Department of Medicine, Stord Hospital, Stord, Norway.
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Neurogastroenterol Motil. 2022 Sep;34(9):e14353. doi: 10.1111/nmo.14353. Epub 2022 Mar 18.
Fecal microbiota transplantation (FMT) interventions have recently been advocated to not succeed in every irritable bowel syndrome (IBS) patient, since the outcome of FMT varies with the IBS subset. This study investigated the factors potentially affecting FMT response using the same patient cohort used in our previous study.
This study included 109 patients who received allogenic FMT. Patients completed five questionnaires that assessed their symptoms and quality of life at baseline and at 2 weeks, 1 month, and 3 months after FMT. Patients also provided fecal samples at baseline and 1 month after FMT. The fecal bacterial profile and dysbiosis index (DI) were determined using 16S rRNA gene PCR DNA amplification covering variable genes V3-V9. Response to FMT was defined as a decrease of ≥50 points in the total IBS-SSS score after FMT.
An IBS patient's response or nonresponse to FMT was not determined by age, IBS duration, IBS subtype, IBS symptoms, fatigue, quality of life, or DI. There were more male nonresponders than responders, and the fluorescence signals of Alistipes were lower in nonresponders than in responders.
We concluded that IBS patients who are male and/or have low fecal Alistipes levels are most likely to not respond to FMT treatment. Whether low fecal Alistipes levels could be used as a marker for predicting the outcome of FMT remains to be determined. www.
gov (NCT03822299).
粪便微生物群移植（FMT）干预措施最近被提倡用于治疗并非所有肠易激综合征（IBS）患者，因为 FMT 的效果因 IBS 亚型而异。本研究使用我们之前研究中使用的相同患者队列，研究了可能影响 FMT 反应的因素。
本研究纳入了 109 名接受同种异体 FMT 的患者。患者在 FMT 前、FMT 后 2 周、1 个月和 3 个月时完成了 5 份评估症状和生活质量的问卷。患者还在 FMT 前和 FMT 后 1 个月提供了粪便样本。使用 16S rRNA 基因 PCR DNA 扩增覆盖可变基因 V3-V9 来确定粪便细菌谱和失调指数（DI）。将 FMT 后 IBS-SSS 总评分至少降低 50 分定义为 FMT 有反应。
FMT 对 IBS 患者的反应或无反应不受年龄、IBS 持续时间、IBS 亚型、IBS 症状、疲劳、生活质量或 DI 的影响。无反应者中男性多于有反应者，无反应者粪便中 Alistipes 的荧光信号低于有反应者。
我们得出结论，男性和/或粪便中 Alistipes 水平较低的 IBS 患者最不可能对 FMT 治疗有反应。粪便中 Alistipes 水平低是否可用作预测 FMT 效果的标志物仍有待确定。www.clinicaltrials.gov（NCT03822299）。
