an alignment-free comparison tool, to measure the DSI, and a phylogenetic analysis tool, to characterize taxonomic changes. Clinical, endoscopic, histologic, and fecal calprotectin outcome measures were also collected.ResultsOne of 5 patients from whom sequencing data were available achieved the primary endpoint of 50% donor similarity at week 4; an additional 2 patients achieved 40% donor similarity. One patient with 40% donor similarity achieved clinical and histologic remission 1 month after FMT. However, these were lost by 2−3 months, and loss correlated with a decrease in DSI. The remaining patients did not demonstrate clinical response or remission. Histology scores improved in all but 1 patient. No patients remained in remission at 3 months after FMT.ConclusionsFollowing a single colonoscopic fecal transplant, a DSI of 40-50% is achieved in about two-thirds of recipients. This level of engraftment correlated with a temporary clinical improvement in only 1/5 patients. Larger sample sizes could further validate this method for measuring engraftment, and changes in transplant frequency or method might improve microbiota engraftment and efficacy.Trial RegistrationClinicalTrials.gov NCT01742754

European consensus conference on faecal microbiota transplantation in clinical practice

“…15 51 75 76 Nevertheless, in many other potential indications than rCDI proven standard procedures are lacking.…”

Propolis from Different Geographic Origins Decreases Intestinal Inflammation and Bacteroides spp. Populations in a Model of DSS‐Induced Colitis

“…We noticed that CP specifically increased the abundance of commensal bacteria belonging to the phyla of Acidobacteria, Proteobacteria, Chloroflexi, Actinobacteria, Gemmatimonadetes, and Rhizobiales Incertae Sedis. Some of these phyla like Actinobacteria and Gemmatimonadetes have been found to be negatively correlated with gut microbiota disruptions and IBD, while some phyla, including Proteobacteria and Chloroflexi have been found to have a potential diagnostic signature of dysbiosis in IBD. We inferred that these phyla might contribute to the inflammatory processes during IBD, while Chinese propolis dramatically increased the gut microbiota diversity, which induced the abundance of some beneficial members of the phylum that will out‐compete more pathogenic members.…”

Complete Microbiota Engraftment Is Not Essential for Recovery from Recurrent Clostridium difficile Infection following Fecal Microbiota Transplantation

“…Others have relied on correlations between patient and donor communities based on taxonomic data (23, 38). However, both of these methods are subject to loss of information by binning OTUs into taxa and may be subjected to biases associated with taxonomic databases (37). SourceTracker has previously been used in environmental and clinical studies to effectively determine sources of contamination using a Bayesian approach without taxonomic binning (28, 39, 40).…”