Fecal microbiota transplantation in the treatment of irritable bowel syndrome: a single-center prospective study in Japan.
Fecal microbiota transplantation
Gastrointestinal endoscopy
Irritable bowel syndrome
Microbiome
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
14 Jul 2022
14 Jul 2022
Historique:
received:
16
06
2021
accepted:
29
06
2022
entrez:
14
7
2022
pubmed:
15
7
2022
medline:
19
7
2022
Statut:
epublish
Résumé
Fecal microbiota transplantation (FMT) is a potential treatment for irritable bowel syndrome (IBS), but its efficacy in Japanese IBS patients is unknown. This study aimed to evaluate the efficacy, side effects, and microbiome changes following FMT in Japanese IBS patients. Seventeen Japanese patients with refractory IBS received FMT (4 donors) under colonoscopy. Responders were defined by an improvement in the IBS severity index (IBS-SI) of 50 points or more after 12 weeks. We evaluated the IBS-SI and Bristol Stool Form Scale (BSFS) and compared the diversity and microbiome before and 12 weeks after FMT. For the microbiome, we analyzed the V3-V4 region of the 16S rRNA gene. IBS-SI decreased an average of 115.58 points after 12 weeks, and 10 patients (58.8%) were considered responders. Eight patients with diarrhea (66.7%) and three patients with constipation (60.0%) showed improvement in the BSFS. Two patients complained of mild abdominal pain, but there were no cases with severe side-effects. α-diversity was increased only in the responder group (p = 0.017). Patients who closely paralleled the donor microbiome had a higher rate of IBS-SI improvement. The relative abundance of Neisseria and Akkermansia increased and Desulfovibrio and Delftia were decreased in the responder group after FMT. Following FMT, about 60% of Japanese patients with IBS showed improvement in both the IBS-SI and BSFS, without severe side effects. Increased α-diversity and similarity to the donor microbiome after FMT may be associated with better treatment effects. This study was registered in the University Hospital Medical Information Network Clinical Trial Registration (UMIN000026363). Registered 31 May 2017, https://rctportal.niph.go.jp/s/detail/um?trial_id=UMIN000026363 . The study was registered prospectively.
Sections du résumé
BACKGROUND
BACKGROUND
Fecal microbiota transplantation (FMT) is a potential treatment for irritable bowel syndrome (IBS), but its efficacy in Japanese IBS patients is unknown. This study aimed to evaluate the efficacy, side effects, and microbiome changes following FMT in Japanese IBS patients.
METHODS
METHODS
Seventeen Japanese patients with refractory IBS received FMT (4 donors) under colonoscopy. Responders were defined by an improvement in the IBS severity index (IBS-SI) of 50 points or more after 12 weeks. We evaluated the IBS-SI and Bristol Stool Form Scale (BSFS) and compared the diversity and microbiome before and 12 weeks after FMT. For the microbiome, we analyzed the V3-V4 region of the 16S rRNA gene.
RESULTS
RESULTS
IBS-SI decreased an average of 115.58 points after 12 weeks, and 10 patients (58.8%) were considered responders. Eight patients with diarrhea (66.7%) and three patients with constipation (60.0%) showed improvement in the BSFS. Two patients complained of mild abdominal pain, but there were no cases with severe side-effects. α-diversity was increased only in the responder group (p = 0.017). Patients who closely paralleled the donor microbiome had a higher rate of IBS-SI improvement. The relative abundance of Neisseria and Akkermansia increased and Desulfovibrio and Delftia were decreased in the responder group after FMT.
CONCLUSIONS
CONCLUSIONS
Following FMT, about 60% of Japanese patients with IBS showed improvement in both the IBS-SI and BSFS, without severe side effects. Increased α-diversity and similarity to the donor microbiome after FMT may be associated with better treatment effects.
TRIAL REGISTRATION
BACKGROUND
This study was registered in the University Hospital Medical Information Network Clinical Trial Registration (UMIN000026363). Registered 31 May 2017, https://rctportal.niph.go.jp/s/detail/um?trial_id=UMIN000026363 . The study was registered prospectively.
Identifiants
pubmed: 35836115
doi: 10.1186/s12876-022-02408-5
pii: 10.1186/s12876-022-02408-5
pmc: PMC9284895
doi:
Substances chimiques
RNA, Ribosomal, 16S
0
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
342Subventions
Organisme : the japan society for the promotion of science
ID : 16K09406
Informations de copyright
© 2022. The Author(s).
