faecal microbiota transplantation
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2022 ◽  
Vol 7 (2) ◽  
pp. 112-114
Author(s):  
David Inglis ◽  
Mohammed Nabil Quraishi ◽  
Christopher Green ◽  
Tariq Iqbal

2022 ◽  
Vol 8 ◽  
Author(s):  
Ling Ding ◽  
Cong He ◽  
Xueyang Li ◽  
Xin Huang ◽  
Yupeng Lei ◽  
...  

Aims: We investigated whether faecal microbiota transplantation (FMT) decreases intra-abdominal pressure (IAP) and improves gastrointestinal (GI) dysfunction and infectious complications in acute pancreatitis (AP).Methods: In this first randomised, single-blind, parallel-group, controlled study, we recruited and enrolled consecutive patients with AP complicated with GI dysfunction. Eligible participants were randomly assigned to receive faecal transplant (n = 30) or normal saline (n = 30) via a nasoduodenal tube once and then again 2 days later. The primary endpoint was the rate of IAP decline; secondary endpoints were GI function, infectious complications, organ failure, hospital stay and mortality. Analyses were based on intention to treat.Results: We enrolled 60 participants and randomly assigned them to the FMT (n = 30) or control (n = 30) group. Baseline characteristics and disease severity were similar for both groups. IAP decreased significantly 1 week after intervention in both groups, with no difference in the IAP decline rate between FMT and Control group [0.1 (−0.6, 0.5) vs. 0.2 (−0.2, 0.6); P = 0.27]. Normal gastrointestinal failure (GIF) scores were achieved in 12 (40%) patients in the FMT group and 14 (47%) in the control group, with no significant difference (P = 0.60). However, D-lactate was significantly elevated in the FMT group compared to the control group, as calculated by the rate of decline [−0.3 (−3.7, 0.8) vs. 0.4 (−1.1, 0.9); P = 0.01]. Infectious complications occurred in 15 (50%) and 16 (53.33%) patients in the FMT and control groups, respectively (P = 0.80). However, interleukin-6 (IL-6) was significantly elevated in the FMT group compared to the control group, as calculated by the rate of decline [0.4 (−3.6, 0.9) vs. 0.8 (−1.7, 1.0); P = 0.03]. One participant experienced transient nausea immediately after FMT, but no serious adverse events were attributed to FMT.Conclusion: FMT had no obvious effect on IAP and infectious complications in AP patients, though GI barrier indictors might be adversely affected. Further multi-centre studies are needed to confirm our findings. The study was registered at https://clinicaltrials.gov (NCT02318134).


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Jianquan He ◽  
Xingxiang He ◽  
Yonghui Ma ◽  
Luxi Yang ◽  
Haiming Fang ◽  
...  

Abstract Background Faecal microbiota transplantation (FMT) is an effective therapy for recurrent Clostridium difficile infections and chronic gastrointestional infections. However, the risks of FMT and the selection process of suitable donors remain insufficiently characterized. The eligibility rate for screening, underlying microbial basis, and core ethical issues of stool donors for FMT are yet to be elucidated in China. Results The potential stool donors were screened from December 2017 to December 2019 with the help of an online survey, clinical assessments, and stool and blood testing. Bioinformatics analyses were performed, and the composition and stability of gut microbiota in stool obtained from eligible donors were dynamically observed using metagenomics. Meanwhile, we build a donor microbial evaluation index (DoMEI) for stool donor screening. In the screening process, we also focused on ethical principles and requirements. Of the 2071 participants, 66 donors were selected via the screening process (3.19% success rate). Although there were significant differences in gut microbiota among donors, we found that the changes in the gut microbiota of the same donor were typically more stable than those between donors over time. Conclusions DoMEI provides a potential reference index for regular stool donor re-evaluation. In this retrospective study, we summarised the donor recruitment and screening procedure ensuring the safety and tolerability for FMT in China. Based on the latest advances in this field, we carried out rigorous recommendation and method which can assist stool bank and clinicians to screen eligible stool donor for FMT.


