Department of Gastroenterology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Institute for Microbial Ecology, School of Medicine, Xiamen University, Xiamen, China.
Microbiol Spectr. 2023 Jun 15;11(3):e0415222. doi: 10.1128/spectrum.04152-22. Epub 2023 Apr 24.
Fecal microbiota transplantation (FMT) can induce clinical remission in ulcerative colitis (UC) patients. Enemas, nasoduodenal tubes, and colonoscopies are the most common routes for FMT administration. However, there is a lack of definitive evidence regarding the effectiveness of capsulized FMT treatment in UC patients. In this study, we administered capsulized FMT to 22 patients with active UC to assess the efficiency of capsulized FMT and determine the specific bacteria and metabolite factors associated with the response to clinical remission. Our results showed that the use of capsulized FMT was successful in the treatment of UC patients. Capsulized FMT induced clinical remission and clinical response in 57.1% (12 of 21) and 76.2% (16 of 21) of UC patients, respectively. Gut bacterial richness was increased after FMT in patients who achieved remission. Patients in remission after FMT exhibited enrichment of sp. and Odoribacter splanchnicus, along with increased levels of indolelactic acid. Patients who did not achieve remission exhibited enrichment of Escherichia coli and Klebsiella and increased levels of biosynthesis of 12,13-DiHOME (12,13-dihydroxy-9Z-octadecenoic acid) and lipopolysaccharides. Furthermore, we identified a relationship between specific bacteria and metabolites and the induction of remission in patients. These findings may provide new insights into FMT in UC treatment and provide reference information about therapeutic microbial manipulation of FMT to enhance its effects. (This study has been registered at ClinicalTrails.gov under registration no. NCT03426683). Fecal microbiota transplantation has been successfully used in patients. Recently, capsulized FMT was reported to induce a response in patients with UC. However, limited patients were enrolled in such studies, and the functional factors of capsulized FMT have not been reported in the remission of patients with UC. In this study, we prospectively recruited patients with UC to receive capsulized FMT. First, we found that capsulized FMT could induce clinical remission in 57.1% of patients and clinical response in 76.2% after 12 weeks, which was more acceptable. Second, we found a relationship between the decrease of opportunistic pathogen and lipopolysaccharide synthesis in patients in remission after capsulized FMT. We also identified an association between specific bacteria and metabolites and remission induction in patients after capsulized FMT. These findings put forward a possibility for patients to receive FMT at home and provide reference information about therapeutic microbial manipulation of FMT to enhance its effects.
粪便微生物群移植（FMT）可诱导溃疡性结肠炎（UC）患者临床缓解。灌肠、鼻十二指肠管和结肠镜检查是 FMT 给药最常用的途径。然而，关于 UC 患者胶囊化 FMT 治疗的有效性仍缺乏明确证据。在这项研究中，我们给 22 名活动期 UC 患者施用胶囊化 FMT，以评估胶囊化 FMT 的疗效，并确定与临床缓解相关的特定细菌和代谢物因素。我们的研究结果表明，胶囊化 FMT 成功治疗了 UC 患者。在接受 FMT 的 21 名 UC 患者中，57.1%（12 名）和 76.2%（16 名）分别实现了临床缓解和临床反应。FMT 后，缓解患者的肠道细菌丰富度增加。FMT 后缓解的患者中， sp. 和 Odoribacter splanchnicus 的丰度增加，吲哚乳酸水平升高。未缓解的患者中，大肠杆菌和克雷伯氏菌丰度增加，12,13-DiHOME（12,13-二羟基-9Z-十八碳烯酸）和脂多糖的生物合成增加。此外，我们还发现了特定细菌和代谢物与患者缓解诱导之间的关系。这些发现可能为 UC 治疗中的 FMT 提供新的见解，并为 FMT 的治疗性微生物操作提供参考信息，以增强其效果。（本研究已在 ClinicalTrails.gov 注册，注册号为 NCT03426683）。FMT 已成功用于患者。最近，有报道称胶囊化 FMT 可诱导 UC 患者产生反应。然而，此类研究纳入的患者有限，且 UC 患者缓解的胶囊化 FMT 的功能因素尚未报道。在这项研究中，我们前瞻性招募 UC 患者接受胶囊化 FMT。首先，我们发现胶囊化 FMT 可在 12 周后诱导 57.1%的患者临床缓解和 76.2%的临床反应，这更为可接受。其次，我们发现胶囊化 FMT 后缓解患者的机会性病原体减少与脂多糖合成之间存在关系。我们还发现了胶囊化 FMT 后患者中特定细菌和代谢物与缓解诱导之间的关联。这些发现为患者在家中接受 FMT 提供了一种可能性，并为 FMT 的治疗性微生物操作提供了参考信息，以增强其效果。
