Faecal microbiota transplant – prospects and safety

Anna Bartnicka, Patrycja Szachta, Mirosława Gałęcka

Abstract


The intestinal microbiota, either directly or indirectly, plays an important role in maintaining the homeostasis of the body. The intestine microorganisms are significant due to the role they play in stimulating the development of the immune system, protecting against pathogens, and also managing metabolic and nutrient processing.

The effectiveness of probiotics and prebiotics in various gastrointestinal diseases has been repeatedly confirmed. However, increasing interest in faecal transplantation has also been observed. Its efficacy in the treatment of pseudomembranous colitis has been repeatedly demonstrated. More often this method is discussed regarding the possibility of using it in other diseases linked with dysbiosis. Faecal microbiota transplantation, because of its rapid efficacy, minimal risk and adverse effects, relatively low cost, and the ability to re‑establish the correct intestinal microbiota profile, could be an alternative treatment method in several other diseases.

This paper will introduce the latest therapeutic aspects of microbiota transplantation, including its implications in the treatment of gastrointestinal diseases.


Keywords


faecal microbiota transplantation; intestinal microbiota; Clostridium difficile infections

Full Text:

PDF

References


Candela M., Rampelli S., Turroni S., Severgnini M., Consolandi C., De Bellis G. et al.: Unbalance of intestinal microbiota in atopic children. BMC Microbiol. 2012, 12, 95–103.

Mai V., Young C.M., Ukhanova M., Wang X., Sun Y., Casella G. et al.: Fecal microbiota in premature infants prior to necrotizing enterocolitis. PLoS ONE. 2011, 6 (6), e20647.

Cani P.D.: Gut microbiota and obesity: lessons from the microbiome. Brief Funct Genomics. 2013, 12 (4), 381–387.

Arthur J.C., Jobin C.: The complex interplay between inflammation, the microbiota and colorectal cancer. Gut Microbes. 2013, 4 (3), 253–258.

Manichanh C., Borruel N., Casellas F., Guarner F.: The gut microbiota in IBD. Nat Rev Gastroenterol Hepatol. 2012, 9 (10), 599–608.

Turnbaugh P.J., Ley R.E., Hamady M., Fraser‑Liggett

C.M., Knight R., Gordon J.I.: The human microbiome project. Nature. 2007, 449, 804–810.

Lund‑Tønnesen S., Berstad A., Schreiner A., Midtvedt T.: Clostridium difficile‑associated diarrhea treated with homologous feces. Tidsskr Nor Laegeforen. 1998, 118 (7), 1027–1030.

Persky S., Brandt L.J.: Treatment of recurrent Clostridium difficile‑associated diarrhea by administration of donated stool directly though a colonoscope. Am J Gastroenterol. 2000, 95 (11), 3283–3285.

Silverman M.S., Davis I., Pillai D.R.: Success of self‑administered home fecal transplantation for chronic Clostridium difficile infection. Clin Gastroenterol Hepatol. 2010, 8 (5), 471–473.

Aas J., Gessert C.E., Bakken J.S.: Recurrent Clostridium difficile colitis: case series involving 18 patients treated with donor stool administered via a nasogastric tube. Clin Infect Dis. 2003, 36 (5), 580–585.

Brandt L.J., Aroniadis O.C.: An overview of fecal microbiota transplantation: techniques, indications, and outcomes. Gastrointest Endosc. 2013, 78 (2), 240–249.

Louie T., Cannon K., O’grady H., Wu K., Ward L.: Fecal microbiome transplantation (FMT) via oral fecal microbial capsules for recurrent Clostridium difficile infection (rCDI). IDWeek 2013, Abstract 89.

Zhang F., Luo W., Shi Y., Fan Z., Ji G.: Should we standardize the 1700‑year‑ old fecal microbiota transplantation? Am J Gastroenterol. 2012, 107 (11), 1755–1756.

Eiseman B., Silen W., Bascom G.S., Kauvar A.J.: Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis. Surgery. 1958, 44 (5), 854–859.

Pathak R., Enuh H.A., Patel A., Wickremesinghe P.: Treatment of relapsing Clostridium difficile infection using fecal microbiota transplantation. Clin Exp Gastroenterol. 2013, 7, 1–6.

Bakken J.S., Polgreen P.M., Beekmann S.E., Riedo F.X., Streit J.A.: Treatment approaches including fecal microbiota transplantation for recurrentClostridium difficile infection (RCDI) among infectious disease physicians. Anaerobe. 2013, 24, 20–24.

Cohen S.H., Gerding D.N., Johnson S., Kelly C.P., Loo V.G., McDonald L.C. et al.: Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol. 2010, 31 (5), 431–455.

Surawicz C.M., Brandt L.J., Binion D.G.,Ananthakrishnan A.N., Curry S.R., Gilligan P.H. et al.: Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol. 2013, 108 (4), 478–498.

Bakken J.S.: Fecal bacteriotherapy for recurrent Clostridium difficile infection. Anaerobe. 2009, 15 (6), 285–289.

Huebner E.S., Surawicz C.M.: Treatment of recurrent Clostridium difficile diarrhea. Gastroenterol Hepatol 2006, 2 (3), 203–208.

Schwan A., Sjölin S., Trottestam U., Aronsson B.: Relapsing Clostridium difficile enterocolitis cured by rectal infusion of homologous faeces. Lancet. 1983, 2, 845.

Chang J.Y., Antonopoulos D.A., Kalra A., Tonelli A., Khalife W.T., Schmidt T.M. et al.: Decreased diversity of the fecal microbiome in recurrent Clostridium difficile‑associated diarrhea. J Infect Dis. 2008, 197 (3), 435–438.

