Changes in microbial ecology after fecal microbiota transplantation for recurrent C. difficile infection affected by underlying inflammatory bowel disease View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-05-15

AUTHORS

Sahil Khanna, Yoshiki Vazquez-Baeza, Antonio González, Sophie Weiss, Bradley Schmidt, David A. Muñiz-Pedrogo, John F. Rainey, Patricia Kammer, Heidi Nelson, Michael Sadowsky, Alexander Khoruts, Stefan L. Farrugia, Rob Knight, Darrell S. Pardi, Purna C. Kashyap

ABSTRACT

BackgroundGut microbiota play a key role in maintaining homeostasis in the human gut. Alterations in the gut microbial ecosystem predispose to Clostridium difficile infection (CDI) and gut inflammatory disorders such as inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) from a healthy donor can restore gut microbial diversity and pathogen colonization resistance; consequently, it is now being investigated for its ability to improve inflammatory gut conditions such as IBD. In this study, we investigated changes in gut microbiota following FMT in 38 patients with CDI with or without underlying IBD.ResultsThere was a significant change in gut microbial composition towards the donor microbiota and an overall increase in microbial diversity consistent with previous studies after FMT. FMT was successful in treating CDI using a diverse set of donors, and varying degrees of donor stool engraftment suggesting that donor type and degree of engraftment are not drivers of a successful FMT treatment of CDI. However, patients with underlying IBD experienced an increased number of CDI relapses (during a 24-month follow-up) and a decreased growth of new taxa, as compared to the subjects without IBD. Moreover, the need for IBD therapy did not change following FMT. These results underscore the importance of the existing gut microbial landscape as a decisive factor to successfully treat CDI and potentially for improvement of the underlying pathophysiology in IBD.ConclusionsFMT leads to a significant change in microbial diversity in patients with recurrent CDI and complete resolution of symptoms. Stool donor type (related or unrelated) and degree of engraftment are not the key for successful treatment of CDI by FMT. However, CDI patients with IBD have higher proportion of the original community after FMT and lack of improvement of their IBD symptoms and increased episodes of CDI on long-term follow-up. More... »

PAGES

55

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s40168-017-0269-3

DOI

http://dx.doi.org/10.1186/s40168-017-0269-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1085379331

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28506317


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28 schema:description BackgroundGut microbiota play a key role in maintaining homeostasis in the human gut. Alterations in the gut microbial ecosystem predispose to Clostridium difficile infection (CDI) and gut inflammatory disorders such as inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) from a healthy donor can restore gut microbial diversity and pathogen colonization resistance; consequently, it is now being investigated for its ability to improve inflammatory gut conditions such as IBD. In this study, we investigated changes in gut microbiota following FMT in 38 patients with CDI with or without underlying IBD.ResultsThere was a significant change in gut microbial composition towards the donor microbiota and an overall increase in microbial diversity consistent with previous studies after FMT. FMT was successful in treating CDI using a diverse set of donors, and varying degrees of donor stool engraftment suggesting that donor type and degree of engraftment are not drivers of a successful FMT treatment of CDI. However, patients with underlying IBD experienced an increased number of CDI relapses (during a 24-month follow-up) and a decreased growth of new taxa, as compared to the subjects without IBD. Moreover, the need for IBD therapy did not change following FMT. These results underscore the importance of the existing gut microbial landscape as a decisive factor to successfully treat CDI and potentially for improvement of the underlying pathophysiology in IBD.ConclusionsFMT leads to a significant change in microbial diversity in patients with recurrent CDI and complete resolution of symptoms. Stool donor type (related or unrelated) and degree of engraftment are not the key for successful treatment of CDI by FMT. However, CDI patients with IBD have higher proportion of the original community after FMT and lack of improvement of their IBD symptoms and increased episodes of CDI on long-term follow-up.
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35 schema:keywords CDI patients
36 CDI relapse
37 Clostridium difficile infection
38 ConclusionsFMT
39 FMT treatment
40 IBD symptoms
41 IBD therapy
42 ResultsThere
43 ability
44 alterations
45 bowel disease
46 changes
47 colonization resistance
48 community
49 complete resolution
50 composition
51 conditions
52 decisive factor
53 degree
54 degree of engraftment
55 difficile infection
56 disease
57 disorders
58 diverse set
59 diversity
60 donor microbiota
61 donor type
62 donors
63 drivers
64 ecology
65 engraftment
66 episodes
67 episodes of CDI
68 factors
69 fecal microbiota transplantation
70 growth
71 gut
72 gut conditions
73 gut microbial composition
74 gut microbial diversity
75 gut microbiota
76 healthy donors
77 higher proportion
78 homeostasis
79 human gut
80 importance
81 improvement
82 increase
83 increased number
84 infection
85 inflammatory bowel disease
86 inflammatory disorders
87 key
88 key role
89 lack
90 lack of improvement
91 landscape
92 microbial composition
93 microbial diversity
94 microbial ecology
95 microbial landscape
96 microbiota
97 microbiota transplantation
98 need
99 new taxon
100 number
101 original community
102 overall increase
103 pathogen colonization resistance
104 pathophysiology
105 patients
106 predispose
107 previous studies
108 proportion
109 recurrent Clostridium difficile infection
110 relapse
111 resistance
112 resolution
113 results
114 role
115 set
116 significant changes
117 study
118 subjects
119 successful treatment
120 symptoms
121 taxa
122 therapy
123 transplantation
124 treatment
125 types
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