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Therapeutic Evaluation of Fecal Microbiota Transplantation in an Interleukin 10-Deficient Mouse Model
Published on: April 6, 2022
Fecal microbiota transplantation restores gut microbiota diversity in children with active Crohn's disease: a
Biao Zou1, Shengxuan Liu1, Chen Dong1
1Pediatric Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Road, Wuhan, 430030, Hubei, China.
Insights
Oral fecal microbiota transplantation (FMT) capsules show promise for treating pediatric Crohn's disease (CD). This therapy, combined with nutritional support, improved gut microbiome diversity and reduced inflammation in children with active CD.
Area of Science:
- Gastroenterology
- Microbiome Research
- Pediatric Inflammatory Bowel Disease
Background:
- Limited clinical data exist for oral fecal microbiota transplantation (FMT) in Crohn's disease (CD).
- Assessing the safety and feasibility of oral FMT in pediatric CD patients is crucial.
Purpose of the Study:
- To evaluate the short-term safety and efficacy of oral FMT capsules combined with partial enteral nutrition (PEN) in pediatric patients with active CD.
- To compare outcomes between oral FMT plus PEN and conventional therapy (PEN plus immunosuppressants).
Main Methods:
- An open-label, prospective trial involving pediatric patients with active CD.
- Patients received either oral FMT capsules plus 80% PEN or 80% PEN plus immunosuppressants.
- Data collected included adverse events, clinical remission, microbiome composition, and inflammatory biomarkers.
Main Results:
- No significant difference in clinical or endoscopic remission rates between groups at week 10.
- The oral FMT group showed significant reductions in fecal calprotectin, CRP, ESR, and CD activity indices.
- FMT increased the abundance of key beneficial gut bacteria, correlating with reduced inflammation (IL-6) and increased IL-10.
- A specific panel of six gut genera effectively distinguished children with CD from healthy controls.
Conclusions:
- Oral FMT capsules combined with 80% PEN represent a potentially effective treatment for active pediatric CD.
- The identified six core functional genera may serve as valuable biomarkers for diagnosing pediatric CD.
Background:
Clinical data on oral fecal microbiota transplantation (FMT), a promising therapy for Crohn's disease (CD), are limited. Herein, we determined the short-term safety and feasibility of FMT for pediatric patients with active CD.
Methods:
In this open-label, parallel-group, single-center prospective trial, patients with active CD were treated with oral FMT capsules combined with partial enteral nutrition (PEN) (80%). The control group comprised pediatric patients with active CD treated with PEN (80%) and immunosuppressants. Thirty-three patients (11.6 ± 1.82 years)-17 in the capsule and 16 in the control groups-were analyzed. Data regarding the adverse events, clinical reactions, intestinal microbiome composition, and biomarker parameters were collected and compared post-treatment.
Results:
At week 10, the clinical and endoscopic remission rates did not differ between the two groups. By week 10, the mean fecal calprotectin level, C-reactive protein level, erythrocyte sedimentation rate, simple endoscopic score for CD, and pediatric CD activity index decreased significantly in the capsule group (all P < 0.05). The main adverse event was mild-to-moderate constipation. Core functional genera, Agathobacter, Akkermansia, Roseburia, Blautia, Subdoligranulum, and Faecalibacterium, were lacking pre-treatment. Post-treatment, the implantation rates of these core functional genera increased significantly, which positively correlated with the anti-inflammatory factor, interleukin (IL)-10, and negatively correlated with the pro-inflammatory factor, IL-6. The combination of these six functional genera distinguished healthy children from those with CD (area under the curve = 0.96).
Conclusions:
Oral FMT capsules combined with PEN (80%) could be an effective therapy for children with active CD. The six core functional genera identified here may be candidate biomarkers for identifying children with CD.
Trial Registration:
ClinicalTrials.gov, retrospectively registered, ID# NCT05321758, NCT05321745, date of registration: 2022-04-04.
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