Günaltay Sezin, Rademacher Lech, Hultgren Hörnquist Elisabeth, Bohr Johan
Sezin Günaltay, Elisabeth Hultgren Hörnquist, Johan Bohr, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, SE-70185 Örebro, Sweden.
World J Gastroenterol. 2017 Feb 21;23(7):1319-1324. doi: 10.3748/wjg.v23.i7.1319.
One to six percent of patients with microscopic colitis are refractory to medical treatment. The effect of faecal microbiota transplantation (FMT) in active collagenous colitis (CC) has, to the best of our knowledge, never been reported before. Here, we report the effect of repeated FMT in a patient with CC. The patient presented with severe symptoms including profuse diarrhea and profound weight loss. Although she responded to budesonide in the beginning, she became gradually refractory to medical treatment, and was therefore treated with FMT. The patient remained in remission for 11 mo after the third faecal transplantation. The immunomodulatory effect of the therapy was evaluated using flow cytometry, which showed alterations in the profile of intraepithelial and lamina propria lymphocyte subsets after the second transplantation. Our observations indicate that FMT can have an effect in CC, which support the hypothesis that luminal factors, influencing the intestinal microbiota, are involved in the pathogenesis of CC.
1%至6%的显微镜下结肠炎患者对药物治疗无效。据我们所知,粪便微生物群移植(FMT)在活动性胶原性结肠炎(CC)中的效果此前从未有过报道。在此,我们报告了FMT对一名CC患者的疗效。该患者出现严重症状,包括大量腹泻和体重显著减轻。尽管她起初对布地奈德有反应,但逐渐对药物治疗产生耐药性,因此接受了FMT治疗。在第三次粪便移植后,该患者缓解了11个月。使用流式细胞术评估了该疗法的免疫调节作用,结果显示第二次移植后上皮内和固有层淋巴细胞亚群的分布发生了变化。我们的观察结果表明,FMT对CC可能有效,这支持了影响肠道微生物群的腔内因素参与CC发病机制的假说。