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. 2020 Aug 3;8(8):268.
doi: 10.3390/biomedicines8080268.

The Effectiveness of Multi-Session FMT Treatment in Active Ulcerative Colitis Patients: A Pilot Study

Dorota Mańkowska-Wierzbicka  1 , Marta Stelmach-Mardas  2 , Marcin Gabryel  1 , Hanna Tomczak  3   4 , Marzena Skrzypczak-Zielińska  5 , Oliwia Zakerska-Banaszak  5 , Anna Sowińska  6 , Dagmara Mahadea  1 , Alina Baturo  1 , Łukasz Wolko  7 , Ryszard Słomski  5 , Agnieszka Dobrowolska  1
Affiliations

The Effectiveness of Multi-Session FMT Treatment in Active Ulcerative Colitis Patients: A Pilot Study

Dorota Mańkowska-Wierzbicka et al. Biomedicines. .

Abstract

The modification of the microbiome through fecal microbiota transplantation (FMT) is becoming a very promising therapeutic option for inflammatory bowel disease (IBD) patients. Our pilot study aimed to assess the effectiveness of multi-session FMT treatment in active ulcerative colitis (UC) patients. Ten patients with UC were treated with multi-session FMT (200 mL) from healthy donors, via colonoscopy/gastroscopy. Patients were evaluated as follows: at baseline, at week 7, and after 6 months, routine blood tests (including C reactive protein (CRP) and calprotectin) were performed. 16S rRNA gene (V3V4) sequencing was used for metagenomic analysis. The severity of UC was classified based on the Truelove-Witts index. The assessment of microbial diversity showed significant differences between recipients and healthy donors. FMT contributed to long-term, significant clinical and biochemical improvement. Metagenomic analysis revealed an increase in the amount of Lactobacillaceaea, Micrococcaceae, Prevotellaceae, and TM7 phylumsp.oral clone EW055 during FMT, whereas Staphylococcaceae and Bacillaceae declined significantly. A positive increase in the proportion of the genera Bifidobacterium, Lactobacillus, Rothia, Streptococcus, and Veillonella and a decrease in Bacillus, Bacteroides, and Staphylococcus were observed based on the correlation between calprotectin and Bacillus and Staphylococcus; ferritin and Lactobacillus, Veillonella, and Bifidobacterium abundance was indicated. A positive change in the abundance of Firmicutes was observed during FMT and after 6 months. The application of multi-session FMT led to the restoration of recipients' microbiota and resulted in the remission of patients with active UC.

Keywords: fecal microbiota transplantation (FMT); gut microbiota; inflammatory bowel disease (IBD); ulcerative colitis (UC).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Gut microbial diversity in terms of operational taxonomic unit (OTU) richness in donors and ulcerative colitis (UC) patients in the peri-fecal microbiota transplantation (FMT) period. * p < 0.05, ** p < 0.01, ns: no significance.
Figure 2
Figure 2
Comparison of microbial composition at the phylum level between recipients and donors. ** p < 0.005.
Figure 3
Figure 3
Comparison of microbial composition at the family level between recipients and donors (A) and in UC patients in the peri-FMT period (B). * p < 0.05, ** p < 0.01.
Figure 4
Figure 4
Comparison of microbial composition at the genus level between recipients and donors (A) and in UC patients in the peri-FMT period (B). The numbers in rectangles represent the abundance for each detected bacterial genus in %. Statistical significance: * p < 0.05, ** p < 0.01, *** p < 0.001.
Figure 5
Figure 5
Comparison of microbial composition at the phylum level between recipients and donors (A) and in UC patients in the peri-FMT period (B). The numbers in rectangles represent the abundance for each detected bacterial phylum in %. Statistical significance: * p < 0.05.
See this image and copyright information in PMC

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