Step-up fecal microbiota transplantation strategy: a pilot study for steroid-dependent ulcerative colitis

被引：155

作者：

Cui, Bota ^{[1
]}

Li, Pan ^{[1
]}

Xu, Lijuan ^{[1
]}

Zhao, Youquan ^{[2
]}

Wang, Huiquan ^{[3
]}

Peng, Zhaoyuan ^{[1
]}

Xu, Hai'e ^{[4
]}

Xiang, Jie ^{[1
]}

He, Zhi ^{[1
]}

Zhang, Ting ^{[1
]}

Nie, Yongzhan ^{[5
,6
]}

Wu, Kaichun ^{[5
,6
]}

Fan, Daiming ^{[5
,6
]}

Ji, Guozhong ^{[1
]}

Zhang, Faming ^{[1
]}

机构：

[1] Nanjing Med Univ, Med Ctr Digest Dis, Affiliated Hosp 2, Nanjing 210011, Jiangsu, Peoples R China

[2] Tianjin Univ, Coll Precis Instrument & Optoelect Engn, Tianjin 300072, Peoples R China

[3] Tianjin Polytech Univ, Dept Biomed Engn, Sch Elect & Informat Engn, Tianjin 300378, Peoples R China

[4] Nanjing Med Univ, Affiliated Hosp 2, Clin Nutr, Nanjing 210011, Jiangsu, Peoples R China

[5] Fourth Mil Med Univ, State Key Lab Canc Biol, Xian 710032, Peoples R China

[6] Fourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R China

来源：

JOURNAL OF TRANSLATIONAL MEDICINE | 2015年 / 13卷

关键词：

Steroid-dependent ulcerative colitis; Step-up fecal microbiota transplantation strategy; Microbiota; CLOSTRIDIUM-DIFFICILE INFECTION; INFLAMMATORY-BOWEL-DISEASE; EVIDENCE-BASED CONSENSUS; CROHNS-DISEASE; THERAPY; MANAGEMENT; REMISSION; IBD; DIAGNOSIS; SAFETY;

D O I：

10.1186/s12967-015-0646-2

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

100103 [病原生物学]; 100218 [急诊医学];

摘要：

Background: The strategy of using fecal microbiota transplantation (FMT) for refractory ulcerative colitis (UC) remains unclear if single FMT failed to induce remission. This study aimed to evaluate the efficacy and safety of a designed step-up FMT strategy for the steroid-dependent UC. Methods: Fifteen patients with steroid-dependent UC were enrolled, and treated with step-up FMT strategy. Followup clinical data was collected for a minimum of 3 months. Fecal microbiota composition before and post FMT of patients and related donors were analyzed by 16S rRNA sequencing. Results: Eight of fourteen (57.1 %) patients achieved clinical improvement and were able to discontinue steroids following step-up FMT. One patient was lost to follow-up. Among the 8 patients who responded, five (35.7 %) received one FMT therapy, one (7.1 %) received two FMTs, and two (14.2 %) received two FMTs plus a scheduled course of steroids. Four (28.6 %) of the 8 patients who responded maintained long-term remission during follow-up (3-18 months). Six patients (42.9 %) failed to meet the criteria of clinical improvement and maintained steroid dependence, though three experienced transient or partial improvement. Microbiota analysis showed that FMT altered the composition greatly, and a microbiota composition highly similar to that of the donor emerged in the patients with successful treatment. No severe adverse events occurred during treatment and follow-up. Conclusions: Step-up FMT strategy shows promise as a therapeutic strategy for patients with steroid-dependent UC, likely due to the successful restructuring of gut microbial composition.

引用

页数：12

共 33 条

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