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Updated: Aug 5, 2026
Therapeutic Evaluation of Fecal Microbiota Transplantation in an Interleukin 10-Deficient Mouse Model
Published on: April 6, 2022
Possible Mechanisms Underlying the Effects of Fecal Microbiota Transplantation in Patients With Irritable Bowel
Magdy El-Salhy1,2, Tora Skarvatun1,2, Dag Arne Lihaug Hoff3
1Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Background/Aims:
: This study aims to identify the mechanisms underlying the effects of fecal microbiota transplantation (FMT).
Methods:
: This study investigated 93 patients included in our previous clinical trial: 24 received 30 g of their own feces (placebo group), while 47 and 22 received 30 g and 60 g of donor feces, respectively. The patients underwent sigmoidoscopy with biopsies, provided fecal samples, and completed questionnaires to assess irritable bowel syndrome (IBS) symptoms, fatigue, and quality of life at the baseline and at 1 month following FMT. The biopsy samples were immunostained for Musashi-1, neurogenin-3, and enteroendocrine and immune cells. The cell densities were quantified by computerized image analysis. Fecal short-chain fatty acids (SCFAs) were measured by gas chromatography, and fecal bacteria were measured by 16S ribosomal RNA polymerase chain reaction DNA amplification.
Results:
: The densities of stem cells, enteroendocrine cell progenitors, serotonin, glucagon-like peptide 1, and peptide YY (PYY) cells increased following FMT in the 30-g and 60-g treated groups but not in the placebo group, and they were inversely correlated with both IBS symptoms and fatigue. The densities of submucosal immune cells and mast cells decreased following FMT in the 30-g and 60-g treated groups but not in the placebo group, and they were correlated with IBS symptoms and fatigue. The fecal level of butyric acid increased in patients treated with donor feces, and this was inversely correlated with IBS symptoms and fatigue.
Conclusions:
: Stem cells, enteroendocrine progenitors, serotonin, and glucagon-like peptide 1 as well as low-grade inflammation may play roles in IBS symptom manifestations. The effects of FMT are probably due to the amelioration of these abnormalities.
Insights
Fecal microbiota transplantation (FMT) increased beneficial gut cells and butyric acid, reducing irritable bowel syndrome (IBS) symptoms and fatigue. These changes suggest FMT ameliorates gut abnormalities contributing to IBS.
Area of Science:
- Gastroenterology
- Microbiome research
- Immunology
Background:
- Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder with complex mechanisms.
- Fecal microbiota transplantation (FMT) shows promise in treating IBS, but its underlying mechanisms require elucidation.
- Understanding these mechanisms is crucial for optimizing FMT efficacy and patient outcomes.
Purpose of the Study:
- To identify the specific biological mechanisms through which FMT exerts its therapeutic effects in patients with IBS.
- To investigate the impact of FMT on gut cell populations, inflammation, and microbial metabolites.
- To correlate these changes with improvements in IBS symptoms, fatigue, and quality of life.
Main Methods:
- A clinical trial involving 93 IBS patients receiving placebo, 30g, or 60g of donor FMT.
- Sigmoidoscopy with biopsies, fecal sample collection, and questionnaires for symptom assessment.
- Immunohistochemistry for cell quantification, gas chromatography for short-chain fatty acids, and 16S rRNA for bacterial analysis.
Main Results:
- FMT increased stem cells, enteroendocrine progenitors (serotonin, GLP-1, PYY), and butyric acid.
- These increases were inversely correlated with reduced IBS symptoms and fatigue.
- FMT decreased submucosal immune and mast cells, correlating with symptom improvement.
Conclusions:
- Stem cells, enteroendocrine cells, and reduced inflammation are implicated in IBS symptom modulation.
- FMT likely ameliorates IBS by correcting these underlying gut abnormalities.
- FMT represents a potential therapeutic strategy by restoring gut homeostasis.
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