Fecal microbiota transplantation ameliorates active ulcerative colitis

Area of Science:

• Gastroenterology and Hepatology
• Microbiology and Infectious Diseases
• Immunology

Background:

• Ulcerative colitis (UC) is a chronic gastrointestinal disorder.
• Microbiota-targeted therapies, like fecal microbiota transplantation (FMT), are emerging as potential treatments for UC.
• Previous research indicates altered gut microbiota composition in UC patients.

Purpose of the Study:

• To evaluate the efficacy and safety of FMT in patients with mild to moderate active UC.
• To investigate the impact of FMT on gut microbiota composition and diversity in UC patients.

Main Methods:

• A single-center, open-label study involving 47 patients with mild or moderate UC.
• Patients received three fresh FMT treatments via colonic transendoscopic enteral tubing within one week.
• Efficacy was assessed using the Inflammatory Bowel Disease Questionnaire, partial Mayo scores, colonoscopy, and inflammatory markers (ESR, CRP, procalcitonin). Gut microbiota alterations were analyzed using 16S ribosomal RNA sequencing.

Main Results:

• FMT significantly increased *Faecalibacterium prausnitzii* levels and decreased Mayo scores at 4 weeks post-treatment.
• High rates of steroid-free clinical response (84.1%) and remission (70.5%) were observed at 4 weeks.
• FMT improved gut microbial diversity (Shannon's index, Chao1 estimator) and was well-tolerated, with no adverse events reported in 93.2% of patients.

Conclusions:

• Fecal microbiota transplantation (FMT) is effective and safe for inducing clinical remission in patients with mild to moderate ulcerative colitis (UC).
• The therapeutic benefits of FMT in UC are associated with significant positive alterations in the intestinal microbiota, particularly an increase in *F. prausnitzii*.
• *Faecalibacterium prausnitzii* may serve as a valuable diagnostic and therapeutic biomarker for FMT in UC management.