Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, United States of America.
Department of Clinical Sciences, Carlson College of Veterinary Medicine at Oregon State University, Corvallis, Oregon, United States of America.
PLoS One. 2021 Jan 14;16(1):e0244381. doi: 10.1371/journal.pone.0244381. eCollection 2021.
BACKGROUND AND AIMS: Fecal microbial transplantation (FMT) is empirically implemented in horses with colitis to facilitate resolution of diarrhea. The purpose of this study was to assess FMT as a clinical treatment and modulator of fecal microbiota in hospitalized horses with colitis. METHODS: A total of 22 horses with moderate to severe diarrhea, consistent with a diagnosis of colitis, were enrolled at two referral hospitals (L1: n = 12; L2: n = 10). FMT was performed in all 12 patients on 3 consecutive days at L1, while treatment at L2 consisted of standard care without FMT. Manure was collected once daily for 4 days from the rectum in all colitis horses, prior to FMT for horses at L1, and from each manure sample used for FMT. Fecal samples from 10 clinically healthy control horses housed at L2, and 30 healthy horses located at 5 barns in regional proximity to L1 were also obtained to characterize the regional healthy equine microbiome. All fecal microbiota were analyzed using 16S amplicon sequencing. RESULTS AND CONCLUSIONS: As expected, healthy horses at both locations showed a greater α-diversity and lower β-diversity compared to horses with colitis. The fecal microbiome of healthy horses clustered by location, with L1 horses showing a higher prevalence of Kiritimatiellaeota. Improved manure consistency (lower diarrhea score) was associated with a greater α-diversity in horses with colitis at both locations (L1: r = -0.385, P = 0.006; L2: r = -0.479, P = 0.002). Fecal transplant recipients demonstrated a greater overall reduction in diarrhea score (median: 4±3 grades), compared to untreated horses (median: 1.5±3 grades, P = 0.021), with a higher incidence in day-over-day improvement in diarrhea (22/36 (61%) vs. 10/28 (36%) instances, P = 0.011). When comparing microbiota of diseased horses at study conclusion to that of healthy controls, FMT-treated horses showed a lower mean UniFrac distance (0.53±0.27) than untreated horses (0.62±0.26, P<0.001), indicating greater normalization of the microbiome in FMT-treated patients.
背景和目的：粪菌移植（FMT）在患有结肠炎的马中被经验性地应用，以促进腹泻的缓解。本研究的目的是评估 FMT 作为一种临床治疗方法和调节患有结肠炎的住院马粪便微生物群的方法。
方法：共有 22 匹患有中度至重度腹泻的马，符合结肠炎的诊断，在两家转诊医院（L1：n=12；L2：n=10）入组。在 L1 对所有 12 例患者连续 3 天进行 FMT，而 L2 的治疗则是标准护理而不进行 FMT。在 L1 的所有结肠炎马中，每天从直肠采集粪便样本一次，共 4 天，用于 FMT 的粪便样本也来自每个粪便样本。还从 L2 收容的 10 匹临床健康对照马和距离 L1 5 个马厩附近的 30 匹健康马中采集粪便样本，以确定该地区健康马的微生物组。使用 16S 扩增子测序分析所有粪便微生物群。
结果与结论：如预期的那样，两个地点的健康马与结肠炎马相比，α多样性更高，β多样性更低。健康马的粪便微生物群按位置聚类，L1 马的 Kiritimatiellaeota 检出率更高。结肠炎马的粪便微生物α多样性与粪便稠度的改善（腹泻评分降低）呈正相关，两个地点的结果均一致（L1：r=-0.385，P=0.006；L2：r=-0.479，P=0.002）。与未接受治疗的马相比（中位数：1.5±3 级，P=0.021），接受粪便移植的马腹泻评分总体下降更大（中位数：4±3 级），且腹泻改善的日增长率更高（22/36（61%）比 10/28（36%），P=0.011）。在研究结束时将患病马的微生物群与健康对照进行比较时，FMT 治疗的马的平均 UniFrac 距离（0.53±0.27）低于未治疗的马（0.62±0.26，P<0.001），表明 FMT 治疗的患者的微生物群更趋于正常化。
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