The kinetics of gut microbial community composition in patients with irritable bowel syndrome following fecal microbiota transplantation

Abstract

BackgroundGut microbiota alterations are important in irritable bowel syndrome (IBS). The aim was to investigate the effect of fecal microbiota transplantation (FMT) on gut microbiota and the symptoms in patients with IBS.Material and methodsThe study included 13 IBS patients according to Rome III criteria and 13 healthy donors. Freshly donated feces were administered to the descending part of the duodenum via a gastroscope. Feces were collected from donors and patients before FMT, and from the patients at 1, 3 and 12 weeks and donors and patients at 20/28 weeks after FMT. Microbiota analysis was performed using GA-map Dysbiosis test (Genetic Analysis AS, Oslo, Norway). The patients completed the following questionnaires before and at the aforementioned weeks after FMT: IBS Symptom Questionnaire (IBS-SQ), IBS-Symptom Severity Scoring system (IBS-SSS), Short Form of Nepean Dyspepsia Index (SF-NDI), Bristol stool form scale, the Eysenck Personality Questionnaire-Neuroticism and Hospital Anxiety and Depression.ResultsDonors and IBS patients had significantly different bacterial strain signals before FMT (Ruminococcus gnavus, Actinobacteria and Bifidobacteria) that became non-significant after 3 weeks following FMT. The changes in gut microbiota were similar between donors and patients at 20/28 weeks after FMT. Thus, patients’ microbiota profiles became more-or-less similar to donors.The scores of all the questionnaires were significantly improved at all time points following FMT. No reported adverse effects.ConclusionsFMT was associated with a change in gut microbiota and improvement in IBS symptoms and quality of life lasting for up to 28 weeks.Trial registrationClinicalTrials.gov ID: NCT03333291

Abnormal Uroguanylin Immunoreactive Cells Density in the Duodenum of Patients with Diarrhea-Predominant Irritable Bowel Syndrome Changes following Fecal Microbiota Transplantation

“…As previously explained in details [26], the donors and patients underwent screening one week before FMT and were physically examined and blood tested to exclude contagious infectious agents for the donors (hepatitis A, B, and C; HIV; Epstein-Barr virus; and cytomegalovirus) and organic disorders for the patients according to previously published recommendations [22,41,42]. Stool samples from both donors and patients were examined for fecal calprotectin and screened for bacteria, viruses, parasites, and eggs.…”

“…Tissue biopsies were taken from the descending part of the duodenum before installation of feces and again after 3 weeks. Fecal samples were collected on the same day of FMT (before the procedure) and 3 weeks after FMT and sent for microbiota analysis using the GA-map™ Dysbiosis Test (Genetic Analysis AS, Oslo, Norway) as previously explained in details [26].…”

“…Previous publications have shown the effect of dietary changes on the symptoms [1,[13][14][15][16], gut microbiota [17,18], and enteroendocrine cells [19][20][21] in IBS patients. In addition, changing the composition of the gut microbiota through fecal microbiota transplantation (FMT) had a positive clinical outcome not only in cases of Clostridium difficile [22,23] but also in IBS [24][25][26][27][28]. The gut neuroendocrine system regulates all the functions of the gastrointestinal tract and consists of enteroendocrine cells and the enteric nervous system [29].…”

“…Newly published studies by our group [26,28] showed that using FMT in patients with diarrhea-predominant IBS (IBS-D) improved their symptoms and changed their gut microbiota profile. Using the same study cohort, the aims of this study were to determine whether there is abnormality in the density of uroguanylin immunoreactive cells in the duodenum of IBS patients compared to healthy controls (controls), to study the effect of changing the gut microbiota through FMT on the density of these cells, and to find the correlations between these cells and IBS symptoms (if any).…”

Faecal microbiota transplant from aged donor mice affects spatial learning and memory via modulating hippocampal synaptic plasticity- and neurotransmission-related proteins in young recipients

“…In addition, dysbiosis has been associated with a variety of neurological disturbances ranging from depression [8] to autism [9,10], along with neurodegenerative diseases such as Parkinson's disease and multiple sclerosis [11,12]. Not surprisingly, faecal microbiota transplant (FMT) is being investigated as a therapeutic option not only for GI-tract-related diseases [13], but also for CNS disorders [14,15]. Thus, it is plausible to hypothesize that age-associated changes in the microbiota composition have a direct effect on the CNS, potentially contributing to the decline of cognitive function seen in the elderly.…”