Fecal Microbiota Transplantation Induces Sustained Gut Microbiome Changes in Pediatric Ulcerative Colitis: A Combined...

Area of Science:

• Gastroenterology
• Microbiome Research
• Pediatric Inflammatory Bowel Disease

Background:

• Pediatric ulcerative colitis (UC) is a chronic inflammatory condition of the colon.
• The gut microbiome plays a crucial role in the pathogenesis of UC.
• Fecal microbiota transplantation (FMT) is an emerging therapeutic strategy for UC.

Purpose of the Study:

• To investigate the long-term impact of FMT on the gut microbiome in pediatric UC patients.
• To identify microbial signatures associated with UC disease severity and clinical outcomes.
• To assess the sustained effects of FMT over 48 weeks.

Main Methods:

• Randomized, double-blind trial with an open-label extension.
• Fecal sample collection at baseline and postintervention.
• Shotgun metagenomic sequencing for microbiome analysis.
• Clinical response evaluation using the Pediatric Ulcerative Colitis Activity Index.

Main Results:

• FMT led to sustained increases in gut microbial diversity over 48 weeks.
• Specific microbial shifts observed: decreased *Klebsiella oxytoca*, increased *Coprobacter fastidiosus*.
• Microbial signatures linked to UC severity (e.g., indole producers, mucin degraders).
• Clinical improvement associated with decreased *Fusobacterium nucleatum* and *Veillonella parvula*.

Conclusions:

• FMT induces sustained gut microbiome alterations in pediatric UC.
• Distinct microbial signatures correlate with disease severity and treatment response.
• Further research is needed to understand FMT and placebo response mechanisms.
• Findings support the development of personalized microbiome-targeted therapies for pediatric UC.