Fecal Microbiota Transplant in Two Ulcerative Colitis Pediatric Cases: Gut Microbiota and Clinical Course...

Area of Science:

• Gastroenterology
• Microbiology
• Immunology

Background:

• Inflammatory bowel disease (IBD), including ulcerative colitis (UC), presents significant management challenges.
• Fecal microbiota transplantation (FMT) is an emerging therapeutic strategy for IBD, but its clinical efficacy and predictability remain under investigation.
• Understanding the gut bacterial ecology shifts post-FMT is crucial for optimizing treatment outcomes.

Purpose of the Study:

• To evaluate the clinical and ecological effects of FMT in two pediatric patients with ulcerative colitis (UC).
• To investigate the impact of FMT on gut microbiota composition and its correlation with clinical response in UC.
• To assess the long-term outcomes of FMT in mild versus moderate UC cases.

Main Methods:

• Clinical monitoring of two pediatric patients (mild and moderate UC) before and after FMT.
• Gut bacterial ecology profiling using microbiota analysis.
• Comparison of patient microbiota profiles with donor and control cohort baseline data.

Main Results:

• Both patients showed initial clinical improvement post-FMT.
• The patient with mild UC achieved clinical remission at 12 months; the patient with moderate UC experienced worsening at 12 weeks.
• FMT increased gut microbiota richness and phylogenetic distance, with specific bacterial taxa (e.g., Collinsella aerofaciens, Eubacterium biforme) inherited from donors.
• Microbiota shifts associated with remission included decreased Proteus and Blautia producta, and increased Parabacteroides, Mogibacteriaceae, Bacteroides eggerthi, Bacteroides plebeius, Ruminococcus bromii, and Bacteroides ovatus.

Conclusions:

• FMT can lead to long-term remission in mild UC.
• Moderate UC may require multiple FMT administrations for sustained clinical benefit.
• FMT reduces potential pathogens and enriches beneficial microorganisms associated with UC remission.