2021 ◽  
Author(s):  
Nanyang Liu ◽  
Tingting Zhang ◽  
Jiahui Sun ◽  
Jianhua Fu ◽  
Hao Li

INTRODUCTION: Faecal microbiota transplantation (FMT) therapeutic strategy has been associated with positive outcomes in multiple diseases. We conducted an umbrella review of the meta-analysis to summarize the available evidence and assess its credibility. METHODS: We evaluated a meta-analysis of randomized controlled trials that investigated the efficacy and safety of FMT for any condition. We used the random-effects model to obtain estimates and corresponding 95% confidence intervals, heterogeneity estimates, and small-study effects. We used AMSTAR 2 to assess methodological quality and GRADE tools to grade the evidence. RESULTS: Seven meta-analyses with a total of 33 outcomes were included in the current umbrella review to evaluate the efficacy and safety of FMT. Overall, there is a moderate certainty of evidence supporting the associations of the use of FMT with better clinical remission in patients with Clostridium difficile infection (RR = 1.74; 95% CI: 1.37-2.22) and inflammatory bowel disease (RR = 1.70; 95% CI: 1.12-2.56). A very low certainty evidence supports the use of FMT to treat antibiotic-resistant bacteria (RR = 5.67; 95% CI: 2.20-14.63) and functional constipation (RR = 1.35; 95% CI: 1.14-1.60) but does not support irritable bowel syndrome (RR = 1.08; 95% CI: 0.65-1.77). DISCUSSION: The umbrella review of the current meta-analysis demonstrates that FMT intervention is associated with positive outcomes for several diseases. However, the credibility of the evidence is not high. Further high-quality randomized controlled trials should be carried out to improve the strength and credibility of the evidence base.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julie Kristine Knudsen ◽  
Thomas Yssing Michaelsen ◽  
Caspar Bundgaard-Nielsen ◽  
René Ernst Nielsen ◽  
Simon Hjerrild ◽  
...  

AbstractDifferences in gut microbiota composition have been observed in patients with major depressive disorder (MDD) compared to healthy individuals. Here, we investigated if faecal microbiota transplantation (FMT) from patients with MDD into rats could induce a depressive-like phenotype. We performed FMT from patients with MDD (FMT-MDD) and healthy individuals (FMT-Healthy) into male Flinders Sensitive Line (FSL) and Flinders Resistant Line (FRL) rats and assessed depressive-like behaviour. No behavioural differences were observed in the FSL rats. In FRL rats, the FMT-Healthy group displayed significantly less depressive-like behaviour than the FMT-MDD group. However, there was no difference in behaviour between FMT-MDD FRL rats and negative controls, indicating that FMT-Healthy FRL rats received beneficial bacteria. We additionally found different taxa between the FMT-MDD and the FMT-Healthy FRL rats, which could be traced to the donors. Four taxa, three belonging to the family Ruminococcaceae and the genus Lachnospira, were significantly elevated in relative abundance in FMT-MDD rats, while the genus Coprococcus was depleted. In this study, the FMT-MDD group was different from the FMT-Healthy group based on behaviour and intestinal taxa.


2021 ◽  
Author(s):  
Thomas SB Schmidt ◽  
Simone S Li ◽  
Oleksandr M Maistrenko ◽  
Wasiu Akanni ◽  
Luis Pedro Coelho ◽  
...  

AbstractFaecal microbiota transplantation (FMT) is an efficacious therapeutic intervention, but its clinical mode of action and underlying microbiome dynamics remain poorly understood. Here, we analysed the metagenomes associated with 142 FMTs, in a time series-based meta-study across five disease indications. We quantified strain-level dynamics of 1,089 microbial species based on their pangenome, complemented with 47,548 newly constructed metagenome-assembled genomes. Using subsets of procedural-, host- and microbiome-based variables, LASSO-regularised regression models accurately predicted the colonisation and resilience of donor and recipient microbes, as well as turnover of individual species. Linking this to putative ecological mechanisms, we found these sets of variables to be informative of the underlying processes that shape the post-FMT gut microbiome. Recipient factors and complementarity of donor and recipient microbiomes, encompassing entire communities to individual strains, were the main determinants of individual strain population dynamics, and mostly independent of clinical outcomes. Recipient community state and the degree of residual strain depletion provided a neutral baseline for donor strain colonisation success, in addition to inhibitive priority effects between species and conspecific strains, as well as putatively adaptive processes. Our results suggest promising tunable parameters to enhance donor flora colonisation or recipient flora displacement in clinical practice, towards the development of more targeted and personalised therapies.


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