Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China.
Nat Commun. 2018 Sep 10;9(1):3663. doi: 10.1038/s41467-018-06103-6.
Fecal microbiota transplantation (FMT) is effective in treating recurrent Clostridium difficile infection (CDI). Bacterial colonization in recipients after FMT has been studied, but little is known about the role of the gut fungal community, or mycobiota. Here, we show evidence of gut fungal dysbiosis in CDI, and that donor-derived fungal colonization in recipients is associated with FMT response. CDI is accompanied by over-representation of Candida albicans and decreased fungal diversity, richness, and evenness. Cure after FMT is associated with increased colonization of donor-derived fungal taxa in recipients. Recipients of successful FMT ("responders") display, after FMT, a high relative abundance of Saccharomyces and Aspergillus, whereas "nonresponders" and individuals treated with antibiotics display a dominant presence of Candida. High abundance of C. albicans in donor stool also correlates with reduced FMT efficacy. Furthermore, C. albicans reduces FMT efficacy in a mouse model of CDI, while antifungal treatment reestablishes its efficacy, supporting a potential causal relationship between gut fungal dysbiosis and FMT outcome.
粪便微生物群移植（FMT）在治疗复发性艰难梭菌感染（CDI）方面是有效的。在 FMT 后，已经对接受者中的细菌定植进行了研究，但对于肠道真菌群落或真菌群知之甚少。在这里，我们展示了 CDI 中肠道真菌失调的证据，并且供体衍生的真菌定植与 FMT 反应相关。CDI 伴随着白念珠菌的过度表达和真菌多样性、丰富度和均匀度的降低。FMT 后的治愈与接受者中供体衍生真菌分类群的定植增加有关。成功进行 FMT 的接受者（“应答者”）在 FMT 后显示出相对较高的酿酒酵母和曲霉的丰度，而“无应答者”和接受抗生素治疗的个体则表现出白色念珠菌的优势存在。供体粪便中白念珠菌的高丰度也与 FMT 疗效降低相关。此外，白色念珠菌降低了 CDI 小鼠模型中 FMT 的疗效，而抗真菌治疗使其疗效恢复，这支持了肠道真菌失调与 FMT 结果之间的潜在因果关系。
