Division of Critical Care Medicine, Department of Neurology, Department of Hospital Medicine, Inha University, Incheon, South Korea.
Division of Gastroenterology, Department of Internal Medicine, Department of Hospital Medicine, Inha University Hospital, Incheon, South Korea.
Curr Med Res Opin. 2021 Oct;37(10):1739-1744. doi: 10.1080/03007995.2021.1957807. Epub 2021 Aug 5.
After fecal microbiota transplantation (FMT) to treat infection (CDI), cognitive improvement is noticeable, suggesting an essential association between the gut microbiome and neural function. Although it is known that the gut microbiome is linked with cognitive function, whether FMT may lead to cognitive improvement in patients with neurodegenerative disorders remains to be elucidated. We present the case of a 90-year-old woman with Alzheimer's dementia and severe CDI who underwent FMT. Cognitive function testing (Mini-Mental State Examination, Montreal Cognitive Assessment, and Clinical Dementia Rating assessment) was performed one month before FMT and one week and one month after FMT. We collected the patients' fecal samples before FMT and 3 weeks after FMT to compare the microbiota composition. The 16S rRNA gene amplicons were analyzed using the QIIME2 platform (version 2020.2) and the Phyloseq R package. The linear discriminant analysis effect size was performed to determine the taxonomic difference between pre- and post-FMT. Functional biomarker analysis using the Kruskal-Wallis test was performed between the pre- and post-FMT. The cognitive function tests after FMT showed an improvement compared to the tests before the procedure. FMT changed the microbiota composition in recipient feces. We found that the genera were reported to be associated with cognitive function. In addition, short-chain fatty acids were found to be significantly different between before and after FMT. This finding suggests the presence of an association between the gut microbiome and cognitive function. Further, it emphasizes the need for clinical awareness regarding the effect of FMT on the brain-gut-microbiome axis and its potential as a therapy for patients with dementia.
在接受粪便微生物群移植（FMT）治疗 感染（CDI）后，认知能力得到显著改善，这表明肠道微生物群与神经功能之间存在着重要联系。虽然已知肠道微生物群与认知功能有关，但 FMT 是否能导致神经退行性疾病患者的认知改善仍有待阐明。我们报告了一例 90 岁女性阿尔茨海默病合并严重 CDI 患者接受 FMT 的案例。在 FMT 前一个月、FMT 后一周和一个月进行认知功能测试（简易精神状态检查、蒙特利尔认知评估和临床痴呆评定）。在 FMT 前和 FMT 后 3 周收集患者的粪便样本，以比较微生物群落组成。使用 QIIME2 平台（版本 2020.2）和 Phyloseq R 包分析 16S rRNA 基因扩增子。采用线性判别分析效应量确定 FMT 前后分类群的差异。采用 Kruskal-Wallis 检验对 FMT 前后的功能生物标志物进行分析。与治疗前相比，FMT 后的认知功能测试有所改善。FMT 改变了受体粪便中的微生物群落组成。我们发现，一些与认知功能有关的细菌属在 FMT 前后发生了变化。此外，FMT 前后短链脂肪酸也存在显著差异。这一发现表明肠道微生物群与认知功能之间存在关联。此外，它强调了需要临床关注 FMT 对脑-肠-微生物群轴的影响及其作为痴呆患者治疗的潜力。
