Department of Gastroenterology and Hepatology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China.
Department of Gastroenterology and Hepatology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou 510180, China.
Oxid Med Cell Longev. 2022 Sep 21;2022:5121496. doi: 10.1155/2022/5121496. eCollection 2022.
Fecal microbiota transplantation (FMT) has been found to be effective in irritable bowel syndrome with predominant diarrhea (IBS-D). We conducted this study to determine the impact of a low FODMAP diet (LFD) on the gut microbiota and the efficacy of FMT in the treatment of IBS-D.
A retrospective analysis of a single-arm open-label prospective study was conducted to investigate the impact of FMT alone ( = 40) and FMT+LFD ( = 40) in refractory IBS-D. The IBS-quality of life (QOL), IBS-severity scoring system (SSS), gastrointestinal symptom rating scale (GSRS), Hamilton anxiety scale (HAMA), and Hamilton depression scale (HAMD) were used to evaluate the efficacy, and partial 16S rDNA amplicon sequencing was used to profile the microbiota.
The response rates were higher in the FMT+LFD group than in the FMT group (1 mo, 3 mo, 6 mo: 70.0% vs. 55.0%, 67.5% vs. 57.5%, 62.5% vs. 27.5%, respectively). The FMT+LFD group showed significantly better improvement in IBS-QOL at 1, 3, and 6 months; IBS-SSS at 6 months; and GSRS at 1 month compared to FMT alone. Changes in HAMA and HAMD were similar in the two groups. The LFD significantly upregulated the FMT-induced microbial diversity (OTUs: 666 vs. 574, Adonis: = 0.02) and significantly strengthened the upregulation of , , and and the downregulation of .
An LFD enhanced the efficacy of FMT, increased the gut microbial diversity after FMT, and strengthened the inhibitory effect of FMT on conditional pathogens.
粪便微生物群移植（FMT）已被证明对以腹泻为主的肠易激综合征（IBS-D）有效。我们进行这项研究是为了确定低 FODMAP 饮食（LFD）对肠道微生物群的影响以及 FMT 在治疗 IBS-D 中的疗效。
对一项单臂开放标签前瞻性研究进行回顾性分析，以研究单独 FMT（n=40）和 FMT+LFD（n=40）对难治性 IBS-D 的影响。采用 IBS 生活质量（QOL）、IBS 严重程度评分系统（SSS）、胃肠道症状评分量表（GSRS）、汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评估疗效，并采用部分 16S rDNA 扩增子测序对微生物组进行分析。
FMT+LFD 组的应答率高于 FMT 组（1 个月、3 个月、6 个月：70.0% vs. 55.0%、67.5% vs. 57.5%、62.5% vs. 27.5%）。FMT+LFD 组在 1、3 和 6 个月时 IBS-QOL 显著改善；6 个月时 IBS-SSS；1 个月时 GSRS 也显著改善。与单独 FMT 相比，FMT+LFD 组 HAMA 和 HAMD 的变化相似。LFD 显著上调了 FMT 诱导的微生物多样性（OTUs：666 对 574，Adonis：=0.02），并显著增强了 、 、 和 的上调和 的下调。
LFD 增强了 FMT 的疗效，增加了 FMT 后肠道微生物多样性，并增强了 FMT 对条件致病菌的抑制作用。
