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Fecal transplant provides long-term positive changes to gut microbiome
Fecal microbiota transplantation results in significant and long-term changes to the gut microbiomes of patients treated for recurrent Clostridium difficile infection, according to recent study results.
After treatment, the patients’ gut microbiota profiles showed a “striking similarity” to their donors’ — more so than what is generally seen between unrelated healthy individuals — throughout a year of follow-up.
“Our results suggest that intestinal microbiota can be modified relatively permanently,” Reetta Satokari, PhD, research fellow at the University of Helsinki in Finland, said in a press release. “This opens new possibilities to the use this treatment for other diseases related to microbial dysbiosis.”
Satokari and colleagues analyzed the microbiota profiles of 14 recurrent CDI patients using a phylogenic microarray analysis of 131 fecal and mucosal samples collected before FMT and throughout the following year. During the same time period, they also analyzed 23 samples from the three universal donors who provided the FMT material.
“The donors’ microbiota was typical for healthy adults, dominated by Firmicutes (85%), Actinobacteria (8.5%) and Bacteroidetes (5.3%) and showed significant individual-specific profiles,” the researchers wrote. “In contrast to the healthy donors, the patients’ microbiota pre-FMT was extremely different. ... The low levels of Clostridia and high levels of Bacilli and Proteobacteria contributed to the majority of the detected differences.”
FMT successfully resolved CDI in all patients, and there were significant changes in microbial diversity and composition resembling their donors’ as early as 3 days after the procedure and lasting up to 1 year. The patients’ bacterial communities became dominated by Clostridium clusters IV and XIVa, which are typical of a healthy gut microbiome.
The similarity between patients’ and their own donors’ microbiota increased from 81.8% before FMT to 95% after (P < .05). Moreover, similarity to other donors’ microbiota was significantly lower compared to a patients’ own donors’ (P < .05).
“Interestingly, the changes of microbial profiles from rectal biopsies before and after FMT-treatment were different than what was observed in the fecal samples,” the researchers noted.
Specifically, Clostridium cluster IX, Proteobacteria, Bacilli and uncultured Clostridiales decreased in abundance in mucosal samples after treatment, while Bacteroidetes increased (P < .05 for all).
The researchers also sought to identify the core microbiota transferred from donor to patient after FMT, and found 24 commonly acquired bacterial taxa, including “some well-studied butyrate producers such as Eubacterium hallii and Roseburia intestinalis.” These species may inform the design of bacteriotherapy products in the future, according to the press release.
“The aim is to develop a so-called bacterial cocktail that could be used to treat patients instead of the fecal material,” Jonna Jalanka, PhD, also from the University of Helsinki, said in the press release.
The researchers concluded that “the microbiota changes both in feces and mucosa explain the rapid clinical recovery of all patients and the superior long-term efficacy over previous antibiotic treatments,” adding that their results “indicate that a specific combination of bacterial taxa seems to underlie the treatment efficacy of FMT for rCDI.” – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.