Serial Fecal Microbiota Transplantation Alters Mucosal Gene Expression in Pediatric Ulcerative Colitis

Kellermayer, Richárd; Nagy‐Szakal, Dorottya; Harris, R. Alan; Luna, Ruth Ann; Pitashny, Milena; Schady, Deborah; Mir, Sabina; López, Mónica E.; Gilger, Mark A.; Belmont, John W.; Hollister, Emily B.; Versalovic, James

doi:10.1038/ajg.2015.19

Cited by 64 publications

(57 citation statements)

References 5 publications

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“…Multiple FMT treatments via a colonoscopy can induce the clinical remission of UC and facilitate the withdrawal from steroid dependence . High‐intensity, serial FMT can improve beneficial microflora and colonic mucosa in pediatric UC . In addition, with the successful reorganization of intestinal microbial composition, the step‐up FMT strategy is expected to become a standard treatment strategy for patients with steroid‐dependent UC .…”

Section: Therapeutic Strategy Of Fmt In Uc and Controversymentioning

confidence: 99%

Gut microbiota in ulcerative colitis: insights on pathogenesis and treatment

Guo

Liu

Hao

2020

J of Digest Diseases

192

110

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Gut microbiota constitute the largest reservoir of the human microbiome and are an abundant and stable ecosystem—based on its diversity, complexity, redundancy, and host interactions This ecosystem is indispensable for human development and health. The integrity of the intestinal mucosal barrier depends on its interactions with gut microbiota. The commensal bacterial community is implicated in the pathogenesis of inflammatory bowel disease (IBD), including ulcerative colitis (UC). The dysbiosis of microbes is characterized by reduced biodiversity, abnormal composition of gut microbiota, altered spatial distribution, as well as interactions among microbiota, between different strains of microbiota, and with the host. The defects in microecology, with the related metabolic pathways and molecular mechanisms, play a critical role in the innate immunity of the intestinal mucosa in UC. Fecal microbiota transplantation (FMT) has been used to treat many diseases related to gut microbiota, with the most promising outcome reported in antibiotic‐associated diarrhea, followed by IBD. This review evaluated the results of various reports of FMT in UC. The efficacy of FMT remains highly controversial, and needs to be regularized by integrated management, standardization of procedures, and individualization of treatment.

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Section: Therapeutic Strategy Of Fmt In Uc and Controversymentioning

confidence: 99%

Gut microbiota in ulcerative colitis: insights on pathogenesis and treatment

Guo

Liu

Hao

2020

J of Digest Diseases

192

110

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“…counted 94 UC patients had been treated by FMT and approximately 90% showed clinical response after FMT 3. In 2015, Kellermayer et al .,8 Rossen et al .,21 and Moayyedi et al 7. also published their successful experiences in treating UC patients by FMT.…”

Section: Discussionmentioning

confidence: 99%

Coordinated Hospital-Home Fecal Microbiota Transplantation via Percutaneous Endoscopic Cecostomy for Recurrent Steroid-Dependent Ulcerative Colitis

Fan

Zhang

et al. 2016

Gut and Liver

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Since its introduction as an alternative intestinal microbiota alteration approach, fecal microbiota transplantation (FMT) has been increasingly used as a treatment of choice for patients with ulcerative colitis (UC), but no reports exist regarding FMT via percutaneous endoscopic cecostomy (PEC). This report describes the case of a 24-year-old man with a 7-year history of recurrent, steroid-dependent UC. He received FMT via PEC once per day for 1 month in the hospital. After the remission of gastrointestinal symptoms, he was discharged from the hospital and continued FMT via PEC twice per week for 3 months at home. The frequency of stools decreased, and the characteristics of stools improved soon thereafter. Enteral nutrition was regained after 1 week, and an oral diet was begun 1 month later. Two months after the FMT end point, the patient resumed a normal diet, with formed soft stools once per day. The follow-up colonoscopy showed normal mucus membranes; then, the PEC set was removed. On the subsequent 12 months follow-up, the patient resumed orthobiosis without any gastrointestinal discomfort and returned to work. This case emphasizes that FMT via PEC can not only induce remission but also shorten the duration of hospitalization and reduce the medical costs; therefore, this approach should be considered an alternative option for patients with UC.

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“…Protocols varied between all studies, and three main routes of administration were used: serial enemas[32], serial enemas with supplementary colonoscopic administration[33], and nasogastric tube (NGT)[34,35]. …”

Section: Fecal Microbial Transplant For Pediatric Inflammatory Bowel mentioning

confidence: 99%

“…3 patients were included; 100% went into clinical remission at week 2, sustained clinical remission at week 4, and had complete withdrawal of immunotherapy at time of publication[33]. Within the limitations of this small case series, there was a correlation between the number of FMT administrations, and the duration of remission.…”

Section: Fecal Microbial Transplant For Pediatric Inflammatory Bowel mentioning

confidence: 99%

Fecal microbial transplant for the treatment of pediatric inflammatory bowel disease

Wang¹,

Popov²,

Pai³

2016

WJG

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The role of fecal microbial transplant (FMT) in the treatment of pediatric gastrointestinal disease has become increasingly popular among pediatric practitioners, patients, and parents. The success of FMT for the treatment of recurrent Clostridium difficile infection (RCDI) has bolstered interest in its potential application to other disease states, such as inflammatory bowel disease (IBD). FMT has particular interest in pediatrics, given the concerns of patients and parents about rates of adverse events with existing therapeutic options, and the greater cumulative medication burden associated with childhood-onset disease. Published literature on the use of FMT in pediatrics is sparse. Only 45 pediatric patients treated for RCDI have been reported, and only 27 pediatric patients with pediatric IBD. The pediatric microbiome may uniquely respond to microbial-based therapies. This review will provide a comprehensive overview of fecal microbial transplant and its potential role in the treatment of pediatric inflammatory bowel disease. We will discuss the microbiome in pediatric inflammatory bowel disease, existing adult and pediatric literature on the use of FMT in IBD treatment, and pediatric FMT trials that are currently recruiting patients. This review will also discuss features of the microbiome that may be associated with host response in fecal transplant, and potential challenges and opportunities for the future of FMT in pediatric IBD treatment.

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Serial Fecal Microbiota Transplantation Alters Mucosal Gene Expression in Pediatric Ulcerative Colitis

Cited by 64 publications

References 5 publications

Gut microbiota in ulcerative colitis: insights on pathogenesis and treatment

Gut microbiota in ulcerative colitis: insights on pathogenesis and treatment

Coordinated Hospital-Home Fecal Microbiota Transplantation via Percutaneous Endoscopic Cecostomy for Recurrent Steroid-Dependent Ulcerative Colitis

Fecal microbial transplant for the treatment of pediatric inflammatory bowel disease

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