Mizuno Shinta, Masaoka Tatsuhiro, Naganuma Makoto, Kishimoto Taishiro, Kitazawa Momoko, Kurokawa Shunya, Nakashima Moeko, Takeshita Kozue, Suda Wataru, Mimura Masaru, Hattori Masahira, Kanai Takanori
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Digestion. 2017;96(1):29-38. doi: 10.1159/000471919. Epub 2017 Jun 21.
BACKGROUND/AIMS: Dysbiosis is associated with various systemic disorders including irritable bowel syndrome (IBS). Fecal microbiota transplantation (FMT) might restore intestinal microbial balance. The study aimed to determine the safety and efficacy of FMT in IBS patients, as well as also positive predictors for FMT.
This was a single-arm, open-label study. Eligible patients were diagnosed based on Rome III Diagnostic Criteria. Fecal materials were administered to the patient via colonoscopy. The primary end point was a change in the Bristol stool form scale at 4 weeks after FMT. Recovery to types 3-4 was considered a clinical response. The secondary end point was a change in intestinal microbiota and psychological status using the Hamilton Rating Scale.
Ten patients were enrolled. Six patients achieved a clinical response. The diversity of patients 4 weeks after FMT increased significantly compared with patients before FMT, and that of responding patients was significantly higher than non-responder patients. The abundance of Bifidobacterium in effective donors was significantly higher than in ineffective donors and patients. Psychological status of all patients was significantly improved after FMT.
FMT for patients with IBS is safe, and relatively effective. Bifidobacterium-rich fecal donor may be a positive predictor for successful FMT. Key Summary: (1) Dysbiosis is associated with various gastrointestinal disorders including IBS. (2) FMT has potential to restore intestinal microbial balance. (3) We showed that FMT improved stool form and psychological status of IBS patients. (4) Bifidobacterium-rich donor efficiently induced symbiosis in IBS patients.
背景/目的：肠道菌群失调与包括肠易激综合征（IBS）在内的多种全身性疾病相关。粪便微生物群移植（FMT）可能恢复肠道微生物平衡。本研究旨在确定FMT对IBS患者的安全性和有效性，以及FMT的阳性预测指标。
这是一项单臂、开放标签研究。符合条件的患者根据罗马III诊断标准进行诊断。通过结肠镜检查将粪便材料给予患者。主要终点是FMT后4周布里斯托大便形态量表的变化。恢复到3-4型被认为是临床反应。次要终点是使用汉密尔顿评定量表评估肠道微生物群和心理状态的变化。
纳入10例患者。6例患者获得临床反应。FMT后4周患者的微生物多样性较FMT前显著增加，且有反应的患者显著高于无反应的患者。有效供体中双歧杆菌的丰度显著高于无效供体和患者。所有患者FMT后的心理状态均显著改善。
IBS患者接受FMT是安全且相对有效的。富含双歧杆菌的粪便供体可能是FMT成功的阳性预测指标。关键总结：（1）肠道菌群失调与包括IBS在内的多种胃肠道疾病相关。（2）FMT有恢复肠道微生物平衡的潜力。（3）我们表明FMT改善了IBS患者的大便形态和心理状态。（4）富含双歧杆菌的供体可有效诱导IBS患者的共生。
