Abstract
Fecal microbiota transplantation (FMT) is a promising strategy in the management of inflammatory bowel disease (IBD). The clinical effects of this practice are still largely unknown and unpredictable. In this study, two children affected by mild and moderate ulcerative colitis (UC), were pre- and post-FMT monitored for clinical conditions and gut bacterial ecology. Microbiota profiling relied on receipts’ time-point profiles, donors and control cohorts’ baseline descriptions. After FMT, the improvement of clinical conditions was recorded for both patients. After 12 months, the mild UC patient was in clinical remission, while the moderate UC patient, after 12 weeks, had a clinical worsening. Ecological analyses highlighted an increase in microbiota richness and phylogenetic distance after FMT. This increase was mainly due to Collinsella aerofaciens and Eubacterium biforme, inherited by respective donors. Moreover, a decrease of Proteus and Blautia producta, and the increment of Parabacteroides, Mogibacteriaceae, Bacteroides eggerthi, Bacteroides plebeius, Ruminococcus bromii, and B Bacteroides ovatus were associated with remission of the patient’s condition. FMT results in a long-term response in mild UC, while in the moderate form there is probably need for multiple FMT administrations. FMT leads to a decrease in potential pathogens and an increase in microorganisms correlated to remission status.
Highlights
Inflammatory bowel disease (IBD) is a chronic inflammatory condition characterized by aberrant immune activation in susceptible individuals that leads to relapsing inflammation of the gastrointestinal (GI) tract [1]
From a clinical point of view, our results demonstrate that for mild ulcerative colitis (UC), a single fecal microbiota transplantation (FMT) acted on disease remission, while it seemed not to prevent relapses in the moderate form
Despite being focused only on two cases, our results seem to suggest that FMT could be considered effective for mild UC patients in need of therapeutic step-up
Summary
Inflammatory bowel disease (IBD) is a chronic inflammatory condition characterized by aberrant immune activation in susceptible individuals that leads to relapsing inflammation of the gastrointestinal (GI) tract [1]. Despite the numerous therapies developed for IBD, a large proportion of patients does not respond to the available drugs [2]. It is known that gut microbiota in IBD patients is characterized by a condition of dysbiosis [4], its tracking has been proposed as a new diagnostic and prognostic tool to interfere with the disease’s natural history [5]. The imbalance in microbiota composition provides the rationale for therapeutic manipulation of the gut microbiota driven by nutritional interventions, probiotic administration and fecal microbiota transplantation (FMT). Studies on prebiotics and probiotics have provided ambiguous results on the amelioration of IBD symptoms [6]. Researchers have tried to develop new interventions to modulate or to reset gut microbiota composition; among others, FMT is one of the most promising
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