Washed microbiota transplantation vs. manual fecal microbiota transplantation: clinical findings, animal studies and in vitro screening

Abstract

Fecal microbiota transplantation (FMT) by manual preparation has been applied to treat diseases for thousands of years. However, this method still endures safety risks and challenges the psychological endurance and acceptance of doctors, patients and donors. Population evidence showed the washed microbiota preparation with microfiltration based on an automatic purification system followed by repeated centrifugation plus suspension for three times significantly reduced FMT-related adverse events. This washing preparation makes delivering a precise dose of the enriched microbiota feasible, instead of using the weight of stool. Intraperitoneal injection in mice with the fecal microbiota supernatant obtained after repeated centrifugation plus suspension for three times induced less toxic reaction than that by the first centrifugation following the microfiltration. The toxic reactions that include death, the change in the level of peripheral white blood cells, and the proliferation of germinal center in secondary lymphoid follicles in spleen were noted. The metagenomic next-generation sequencing (NGS) indicated the increasing types and amount of viruses could be washed out during the washing process. Metabolomics analysis indicated metabolites with pro-inflammatory effects in the fecal microbiota supernatant such as leukotriene B4, corticosterone, and prostaglandin G2 could be removed by repeated washing. Near-infrared absorption spectroscopy could be served as a rapid detection method to control the quality of the washingprocess. In conclusion, this study for the first time provides evidence linking clinical findings and animal experiments to support that washed microbiota transplantation (WMT) is safer, more precise and more quality-controllable than the crude FMT by manual.

The Efficacy of Washed Microbiota Transplantation on Helicobacter pylori Eradication: A Pilot Study

“…In addition, prolonged eradication therapy for H. pylori infection also leads to dysbiosis of the intestinal microbiota and increases the expression of resistance genes, which may further induce various diseases [ 12 , 15 , 16 , 29 ]. However, with the emergence of WMT and fecal suspension capsules, the safety and convenience of WMT have been significantly improved [ 23 , 30 ]. It is notable that WMT may be used for refractory H. pylori infection (defined as those who have failed the first eradication treatment or with recurrence of H. pylori infection).…”

“…It has been demonstrated that FMT is efficacious for the treatment of a variety of gut microbiota-related diseases, including digestive system and nondigestive system diseases [ 19 – 22 ]. FMT on the basis of washed microbiota preparation, known as washed microbiota transplantation (WMT), has been proven to decrease adverse events caused by traditional fecal suspension preparation and greatly improve the efficacy [ 23 , 24 ]. We speculate that WMT can also be used, alone or in combination with currently recommended regimens, to eradicate H. pylori infection, by restoring the gut microbiota.…”

Composition of “gold juice” using an ancient method based on intestinal microecology

“…For example, Ott et al 54 used sterile-filtered stools from healthy donors for patients with symptomatic chronic-relapsing C. difficile infection; they showed that these methods effectively eliminated symptoms in patients, whereas fecal microbiota did not. In addition, Zhang et al 55 reported that transplantation of washed microbiota may be safer and more easily controlled approach, compared with FMT prepared manually. The previous and ongoing studies (both preclinical and clinical) will serve to advance the use of FMT in clinical practice.…”

Treatment of COVID-19 patients suspected with gut microbiota dysbiosis with washed microbiota transplantation: study protocol for a randomized controlled trial

“…Washed microbiota transplantation (WMT) is an updated version of FMT developed on the basis of washed bacteria preparation, which has signi cant effects on the improvement of microbiota dysbiosis. 8 In this clinical trial protocol, WMT will be employed to treat GMD. We design this clinical trial protocol to explore the clinical e cacy and safety of WMT on COVID-19 suspected with GMD.…”