Clinical Utility and Alterations in Bacterial Flora in Fecal Microbiome Transplantation
Dysbiotic states of gut ecology can be altered directly by transplantation of fecal preparation from healthy donors to patients with therapeutic intent. This paper assesses this fecal microbiota transplantation (FMT) in two respects: (1) the bacterial shifts in patient microbiomes with FMT and (2) clinical outcomes and variables of FMT. The PubMed database was searched using the MeSH terms “Feces/microbiology,” “Microbiota,” and “Transplantation.” Thirteen papers found examined clinical outcomes and variables of FMT, and eight assessed metagenomic data and bacterial composition in the peri-FMT period. FMT was reported to have high cure rates in Clostridium difficile infection (CDI), generally increased levels of members of the phyla Bacteriodetes and Firmicutes, and decreased levels of members of Proteobacteria. Therapeutic FMT alters bacterial composition from a dysbiotic state pre-FMT to a healthy commensal state post-FMT in CDI patients, but further studies are necessary to understand its role in the treatment of other diseases
2. Song Y, Garg S, Girotra M, Maddox C, von Rosenvinge EC, Dutta A, et al. Microbiota dynamics in patients treated with fecal microbiota transplanta¬tion for recurrent Clostridium difficile infection. PLoS ONE. 2013;8(11):e81330.
3. Vrieze A, van Nood E, Holleman F, Salojärvi J, Kootte RS, Bartelsman JF, et al. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome. Gastroenterology. 2012 Oct;143(4):913–6.e7.
4. Kump PK, Gröchenig HP, Lackner S, Trajanoski S, Reicht G, Hoffmann KM, et al. Alteration of intestinal dysbiosis by fecal microbiota transplantation does not induce remission in patients with chronic active ulcerative colitis. Inflamm Bowel Dis. 2013 Sep;19(10):2155–65.
5. Colman RJ, Rubin DT. Fecal microbiota transplantation as therapy for in¬flammatory bowel disease: a systematic review and meta-analysis. J Crohns Colitis. 2014 Dec;8(12):1569–81.
6. Borody TJ, Campbell J, Torres M. Reversal of idiopathic thrombocytopenic purpura (ITP) with fecal microbiota transplantation (FMT) [abstract]. Am J Gastroenterol 2011; 106:S352.
7. Borody TJ, Nowak A, Torres M, Campbell J, Finlayson S, Leis S. Bacterio¬therapy in chronic fatigue syndrome: a retrospective review [abstract]. Am J Gastroenterol 2012; 107 (Suppl 1):S591–S592. (A1481).
8. Anathaswamy A. Fecal transplant eases symptoms of Parkinson’s. New Sci 2011;2796:8–9.
9. Borody TJ, Leis S, Campbell J. Fecal microbiota transplantation (FMT) in multiple sclerosis (MS) [abstract]. Am J Gastroenterol 2011; 106:S352.
10. Youngster I, Russell GH, Pindar C, Ziv-Baran T, Sauk J, Hohmann EL. Oral, capsulized, frozen fecal microbiota transplantation for relapsing Clostridium difficile infection. JAMA. 2014 Nov 5;312(17):1772–8.
11. Seekatz AM, Aas J, Gessert CE, Rubin TA, Saman DM, Bakken JS, et al. Recovery of the gut microbiome following fecal microbiota transplantation. MBio. 2014;5(3):e00893–00814.
12. Fuentes S, van Nood E, Tims S, Heikamp-de Jong I, ter Braak CJ, Keller JJ, et al. Reset of a critically disturbed microbial ecosystem: faecal transplant in recurrent Clostridium difficile infection. ISME J. 2014 Aug;8(8):1621–33.
13. Kelly CR, Ihunnah C, Fischer M, Khoruts A, Surawicz C, Afzali A, et al. Fecal microbiota transplant for treatment of Clostridium difficile infection in immunocompromised patients. Am J Gastroenterol. 2014 Jul;109(7):1065–71.
14. Gough E, Shaikh H, Manges AR. Systematic review of intestinal microbiota transplantation (fecal bacteriotherapy) for recurrent Clostridium difficile in¬fection. Clin Infect Dis. 2011 Nov;53(10):994–1002.
15. van Nood E, Vrieze A, Nieuwdorp M, Fuentes S, Zoetendal EG, de Vos WM, et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med. 2013 Jan 31;368(5):407–15.
16. Brandt LJ, Aroniadis OC, Mellow M, Kanatzar A, Kelly C, Park T, et al. Long-term follow-up of colonoscopic fecal microbiota transplant for recurrent Clostridium difficile infection. Am J Gastroenterol. 2012 Jul;107(7):1079–87.
17. Dutta SK, Girotra M, Garg S, Dutta A, von Rosenvinge EC, Maddox C, et al. Efficacy of combined jejunal and colonic fecal microbiota transplantation for recurrent Clostridium difficile Infection. Clin Gastroenterol Hepatol. 2014 Sep;12(9):1572–6.
18. Youngster I, Sauk J, Pindar C, Wilson RG, Kaplan JL, Smith MB, et al. Fecal microbiota transplant for relapsing Clostridium difficile infection using a frozen inoculum from unrelated donors: a randomized, open-label, contro¬lled pilot study. Clin Infect Dis. 2014 Jun;58(11):1515–22.
19. Russell GH, Kaplan JL, Youngster I, Baril-Dore M, Schindelar L, Hohmann E, et al. Fecal transplant for recurrent Clostridium difficile infection in children with and without inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2014 May;58(5):588–92.
20. Moayyedi P, Surette MG, Kim PT, Libertucci J, Wolfe M, Onischi C, et al. Fecal Microbiota Transplantation Induces Remission in Patients With Active Ulcerative Colitis in a Randomized Controlled Trial. Gastroenterology. 2015 Jul;149(1):102–9.e6.
21. Rossen NG, Fuentes S, van der Spek MJ, Tijssen JG, Hartman JH, Duflou A, et al. Findings From a Randomized Controlled Trial of Fecal Trans¬plantation for Patients With Ulcerative Colitis. Gastroenterology. 2015 Jul;149(1):110–8.
22. Kunde S, Pham A, Bonczyk S, Crumb T, Duba M, Conrad H Jr, et al. Safe¬ty, tolerability, and clinical response after fecal transplantation in children and young adults with ulcerative colitis. J Pediatr Gastroenterol Nutr. 2013 Jun;56(6):597–601.
23. Suskind DL, Singh N, Nielson H, Wahbeh G. Fecal microbial transplant via nasogastric tube for active pediatric ulcerative colitis. J Pediatr Gastroenterol Nutr. 2015 Jan;60(1):27–9.
24. Angelberger S, Reinisch W, Makristathis A, Lichtenberger C, Dejaco C, Pa¬pay P, et al. Temporal bacterial community dynamics vary among ulcerative colitis patients after fecal microbiota transplantation. Am J Gastroenterol. 2013 Oct;108(10):1620–30.
25. Shankar V, Hamilton MJ, Khoruts A, Kilburn A, Unno T, Paliy O, et al. Species and genus level resolution analysis of gut microbiota in Clostridium difficile patients following fecal microbiota transplantation. Microbiome. 2014;2:13.
26. Hamilton MJ, Weingarden AR, Unno T, Khoruts A, Sadowsky MJ. High-throu¬ghput DNA sequence analysis reveals stable engraftment of gut microbiota following transplantation of previously frozen fecal bacteria. Gut Microbes. 2013 Apr;4(2):125–35.
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