Fecal microbiota transplantation through mid-gut for refractory Crohn's disease: Safety, feasibility, and efficacy trial results
Top Cited Papers
- 27 August 2014
- journal article
- research article
- Published by Wiley in Journal of Gastroenterology and Hepatology
- Vol. 30 (1), 51-58
- https://doi.org/10.1111/jgh.12727
Abstract
Background and Aim The gut microbiota plays a pivotal role in the intestinal diseases. Fecal microbiota transplantation (FMT) might be a rescue therapy for refractory inflammatory bowel disease. This study aimed to evaluate the safety, feasibility, and efficacy of FMT through mid‐gut for refractory Crohn's disease (CD). Methods We established standardized laboratory protocol and clinical work flow for FMT. Only refractory CD patients with Harvey–Bradshaw Index (HBI) score ≥ 7 were enrolled for this study. All included patients were treated with single FMT through mid‐gut and assessed during follow‐up. Results Metagenomics analysis showed a high concordance between feces sample and purified fecal microbiota from same donors. Standardized fecal microbiota preparation and clinical flow significantly simplified the practical aspects of FMT. Totally, 30 patients were qualified for the present analysis. The rate of clinical improvement and remission based on clinical activity at the first month was 86.7% (26/30) and 76.7% (23/30), respectively, which was higher than other assessment points within 15‐month follow‐up. Patients' body weight increased after FMT, and the lipid profile improved as well. FMT also showed a fast and continuous significant effect in relieving the sustaining abdominal pain associated with sustaining CD. Conclusion This is a pilot study with the largest sample of patients with refractory CD who underwent single FMT. The results demonstrated that FMT through mid‐gut might be a safe, feasible, and efficient rescue therapy for refractory CD.Funding Information
- Intestine Initiative Foundation
- Clinical Science and Technology Foundation of Jiangsu Province (BL2014097)
- National Science and Technology Major Project (2012BAI06B03)
This publication has 28 references indexed in Scilit:
- Systematic review: faecal microbiota transplantation in the management of inflammatory bowel diseaseAlimentary Pharmacology & Therapeutics, 2012
- Host-Gut Microbiota Metabolic InteractionsScience, 2012
- Fecal microbiota transplantation and emerging applicationsNature Reviews Gastroenterology & Hepatology, 2011
- Therapeutic transplantation of the distal gut microbiotaMucosal Immunology, 2010
- Correlation Between the Crohn's Disease Activity and Harvey–Bradshaw Indices in Assessing Crohn's Disease SeverityClinical Gastroenterology and Hepatology, 2010
- A human gut microbial gene catalogue established by metagenomic sequencingNature, 2010
- Review article: the role of butyrate on colonic functionAlimentary Pharmacology & Therapeutics, 2007
- Molecular-phylogenetic characterization of microbial community imbalances in human inflammatory bowel diseasesProceedings of the National Academy of Sciences of the United States of America, 2007
- Serious Infections and Mortality in Association With Therapies for Crohn’s Disease: TREAT RegistryClinical Gastroenterology and Hepatology, 2006
- The management of refractory Crohn's diseaseAlimentary Pharmacology & Therapeutics, 2002