A51 Effect of Lyophilized Sterile Fecal Filtrate vs Lyophilized Donor Stool on Recurrent Clostridium Difficile Infection (Rcdi): Preliminary Results From a Randomized, Double-Blind Pilot Study

Kao, Dina; Roach, Brandi; Walter, Jens; Löbenberg, Raimar; Wong, Karen

doi:10.1093/jcag/gwz006.050

Cited by 25 publications

(28 citation statements)

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“…In CD, contrasting results have been reported whereby one study reported increased clinical improvement and remission using fresh stool compared with frozen specimens,74 while a meta-analysis found no significant difference in clinical remission rates between fresh and frozen FMT preparations 75. These observations raise the question about whether viability of micro-organisms in frozen stools is important for FMT success; in a pilot study of four patients, lyophilised sterile faecal filtrates and whole stool achieved similar efficacy for rCDI 76…”

Section: Formulating Fmt Preparations and Delivery Proceduresmentioning

confidence: 97%

Scientific frontiers in faecal microbiota transplantation: joint document of Asia-Pacific Association of Gastroenterology (APAGE) and Asia-Pacific Society for Digestive Endoscopy (APSDE)

Kamm

Yeoh

et al. 2019

Gut

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ObjectiveThe underlying microbial basis, predictors of therapeutic outcome and active constituent(s) of faecal microbiota transplantation (FMT) mediating benefit remain unknown. An international panel of experts presented key elements that will shape forthcoming FMT research and practice.DesignSystematic search was performed, FMT literature was critically appraised and a 1-day round-table discussion was conducted to derive expert consensus on key issues in FMT research.Results16 experts convened and discussed five questions regarding (1) the role of donor and recipient microbial (bacteria, viruses, fungi) parameters in FMT; (2) methods to assess microbiota alterations; (3) concept of keystone species and microbial predictors of FMT, (4) influence of recipient profile and antibiotics pretreatment on FMT engraftment and maintenance and (5) new developments in FMT formulations and delivery. The panel considered that variable outcomes of FMT relate to compositional and functional differences in recipient’s microbiota, and likely donor-associated and recipient-associated physiological and genetic factors. Taxonomic composition of donor intestinal microbiota may influence the efficacy of FMT in recurrent Clostridioides difficile infections and UC. FMT not only alters bacteria composition but also establishes trans-kingdom equilibrium between gut fungi, viruses and bacteria to promote the recovery of microbial homeostasis. FMT is not a one size fits all and studies are required to identify microbial components that have specific effects in patients with different diseases.ConclusionFMT requires optimisation before their therapeutic promise can be evaluated for different diseases. This summary will guide future directions and priorities in advancement of the science and practice of FMT.

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Section: Formulating Fmt Preparations and Delivery Proceduresmentioning

confidence: 97%

Scientific frontiers in faecal microbiota transplantation: joint document of Asia-Pacific Association of Gastroenterology (APAGE) and Asia-Pacific Society for Digestive Endoscopy (APSDE)

Kamm

Yeoh

et al. 2019

Gut

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“…Recent data suggest that sterile fecal filtrate in which bacteria have been removed (but phages retained) can also effectively cure C. difficile infections [98,99]. Moreover, successful FMT was associated with the stable transfer of phages from donor to recipient [100][101][102].…”

Section: Fecal Microbiota Transplantation-focus On Viruses and Cancermentioning

confidence: 99%

The Roles of the Virome in Cancer

Broecker

Moelling

2021

Microorganisms

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Viral infections as well as changes in the composition of the intestinal microbiota and virome have been linked to cancer. Moreover, the success of cancer immunotherapy with checkpoint inhibitors has been correlated with the intestinal microbial composition of patients. The transfer of feces—which contain mainly bacteria and their viruses (phages)—from immunotherapy responders to non-responders, known as fecal microbiota transplantation (FMT), has been shown to be able to convert some non-responders to responders. Since phages may also increase the response to immunotherapy, for example by inducing T cells cross-reacting with cancer antigens, modulating phage populations may provide a new avenue to improve immunotherapy responsiveness. In this review, we summarize the current knowledge on the human virome and its links to cancer, and discuss the potential utility of bacteriophages in increasing the responder rate for cancer immunotherapy.

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“…A restored normal stool microbiome and CDI symptom elimination, including diarrhea, as well as longitudinal changes in the microbial and viral community in all 5 patients after FFT was observed [ 55 ]. Furthermore, Kao et al (2019) supported the observations of Ott et al (2017) on symptom elimination in CDI patients [ 57 ]. Kao et al (2019) presented the randomized, double-blind pilot study on the effect of lyophilized sterile fecal filtrate (LSSF) vs. lyophilized fecal microbiota transplantation (LFMT) on recurrent C. difficile infection (RCDI).…”

Section: Phages In Diseasesmentioning

confidence: 65%

“…The 75% (¾) patients of the LSFF and 80% (4/5) patients of the LFMT group was demonstrated the primary outcome of the therapy. The authors pointed out that this preliminary study shows that the clinical efficacy of FMT in rCDI therapy did not depend on the presence of live microbes in the donor stool [ 57 ].…”

Section: Phages In Diseasesmentioning

confidence: 99%

The Presence of Bacteriophages in the Human Body: Good, Bad or Neutral?

et al. 2020

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The presence of bacteriophages (phages) in the human body may impact bacterial microbiota and modulate immunity. The role of phages in human microbiome studies and diseases is poorly understood. However, the correlation between a greater abundance of phages in the gut in ulcerative colitis and diabetes has been suggested. Furthermore, most phages found at different sites in the human body are temperate, so their therapeutic effects and their potential beneficial effects remain unclear. Hence, far, no correlation has been observed between the presence of widespread crAssphage in the human population and human health and diseases. Here, we emphasize the beneficial effects of phage transfer in fecal microbiota transplantation (FMT) in Clostridioides difficile infection. The safety of phage use in gastrointestinal disorders has been demonstrated in clinical studies. The significance of phages in the FMT as well as in gastrointestinal disorders remains to be established. An explanation of the multifaceted role of endogenous phages for the development of phage therapy is required.

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A51 Effect of Lyophilized Sterile Fecal Filtrate vs Lyophilized Donor Stool on Recurrent Clostridium Difficile Infection (Rcdi): Preliminary Results From a Randomized, Double-Blind Pilot Study

Cited by 25 publications

References 0 publications

Scientific frontiers in faecal microbiota transplantation: joint document of Asia-Pacific Association of Gastroenterology (APAGE) and Asia-Pacific Society for Digestive Endoscopy (APSDE)

Scientific frontiers in faecal microbiota transplantation: joint document of Asia-Pacific Association of Gastroenterology (APAGE) and Asia-Pacific Society for Digestive Endoscopy (APSDE)

The Roles of the Virome in Cancer

The Presence of Bacteriophages in the Human Body: Good, Bad or Neutral?

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