Healthy Donor Fecal Microbiota Transplantation in Steroid-Ineligible Severe Alcoholic Hepatitis: A Pilot Study

Philips, Cyriac Abby; Pande, Apurva; Shasthry, Saggere Muralikrishna; Jamwal, Kapil Dev; Khillan, Vikas; Chandel, Shivendra Singh; Kumar, Guresh; Sharma, Manoj Kumar; Maiwall, Rakhi; Jindal, Ankur; Choudhary, Ashok; Hussain, Shabbir; Sharma, Shvetank; Sarin, Shiv Kumar

doi:10.1016/j.cgh.2016.10.029

Cited by 277 publications

(231 citation statements)

References 7 publications

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“…Moreover, FMT has already been used in human with chronic liver disease. A recent pilot study of patients with severe alcoholic hepatitis showed that FMT was associated with increased survival and resolved ascite . Philips et al .…”

Section: Fmt As a Possible Therapy For Various Type Of Cancers And Camentioning

confidence: 99%

Fecal microbiota transplantation in cancer management: Current status and perspectives

Chen

Jin

et al. 2018

Intl Journal of Cancer

223

161

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The human gut is home to a large and diverse microbial community, comprising about 1,000 bacterial species. The gut microbiota exists in a symbiotic relationship with its host, playing a decisive role in the host's nutrition, immunity and metabolism. Accumulating studies have revealed the associations between gut dysbiosis or some special bacteria and various cancers. Emerging data suggest that gut microbiota can modulate the effectiveness of cancer therapies, especially immunotherapy. Manipulating the microbial populations with therapeutic intent has become a hot topic of cancer research, and the most dramatic manipulation of gut microbiota refers to fecal microbiota transplantation (FMT) from healthy individuals to patients. FMT has demonstrated remarkable clinical efficacy against Clostridium difficile infection (CDI) and it is highly recommended for the treatment of recurrent or refractory CDI. Lately, interest is growing in the therapeutic potential of FMT for other diseases, including cancers. We briefly reviewed the current researches about gut microbiota and its link to cancer, and then summarized the recent preclinical and clinical evidence to indicate the potential of FMT in cancer management as well as cancer‐treatment associated complications. We also presented the rationale of FMT for cancer management such as reconstruction of intestinal microbiota, amelioration of bile acid metabolism, and modulation of immunotherapy efficacy. This article would help to better understand this new therapeutic approach for cancer patients by targeting gut microbiota.

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Section: Fmt As a Possible Therapy For Various Type Of Cancers And Camentioning

confidence: 99%

Fecal microbiota transplantation in cancer management: Current status and perspectives

Chen

Jin

et al. 2018

Intl Journal of Cancer

223

161

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“…In a small pilot study, 8 patients with alcoholic hepatitis underwent FMT and received stool from a donor within their family. One year after FMT, favorable changes to the microbiome were present, and -compared with alcoholic hepatitis patients receiving standard care -patients who underwent FMT had improved mortality (99). A recently published RCT showed that, compared with the standard of care, HE patients that received FMT from a rationally selected donor had improved brain function, a remarkable reduction of both HE recurrence and all hospitalizations, and a restoration of antibiotic-associated loss of diversity (100).…”

Section: Therapeutic Strategies Targeting the Microbiota In Cirrhosismentioning

confidence: 99%

Microbiota, cirrhosis, and the emerging oral-gut-liver axis

2017

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“…But the risk of recidivism and severe infections in such sick patients do not make this a practical option for many. In the study by Philips et al in steroid ineligible SAH, resolution of ascites and HE following FMT associated with improved 1 year survival rate compared with historical controls (87.5% compared with 33.3%) was noted 6. Bajaj et al , in their study on FMT versus standard of care for recurrent HE found that none of the patients in the FMT arm developed overt HE and that FMT increased diversity and beneficial taxa in treated patients 8…”

Section: Discussionmentioning

confidence: 97%

“…Ferrere et al confirmed that manipulation of IM prevented alcohol-induced liver injury in mice and IM manipulation be considered as a new therapeutic target in ALD 5. A small pilot study on faecal microbiota transplantation (FMT) in patients with SAH who were ineligible for steroid treatment (due to various contraindications) demonstrated significant survival benefit, in the short and long term in comparison to historical controls with similar disease severity profile 6. There is no report on the use of FMT in patients with SAH who are CS treatment failures.…”

Section: Introductionmentioning

confidence: 98%

Healthy donor faecal transplant for corticosteroid non-responsive severe alcoholic hepatitis

Philips¹,

Phadke

Ganesan³

et al. 2017

BMJ Case Reports

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Patients with severe alcoholic hepatitis (SAH) have high mortality in the presence of steroid unresponsiveness in the absence of clear treatment recommendations. Liver transplantation is the curative option in such cases but is controversial in the wake of severe infections, post-transplant recidivism and long waiting on deceased donor listing. Animal and human studies have shed light on the beneficial effects of gut microbiota modulation in alcoholic liver disease. We present the first report of faecal microbiota transplantation (FMT) in a steroid non-responder in whom, clinical, biochemical and liver disease severity scores improved post-FMT and demonstrate distinct bacterial population changes pre-FMT and post-FMT. Healthy donor FMT could be safe and efficacious in SAH not responding to corticosteroid treatment, as a bridge to liver transplantation (LT) or in candidates who are unwilling or not ideal for LT for improvement in short-term transplant free survival. Larger controlled studies are required for confirmation.

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Healthy Donor Fecal Microbiota Transplantation in Steroid-Ineligible Severe Alcoholic Hepatitis: A Pilot Study

Cited by 277 publications

References 7 publications

Fecal microbiota transplantation in cancer management: Current status and perspectives

Fecal microbiota transplantation in cancer management: Current status and perspectives

Microbiota, cirrhosis, and the emerging oral-gut-liver axis

Healthy donor faecal transplant for corticosteroid non-responsive severe alcoholic hepatitis

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