Alterations and Prediction of Functional Profiles of Gut Microbiota After Fecal Microbiota Transplantation for Iranian Recurrent Clostridioides difficile Infection with Underlying Inflammatory Bowel Disease: A Pilot Study

Abstract

Background and Purpose: Fecal microbiota transplantation (FMT) has emerged for the therapeutic treatment of recurrent Clostridioides difficile infection (rCDI) with concurrent inflammatory bowel disease (IBD). As the first Iranian population cohort, we examined how gut microbiota and their functional profiles change in Iranian rCDI patients with underlying IBD before and after FMT. Patients and Methods: FMT was performed to eight IBD patients via colonoscopy. Profiles of gut microbiota from donors and recipients were investigated using 16S rRNA gene sequence analysis. Results: Patients experienced no IBD flare-ups or other adverse effects, and all recovered to full health. Moreover, all rCDI patients lacked the Bacteroidetes present in donor samples. After FMT, the proportion of Bacteroidetes increased until a normal range was achieved. More specifically, the relative abundance of Prevotella was found to increase significantly following FMT. Prevotella was also found to correlate negatively with inflammation metrics, suggesting that Prevotella may be a key factor for resolving CDI and IBD. Gut microbiota diversity was found to increase following FMT, while dysbiosis decreased. However, the similarity of microbial communities of host and recipients did not increase, and wide variation in the extent of donor stool engraftment indicated that the gut bacterial communities of recipients do not shift towards those of donors. Conclusion: FMT leads to significant alterations of the community structure of gut bacteria in rCDI patients with IBD. The change in relative abundance of Proteobacteria and bacterial diversity indicated that FMT promotes recovery from intestinal permeability and inflammation in rCDI patients. Moreover, strong negative correlation between Prevotella and inflammation index, and decreased dysbiosis index advocate that the improvement of CDI is possibly due to gut microbiome alteration. Collectively, our findings show that FMT would be a promising therapy to help reprogram the gut microbiome of Iranian rCDI patients with IBD.

Functional Fermented Milk with Fruit Pulp Modulates the In Vitro Intestinal Microbiota

“…This phylum is related to a healthy microbiota, since it harbors the main bacteria that play a protective role in maintaining intestinal barrier homeostasis [ 49 ], such as acetate producing Bifidobacteria [ 50 ]. On the other hand, the decrease in the Proteobacteria phylum is desirable, since this phylum, which includes the genera Clostridium and Bacillus, is related to the incidence of inflammatory diseases [ 51 ] and is known for its proteolytic activity [ 52 ]. In the present study, the decrease in Proteobacteria may be related to the lower availability of amino acids, which may have been metabolized by LAB with proteolytic activity during the fermentation process of the FM.…”

Akkermansia deficiency and mucin depletion are implicated in intestinal barrier dysfunction as earlier event in the development of inflammation in interleukin-10-deficient mice

“…The decrease in the genus Prevotella was observed in the feces and mucosa of IL-10-deficient mice. This genus has been defined as protective in the development of IBD, due to its role as a commensal microbiota that intervenes in the degradation of fibers and organic compounds ( Kovatcheva-Datchary et al, 2015 ; Azimirad et al, 2022 ). In addition, the considerable decrease on Akkermansia abundance was corroborated in both feces and colonic mucosa and is presumably a direct consequence of the drastic reduction of the mucus layer.…”

Application of recombinant antibodies for treatment of Clostridioides difficile infection: Current status and future perspective

“…Furthermore, rectal administration, e.g. as a supplement to fecal microbiome transplantation (FMT), may also be possible ( 253 , 275 – 277 ). For this purpose, immobilization of rAbs on beads may help their absorption and eliminate soluble toxins through the rectum.…”