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Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Serial Fecal Microbiota Infusions via Colonoscopy for Active Ulcerative Colitis: A Feasibility, Safety, and
Loris Riccardo Lopetuso1,2,3, Lucrezia Laterza1, Valentina Petito1,4
1IBD Unit, CEMAD, Digestive Diseases Center, Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, L. Go A. Gemelli 8, 00168 Rome, Italy.
Serial fecal microbiota transplantation (FMT) via colonoscopy shows promise for treating ulcerative colitis (UC). This safe and feasible approach may induce and maintain clinical response, with specific gut bacteria predicting treatment success.
Area of Science:
- Gastroenterology
- Microbiome research
- Immunology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease with limited treatment options.
- The efficacy of fecal microbiota transplantation (FMT) for UC is not fully established.
- Understanding the role of gut microbiota in UC pathogenesis is crucial.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of serial FMT infusions in active UC patients.
- To compare FMT outcomes with a control group receiving Infliximab.
- To identify microbial predictors of treatment response.
Main Methods:
- Nineteen patients with mild-to-moderate active UC received three consecutive FMT infusions via colonoscopy.
- A control group received Infliximab treatment.
- Clinical, endoscopic, and microbial outcomes were assessed, along with adverse events.
Main Results:
- Clinical response was observed in 9/19 patients by week 12 and maintained in 8/19 at 24 weeks.
- Endoscopic remission was achieved in 6/19 patients by week 12.
- Responders showed higher microbiota richness and specific bacterial enrichment (e.g., Faecalibacterium, Akkermansia) compared to non-responders.
Conclusions:
- Serial FMT infusions are feasible, safe, and effective for inducing and maintaining clinical response in UC.
- Specific gut bacterial profiles can predict FMT response in UC patients.
- FMT represents a potential therapeutic strategy for ulcerative colitis.
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