Références
Handb Exp Pharmacol. 2015;230:217-30
pubmed: 26162837
Eur J Pediatr. 2015 Feb;174(2):151-67
pubmed: 25563215
Appl Environ Microbiol. 2006 Jul;72(7):5069-72
pubmed: 16820507
Bioinformatics. 2010 Oct 1;26(19):2460-1
pubmed: 20709691
United European Gastroenterol J. 2019 Oct;7(8):1033-1041
pubmed: 31662860
World J Gastroenterol. 2021 May 14;27(18):2219-2237
pubmed: 34025075
Lancet Gastroenterol Hepatol. 2019 Sep;4(9):675-685
pubmed: 31326345
Genome Biol. 2011 Jun 24;12(6):R60
pubmed: 21702898
Expert Rev Gastroenterol Hepatol. 2015;9(9):1161-74
pubmed: 26162959
Psychosom Med. 2017 Oct;79(8):857-867
pubmed: 28422780
Gut. 2017 Apr;66(4):569-580
pubmed: 28087657
Methods Enzymol. 2013;531:371-444
pubmed: 24060131
Nat Med. 2019 Jul;25(7):1096-1103
pubmed: 31263284
Gastroenterology. 2021 Jan;160(1):145-157.e8
pubmed: 32681922
Neurogastroenterol Motil. 2015 Jan;27(1):19-29
pubmed: 25424663
Front Cell Infect Microbiol. 2019 Jan 21;9:2
pubmed: 30719428
Digestion. 2017;96(1):29-38
pubmed: 28628918
Exp Mol Med. 2018 Feb 23;50(2):e450
pubmed: 29472701
PLoS One. 2016 Aug 16;11(8):e0161174
pubmed: 27529553
mBio. 2014 Jun 17;5(3):e00893-14
pubmed: 24939885
Neurogastroenterol Motil. 2014 Jul;26(7):1036-48
pubmed: 24796536
Aliment Pharmacol Ther. 2020 Jun;51(12):1321-1331
pubmed: 32343000
Aliment Pharmacol Ther. 2003 Oct 1;18(7):671-82
pubmed: 14510740
Digestion. 2019;100(2):127-138
pubmed: 30423561
Neurogastroenterol Motil. 2021 Nov;33(11):e14157
pubmed: 34236740
Gut. 2020 May;69(5):859-867
pubmed: 31852769
Lancet Gastroenterol Hepatol. 2018 Jan;3(1):17-24
pubmed: 29100842
World J Gastroenterol. 2014 Mar 14;20(10):2470-81
pubmed: 24627584
J Clin Pharm Ther. 2018 Oct;43(5):752-756
pubmed: 30014556
Clin Transl Gastroenterol. 2019 Apr;10(4):e00034
pubmed: 31009405
Gastroenterology. 2000 Sep;119(3):654-60
pubmed: 10982758
Aliment Pharmacol Ther. 2015 Feb;41(4):342-51
pubmed: 25521822
Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Jul 10;23(Z1):48-55
pubmed: 32594726
Clin Gastroenterol Hepatol. 2019 Jan;17(2):322-332
pubmed: 30292888
Gastroenterology. 2014 May;146(6):1500-12
pubmed: 24583088
Dig Dis Sci. 2004 Jun;49(6):1046-53
pubmed: 15309899
Mol Pain. 2015 May 02;11:24
pubmed: 25934637
N Engl J Med. 2013 Jan 31;368(5):407-15
pubmed: 23323867
Nat Rev Gastroenterol Hepatol. 2015 Jan;12(1):36-49
pubmed: 25446728
Aliment Pharmacol Ther. 1997 Apr;11(2):395-402
pubmed: 9146781
Curr Opin Gastroenterol. 2017 Jan;33(1):8-13
pubmed: 28134687
Aliment Pharmacol Ther. 2012 Apr;35(7):828-38
pubmed: 22315951
Circulation. 2016 Jun 14;133(24):2434-46
pubmed: 27143680
Am J Gastroenterol. 2010 Nov;105(11):2420-8
pubmed: 20648002
J Clin Med. 2018 Sep 22;7(10):
pubmed: 30248988
DNA Res. 2016 Apr;23(2):125-33
pubmed: 26951067
Nat Methods. 2010 May;7(5):335-6
pubmed: 20383131
Neurogastroenterol Motil. 2011 Mar;23(3):249-54
pubmed: 21122032
J Dig Dis. 2019 Aug;20(8):401-408
pubmed: 31070838
World J Gastroenterol. 2015 Jul 7;21(25):7621-36
pubmed: 26167065
Microb Ecol Health Dis. 2015 Feb 02;26:26191
pubmed: 25651997
Curr Gastroenterol Rep. 2017 Apr;19(4):15
pubmed: 28374308
Hepatol Int. 2019 Mar;13(2):234-244
pubmed: 30737678
BMC Med. 2016 Oct 11;14(1):155
pubmed: 27724956
Nucleic Acids Res. 2017 Jul 3;45(W1):W180-W188
pubmed: 28449106
Proc Natl Acad Sci U S A. 2013 May 28;110(22):9066-71
pubmed: 23671105
Gut. 2018 Dec;67(12):2107-2115
pubmed: 29980607
Expert Rev Gastroenterol Hepatol. 2018 May;12(5):439-445
pubmed: 29493330
Gastroenterology. 2016 Feb 18;:
pubmed: 27144627
J Gastroenterol Hepatol. 2010 Jun;25(6):1151-6
pubmed: 20594232