Department of Plant and Environmental Sciences, University of Copenhagen, Frederiksberg, Denmark.
Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
Gut Microbes. 2021 Jan-Dec;13(1):1-16. doi: 10.1080/19490976.2021.1927635.
Dysbiosis of the gut microbiome has been correlated with irritable bowel syndrome (IBS). Fecal microbiota transplantation (FMT) is being explored as a therapeutic option. Little is known of the mechanisms of engraftment of microbes following FMT and whether the engraftment of certain microbes correlate with clinical improvement in IBS. Microbiome data, from a previously reported placebo-controlled trial of treatment of IBS with FMT or placebo capsules, were used to investigate microbial engraftment 15 days, 1, 3 and 6 months after treatment through assessment of gains, losses and changes in abundance of amplicon sequence variants (ASVs) and microbial diversity (CHAO-1 richness) between the FMT group and the placebo group. These data were compared to changes in IBS Symptom Severity Scores (IBS-SSS). Twelve days of treatment with 25 daily multi-donor FMT capsules induced significant short- and long-term changes in the recipients' microbiomes for at least 6 months, with persistent engraftment of a variety of anaerobic bacteria from keystone genera, such as and and increased microbial diversity, particularly in patients with low initial diversity. FMT recipients lost ASVs after treatment, which was seen to a much lesser extent in the placebo group. No ASVs increased to a greater extent between FMT responders and non-responders following treatment. Major long-term changes, lasting for at least 6 months, in the gut microbiomes of IBS patients are seen following treatment with FMT capsules. None of these changes correlated with clinical improvement. The relationship between the microbiome and the etiology of IBS still remains unsolved.
肠道微生物组的失调与肠易激综合征(IBS)有关。粪便微生物群移植(FMT)正被探索作为一种治疗选择。关于 FMT 后微生物定植的机制知之甚少,也不知道定植的某些微生物是否与 IBS 的临床改善相关。使用先前报道的 FMT 或安慰剂胶囊治疗 IBS 的安慰剂对照试验的微生物组数据,通过评估 FMT 组和安慰剂组之间扩增子序列变体(ASV)和微生物多样性(CHAO-1 丰富度)的增益、损失和丰度变化,来研究微生物定植情况。这些数据与 IBS 症状严重程度评分(IBS-SSS)的变化进行了比较。12 天每天接受 25 个多供体 FMT 胶囊治疗可在至少 6 个月内诱导受者的微生物组发生显著的短期和长期变化,来自关键属的各种厌氧菌(如 和 )持续定植,微生物多样性增加,特别是在初始多样性较低的患者中。FMT 受者在治疗后丢失 ASV,而安慰剂组则较少发生这种情况。在治疗后,FMT 应答者和非应答者之间没有任何 ASV 增加到更大程度。IBS 患者的肠道微生物组在 FMT 胶囊治疗后发生了至少持续 6 个月的主要长期变化。这些变化均与临床改善无关。微生物组与 IBS 的病因之间的关系仍然没有解决。
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