Abstract
BackgroundFecal microbiota transplantation may contribute to disease remission in ulcerative colitis; however, the factors that determine the effects of treatment remain unknown. The aim of the present study was to prospectively investigate the clinical efficacy of fecal microbiota transplantation in patients with ulcerative colitis and identify the bacterial signatures associated with clinical remission.MethodsA total of 20 patients with ulcerative colitis were included in this prospective and uncontrolled study. All patients underwent gastroscopy five times, once every 3 weeks. Clinical indices were used to assess the efficacy of fecal microbiota transplantation, as well as the Mayo score, a score used to evaluate the extent of intestinal mucosal lesions in patients with ulcerative colitis. The changes in intestinal flora were detected by 16S ribosomal RNA-sequencing, and the relationship between ulcerative colitis and intestinal flora was analyzed.ResultsAfter treatment, clinical index scores for diarrhea, abdominal pain, and blood stool decreased significantly (p < 0.05). Erythrocyte sedimentation rate and C-reactive protein levels had not changed significantly; however, the clinical index score for intestinal mucosal lesions and the Mayo score decreased significantly. In addition, 16S ribosomal RNA-sequencing revealed that the intestinal flora in patients diagnosed with ulcerative colitis was different from that of donors.ConclusionFecal microbiota transplantation has a potential therapeutic value for the treatment of ulcerative colitis as it changes the abundance of bacterial flora and improves the scores for diarrhea, abdominal pain, and mucous membrane lesions in patients with this disease.Trial registrationThe clinical trial was retrospectively registered with ClinicalTrials.gov (NCT03016780) on January 11th, 2017.
Highlights
Fecal microbiota transplantation may contribute to disease remission in ulcerative colitis; the factors that determine the effects of treatment remain unknown
This study evaluated clinical efficacy and safety of Fecal microbiota transplantation (FMT) and analyzed the relationship between Ulcerative colitis (UC) and intestinal flora
The results showed that the patients’ abdominal pain score, diarrhea score, bloody stool score, intestinal mucosal lesion, and Mayo score significantly decreased after treatment
Summary
Fecal microbiota transplantation may contribute to disease remission in ulcerative colitis; the factors that determine the effects of treatment remain unknown. The aim of the present study was to prospectively investigate the clinical efficacy of fecal microbiota transplantation in patients with ulcerative colitis and identify the bacterial signatures associated with clinical remission. Ulcerative colitis (UC) is a chronic and progressive intestinal inflammatory disease that can seriously affect patient quality of life. The main pathogenic mechanism of UC is thought to be aberrant activation of the immune system in response to a change in the gut environment [1,2,3,4]. The cause of this pathological immune system activation is not fully understood. The flora adheres to the surface of the intestinal mucosa to form a chemical barrier against external stimuli, which regulates intestinal immunity. Once the homeostasis of the intestinal microenvironment is disturbed, patients are susceptible to intestinal diseases
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