Goldin B.R., Gorbach S.L., Saxelin M., Barakat S., Gualtieri L., Salminen S.: Survival of Lactobacillus species (strain GG) in human gastrointestinal tract. Dig Dis Sci. 1992, 37 (1), 121–128.

Grehan M.J., Borody T.J., Leis S.M., Campbell J., Mitchell H., Wettstein A.: Durable alteration of the colonic microbiota by the administration of donor fecal flora. J Clin Gastroenterol. 2010, 44 (8), 551–561.

Khoruts A., Dicksved J., Jansson J.K., Sadowsky M.J.: Changes in the composition of the human fecal microbiome after bacteriotherapy for recurrent Clostridium difficile‑associated diarrhea. J Clin Gastroenterol. 2010, 44 (5), 354–360.

Hamilton M.J., Weingarden A.R., Unno T., Khoruts A., Sadowsky M.J.: High‑throughput DNA sequence analysis reveals stable engraftment of gut microbiota following transplantation of previously frozen fecal bacteria. Gut Microbes. 2013, 4 (2), 125–135.

Brandt L.J., Aroniadis O.C., Mellow M., Kanatzar A., Kelly C., Park T. et al.: Long‑term follow‑up of colonoscopic fecal microbiota transplantation for recurrent Clostridium difficile infection. Am J Gastroenterol. 2012, 107 (7), 1079–1087.

van Nood E., Vrieze A., Nieuwdorp M., Fuentes S., Zoetendal E.G., de Vos W.M. et al.: Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med. 2013, 368 (5), 407–415.

Yoon S.S., Brandt L.J.: Treatment of refractory/recurrent C. difficile‑associated disease by donated stool transplanted via colonoscopy. A case series of 12 patients. J Clin Gastroenterol. 2010, 44 (8), 562–566.

Rohlke F., Surawicz C.M., Stollman N.: Fecal flora reconstitution for recurrent Clostridium difficile infection: results and methodology. J Clin

Gastroenterol. 2010, 44 (8), 567–570.

Borody T.J., Warren E.F., Leis S.M., Surace R., Ashman O., Siarakas S.: Bacteriotherapy using fecal flora: toying with human motions. J Clin Gastroenterol.

, 38 (6), 475–483.

Borody T.J., Khoruts A.: Fecal microbiota transplantation and emerging applications. Nat Rev Gastroenterol Hepatol. 2011, 9 (2), 88–96.

Anderson J.L., Edney R.J., Whelan K.: Systematic review: faecal microbiota transplantation in the management of inflammatory bowel disease. Aliment Pharmacol Ther. 2012, 36 (6), 503–516.

Damman C.J., Miller S.I., Surawicz C.M., Zisman T.L.: The microbiome and inflammatory bowel disease: is there a role for fecal microbiota transplantation? Am J Gastroenterol. 2012, 107 (10), 1452–1459.

Turnbaugh P.J., Ley R.E., Mahowald M.A., Magrini V., Mardis E.R., Gordon J.I.: An obesity‑associated gut microbiome with increased capacity for energy harvest. Nature. 2006, 444, 1027–1031.

Vrieze A., Van Nood E., Holleman F., Salojärvi J., Kootte R.S., Bartelsman J.F. et al.: Transfer of intestinal microbiota from lean donors increases insulin sensitivity in subjects with metabolic syndrome. Gastroenterology. 2012, 143 (4), 913–916.e7.

Anathaswamy A.: Faecal transplant eases symptoms of Parkinson’s. New Scientist. 2011, 209, 8–9.

Rajilić‑Stojanović M., Biagi E., Heilig H.G., Kajander K., Kekkonen R.A., Tims S. et al.: Global and deep molecular analysis of microbiota signatures in fecal samples from patients with irritable bowel syndrome. Gastroenterology. 2011, 141 (5), 1792–1801.

Borody T.J., Leis S., Campbell J., Torres M., Nowak A.: Fecal microbiota transplantation (FMT) in multiple sclerosis (MS). Am J Gastroenterol. 2011, 106, S352.

Borody T.J., Rosen D.M., Torres M.: Myoclonus‑dystonia

(M‑D) mediated by GI microbiota diarrhoea treatment improves M‑D sympoms. Am J Gastroenterol. 2011, 106, S352.

Finegold S.M., Molitors D., Song Y., Liu C., Vaisanen M.L., Bolte E. et al.: Gastrointestinalmicro flora studies in late‑onset autism. Clin Infect Dis. 2002, 35 (Suppl. 1), S6–S16.

Bakken J.S., Borody T., Brandt L.J., Brill J.V., Demarco D.C., Franzos M.A. et al.: Treating Clostridium difficile infection with fecal microbiota transplantation.Clin Gastroenterol Hepatol. 2011, 9 (12), 1044–1049.

Hamilton M.J., Weingarden A.R., Sadowsky M.J., Khoruts A.: Standardized frozen preparation for transplantation of fecal microbiota for recurrent Clostridium difficile infection. Am J Gastroenterol. 2012, 107 (5), 761–767.

Gough E., Shaikh H., Manges A.R.: Systematic review of intestinal microbiotatransplantation (fecal bacteriotherapy) for recurrent Clostridium difficile infection. Clin Infect Dis. 2011, 53 (10), 994–1002.




DOI: https://doi.org/10.21164/pomjlifesci.98

Copyright (c) 2015

License URL: https://creativecommons.org/licenses/by-nc-nd/3.0/pl/