Systematic review of donor and recipient predictive biomarkers of response to faecal microbiota transplantation in patients with ulcerative colitis

Rees, Nia Paddison; Shaheen, Walaa; Quince, Christopher; Tselepis, Chris; Horniblow, Richard D.; Sharma, Naveen; Beggs, Andrew D.; Iqbal, Tariq; Quraishi, Mohammed Nabil

doi:10.1016/j.ebiom.2022.104088

Cited by 34 publications

(20 citation statements)

References 52 publications

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“…Studies of FMT in patients with active UC have assessed the effect of using single vs multiple donors for product preparation on achieving response to therapy. Patients with UC have variable clinical backgrounds, so that the “recipient effect” is more important than “donor effect” for treatment success ( 60 , 61 ). Pooling different donors enriches the fecal product and increases the repertoire diversity of beneficial bacteria and functionalities that could substantially improve patient's status.…”

Section: Discussionmentioning

confidence: 99%

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

Levast

Fontaine

Nancey

et al. 2023

Clin Transl Gastroenterol

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INTRODUCTION: Patients with ulcerative colitis (UC) have a less diverse microbiome than healthy subjects. Multiple studies have evaluated fecal microbiota transfer (FMT) in these patients using different methods of product preparation, doses, and routes of administration. A systematic review and meta-analysis was performed to compare the efficacy of single-donor (SDN) and multidonor (MDN) strategies for product preparation. METHODS: Systematic searches were performed in Web of Science, Scopus, PubMed, and Orbit Intelligence for studies comparing FMT products manufactured using SDN or MDN strategies to placebo in patients with UC. Fourteen controlled studies were selected for meta-analysis (10 randomized and 4 nonrandomized). The treatment response was assessed by using fixed- and random-effects models, and the significance of the indirect difference between the interventions was assessed using a network approach. RESULTS: Considering all 14 studies, MDN and SDN were superior to placebo in terms of treatment response (risk ratios [RRs]: 4.41 and 1.57, respectively [P ≤ 0.001 for both]), and MDN was superior to SDN (RR: 2.81, P = 0.005). Meta-analysis of the 10 studies with high quality of evidence showed that MDN was superior to SDN in terms of treatment response (RR: 2.31, P = 0.042). Results were identical for both models. DISCUSSION: There was a significant clinical benefit (remission) for patients with UC who received FMT with products manufactured by MDN strategies. Reduction of donor effect may lead to a gain in microbial diversity that could improve response to treatment. These results may have implications in the treatment approach of other diseases amenable to microbiome manipulation. JOURNAL/cltg/04.03/01720094-202305000-00002/2FFU1/v/2023-08-14T034823Z/r/image-tiff

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Section: Discussionmentioning

confidence: 99%

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

Levast

Fontaine

Nancey

et al. 2023

Clin Transl Gastroenterol

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“…In terms of the importance of donor diversity, remarkably few studies have assessed its association with remission of symptoms after FMT, and studies that have are retrospective, lack replication, and/or are poorly controlled for confounding factors. Despite such shortcomings, evidence supporting donor diversity for FMT success is accumulating (16)(17)(18), but much more remains to be learned.…”

Section: Discussionmentioning

confidence: 99%

The biodiversity dose-response curve translates theory and practice from ecological restoration into research and clinical priorities for fecal microbiota transplantation

Orr

2022

Front. Med.

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Discoveries of the beneficial effects of gut microbiota have led to efforts to cultivate healthy gut flora to treat disease. The field of ecological restoration specializes on reestablishment of desired species in disturbed ecosystems, which suggests that it may be applicable to microbe restoration in the gut. Common language can lower barriers to interdisciplinary insights. Here I introduce the concept of a “biodiversity dose-response curve” to translate ideas from ecological restoration into research and clinical priorities for fecal microbiota transplantation (FMT). The curve is based on a relationship between ecosystem structure, measured as species diversity found in both nature and gut ecosystems, and ecosystem function, which are the measurable parameters that contribute to ecosystem and human health. I explain why the biodiversity dose-response curve may follow the ecological model of a “rivet-redundancy” relationship, in which the overlap of multiple organisms’ functional contributions to a system mask the impact of initial losses of diversity, but, at a certain level of loss, function declines sharply. (Imagine an airplane that flies with a few rivets missing, until it loses enough to fail.) The biodiversity dose-response curve indicates that seemingly healthy individuals may be suboptimal donors; it highlights the importance of recipient diet in FMT success; and it introduces the concept of “passive restoration” into the field of gut medicine. These insights, which may help to explain low success rates of FMT in the treatment of non-Clostridium dificile conditions, are less apparent in the absence of interdisciplinary integration.

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“…This approach has been utilized as a primary or adjunctive treatment for a variety of intestinal and extraintestinal diseases. 147 It has been reported that FMT can treat Clostridium difficile infections, 148 and it has also been used in the treatment of colitis 149 and tumor immunization. 150 These treatments operate by modulating the intestinal flora.…”

Section: Fecal Microbiota Transplantationmentioning

confidence: 99%

Gut microbiome-based therapies for alleviating cognitive impairment: state of the field, limitations, and future perspectives

Bu,

Wang,

Bai

et al. 2024

Food Funct.

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Systematic review of donor and recipient predictive biomarkers of response to faecal microbiota transplantation in patients with ulcerative colitis

Cited by 34 publications

References 52 publications

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

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

The biodiversity dose-response curve translates theory and practice from ecological restoration into research and clinical priorities for fecal microbiota transplantation

Gut microbiome-based therapies for alleviating cognitive impairment: state of the field, limitations, and future perspectives

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