Single-Donor and Pooling Strategies for Fecal Microbiota Transfer Product Preparation in Ulcerative Colitis: Systematic Review and Meta-Analysis

Levast, Benoît; Fontaine, Mathieu; Nancey, Stéphane; Déchelotte, Pierre; Doré, Joël; Lehert, Philippe

doi:10.14309/ctg.0000000000000568

Cited by 9 publications

(4 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mathematical modeling based on the RCT by Moayyedi et al [ 90 ] suggested that pooling of 2 or 3 donors can increase remission rates in UC [ 93 ]. Multi-donor or pooled FMT have been compared with single donor FMT in a meta-analysis of 14 studies that indicate the superiority of the former (RR, 2.31; P = 0.04) in terms of treatment response in IBD [ 94 ]. Another meta-analysis that did not detect any effect of single or pooled donors attributed this to the possibility of “super donors” in those receiving from a single donor.…”

Section: Procedure-related Factors and Outcome Determinants In Fmtmentioning

confidence: 99%

The practice of fecal microbiota transplantation in inflammatory bowel disease

Arora,

Kedia,

Ahuja

2024

Intest Res

View full text Add to dashboard Cite

Current evidence posits a central role for gut microbiota and the metabolome in the pathogenesis and progression of inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) has been established as a means to manipulate this microbiome safely and sustainably. Several aspects of the technical improvement including pretreatment with antibiotics, use of frozen stool samples as well as short donor-to-recipient time are proposed to improve its response rates. Its efficacy in ulcerative colitis has been proven in clinical trials while data is emerging for Crohn’s disease. This review describes briefly the biology behind FMT, the available evidence for its use in IBD, and the host, recipient and procedural factors which determine the clinical outcomes.

show abstract

Section: Procedure-related Factors and Outcome Determinants In Fmtmentioning

confidence: 99%

The practice of fecal microbiota transplantation in inflammatory bowel disease

Arora,

Kedia,

Ahuja

2024

Intest Res

View full text Add to dashboard Cite

show abstract

“…In accordance with this idea, the donor microbiota richness and the number of transferred phylotypes were associated with treatment success ( 51 ). Accordingly, multi-donor studies were superior to single-donor designs ( 8 ). As a limitation of this approach, in most randomized controlled trials, remission was observed in only approximately 30% of patients (but superior to controls) ( 52 ), and the benefit of fecal microbiome transfer in Crohn’s disease has not been consistently observed ( 9 , 53 ).…”

Section: Antibiotics Probiotics and Microbiome Transfer In Ibdmentioning

confidence: 99%

“…Surgical diversion of the intestinal contents has long been known to alleviate distal inflammation, and a limited benefit of fecal microbiome transfer has also been shown, at least for ulcerative colitis. The evidence for Crohn’s disease is less convincing ( 8 , 9 ). However, with a few exceptions, such as pouchitis, antibiotics generally are not effective in IBD ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Dysbiosis in inflammatory bowel diseases: egg, not chicken

Stange

2024

Front. Med.

View full text Add to dashboard Cite

There is agreement that inflammatory bowel diseases are, both in terms of species composition and function, associated with an altered intestinal microbiome. This is usually described by the term “dysbiosis,” but this is a vague definition lacking quantitative precision. In this brief narrative review, the evidence concerning the primary or secondary role of this dysbiotic state is critically evaluated. Among others, the following facts argue against a primary etiological impact: 1) There is no specific dysbiotic microbiome in IBD, 2) the presence or absence of mucosal inflammation has a profound impact on the composition of the microbiome, 3) dysbiosis is not specific for IBD but linked to many unrelated diseases, 4) antibiotics, probiotics, and microbiome transfer have a very limited therapeutic effect, 5) the microbiome in concordant twins is similar to disease-discordant twins, and 6) the microbiome in relatives of IBD patients later developing IBD is altered, but these individuals already display subclinical inflammation.

show abstract

“…We further evidenced that microbiota engraftment was improved when increasing the number of donors who contributed to the received pooled product ( 18 , 36 ). In line, we performed a systematic meta-analysis demonstrating the superiority of pooled fecal microbiotherapy compared to single donor-derived products to achieve a clinical benefit in ulcerative colitis patients ( 37 ). The aim of this study was to evaluate the anti-infectious effect of the two microbiotherapy formulations, i.e., the microbiome of human single donor-derived products and corresponding pooled products in two well-established preclinical mouse models of infection with Salmonella enterica and Clostridioides difficile .…”

Section: Introductionmentioning

confidence: 99%

Reduction of product composition variability using pooled microbiome ecosystem therapy and consequence in two infectious murine models

Reygner,

Delannoy,

Barba-Goudiaby

et al. 2024

Appl Environ Microbiol

Self Cite

View full text Add to dashboard Cite

Growing evidence demonstrates the key role of the gut microbiota in human health and disease. The recent success of microbiotherapy products to treat recurrent Clostridioides difficile infection has shed light on its potential in conditions associated with gut dysbiosis, such as acute graft-versus-host disease, intestinal bowel diseases, neurodegenerative diseases, or even cancer. However, the difficulty in defining a “good” donor as well as the intrinsic variability of donor-derived products’ taxonomic composition limits the translatability and reproducibility of these studies. Thus, the pooling of donors’ feces has been proposed to homogenize product composition and achieve higher taxonomic richness and diversity. In this study, we compared the metagenomic profile of pooled products to corresponding single donor-derived products. We demonstrated that pooled products are more homogeneous, diverse, and enriched in beneficial bacteria known to produce anti-inflammatory short chain fatty acids compared to single donor-derived products. We then evaluated pooled products’ efficacy compared to corresponding single donor-derived products in Salmonella and C. difficile infectious mouse models. We were able to demonstrate that pooled products decreased pathogenicity by inducing a structural change in the intestinal microbiota composition. Single donor-derived product efficacy was variable, with some products failing to control disease progression. We further performed in vitro growth inhibition assays of two extremely drug-resistant bacteria, Enterococcus faecium vanA and Klebsiella pneumoniae oxa48, supporting the use of pooled microbiotherapies. Altogether, these results demonstrate that the heterogeneity of donor-derived products is corrected by pooled fecal microbiotherapies in several infectious preclinical models. IMPORTANCE Growing evidence demonstrates the key role of the gut microbiota in human health and disease. Recent Food and Drug Administration approval of fecal microbiotherapy products to treat recurrent Clostridioides difficile infection has shed light on their potential to treat pathological conditions associated with gut dysbiosis. In this study, we combined metagenomic analysis with in vitro and in vivo studies to compare the efficacy of pooled microbiotherapy products to corresponding single donor-derived products. We demonstrate that pooled products are more homogeneous, diverse, and enriched in beneficial bacteria compared to single donor-derived products. We further reveal that pooled products decreased Salmonella and Clostridioides difficile pathogenicity in mice, while single donor-derived product efficacy was variable, with some products failing to control disease progression. Altogether, these findings support the development of pooled microbiotherapies to overcome donor-dependent treatment efficacy.

show abstract

Single-Donor and Pooling Strategies for Fecal Microbiota Transfer Product Preparation in Ulcerative Colitis: Systematic Review and Meta-Analysis

Cited by 9 publications

References 66 publications

The practice of fecal microbiota transplantation in inflammatory bowel disease

The practice of fecal microbiota transplantation in inflammatory bowel disease

Dysbiosis in inflammatory bowel diseases: egg, not chicken

Reduction of product composition variability using pooled microbiome ecosystem therapy and consequence in two infectious murine models

Contact Info

Product

Resources

About