Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Pediatric Division and Center for Microbiome Research, Shamir Medical Center, Be'er Ya'akov, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Eur J Intern Med. 2021 Oct;92:17-23. doi: 10.1016/j.ejim.2021.03.038. Epub 2021 Apr 19.
We recently reported that autologous fecal microbiota transplantation (aFMT), derived from the time of maximal weight-loss and administrated in the regain-phase, might preserve weight loss and glycemic control in moderately obese subjects, and is associated with specific microbiome signatures. Here, we sought to explore the global effect of aFMT on adipokines, inflammatory markers and blood cholesterol and on the overall gut microbiome preservation.
In the DIRECT-PLUS weight-loss trial, abdominally obese participants were randomized to three distinct weight-loss diets. Following the expected weight loss phase (0-6 m), 90 participants were randomized to receive their personal frozen fecal microbiota or placebo oral capsules (ten 1 g-capsules over ten sessions-total=100 g) during the expected weight regain phase (8-14 m).
Of the 90 participants (age=52 yr; 0-6 m weight loss=-8.3 kg), 95.6% ingested at least 80/100 oral aFMT/placebo capsules over 6 months. Overall, the gut microbiome community structure was associated with plasma levels of leptin, cholesterol and interleukin-6 at baseline and after 6 m, whereas 6 m (weight loss phase) changes in specific microbiome species associated with the dynamic of leptin and inflammatory biomarkers. Following the 8-14 m aFMT administration phase, aFMT maintained decreased levels of leptin (ΔaFMT=-3.54 ng/mL vs. Δplacebo=-0.82 ng/mL;P = 0.04), C-reactive-protein (ΔaFMT=-1.45 mg/L vs. Δplacebo=-0.66 mg/L;P = 0.009), Interleukin-6 (ΔaFMT=-0.03pg/mL vs. Δplacebo=1.11pg/mL;P = 0.03) and total cholesterol (ΔaFMT=2.2 mg/dl vs. Δplacebo=13.1 mg/dl;P = 0.04) achieved in the weight loss phase. Overall, aFMT induced a significant preservatory effect on personal gut microbiome global composition (P = 0.03;Jensen-Shannon distance), as compared to placebo.
aFMT treatment in the regain phase might retain weight-loss induced metabolic benefits. These findings may suggest a novel aFMT treatment approach for personal metabolic attainment preservation.
我们最近报道称，源自最大减重时期并在体重回升期给予的自体粪菌移植（aFMT）可能有助于保持中度肥胖受试者的减重和血糖控制，并与特定的微生物组特征相关。在此，我们试图探索 aFMT 对脂肪因子、炎症标志物和血液胆固醇的整体影响，以及对整体肠道微生物组的保存作用。
在 DIRECT-PLUS 减重试验中，腹部肥胖参与者被随机分为三种不同的减重饮食。在预期的体重减轻阶段（0-6 个月）之后，90 名参与者被随机分配接受他们个人的冷冻粪便微生物群或安慰剂口服胶囊（十次每次 1 克胶囊共 100 克）在预期的体重回升阶段（8-14 个月）。
在 90 名参与者中（年龄=52 岁；0-6 个月体重减轻=-8.3 公斤），95.6%至少摄入了 80/100 个口服 aFMT/安慰剂胶囊 6 个月。总体而言，肠道微生物组群落结构与基线和 6 个月时的瘦素、胆固醇和白细胞介素-6 水平相关，而 6 个月（体重减轻阶段）特定微生物物种的变化与瘦素和炎症生物标志物的动态相关。在 8-14 个月的 aFMT 给药阶段之后，aFMT 维持了瘦素水平的降低（ΔaFMT=-3.54ng/mL 与 Δplacebo=-0.82ng/mL；P=0.04）、C 反应蛋白（ΔaFMT=-1.45mg/L 与 Δplacebo=-0.66mg/L；P=0.009）、白细胞介素-6（ΔaFMT=-0.03pg/mL 与 Δplacebo=1.11pg/mL；P=0.03）和总胆固醇（ΔaFMT=2.2mg/dl 与 Δplacebo=13.1mg/dl；P=0.04），这些在减重阶段都达到了。总体而言，与安慰剂相比，aFMT 对个人肠道微生物组的整体组成产生了显著的保存效果（P=0.03；Jensen-Shannon 距离）。
在回升期给予 aFMT 治疗可能会保留减重诱导的代谢益处。这些发现可能提示了一种新的针对个人代谢实现保存的 aFMT 治疗方法。
