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Fecal Microbiota Transplant via Endoscopic Delivering Through Small Intestine and Colon: No Difference for Crohn’s Disease

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Abstract

Background and Aims

Crohn’s disease (CD) is a chronic inflammatory bowel disorder associated with intestinal dysbiosis. This study aimed to determine the efficacy and safety of different methods of fecal microbiota transplantation (FMT), a potential therapy for CD.

Methods

Patients with CD were randomized to receive FMT by gastroscopy or colonoscopy; a second transplantation was performed 1 week later. Patients were assessed by clinical evaluation and serum testing (at weeks 1, 2, 4, 6, and 8) and endoscopy (8 weeks after transplantation). Fecal DNA was extracted and analyzed using the Illuminal sequencing platform.

Results

Of the 27 patients included in the study, clinical remission was achieved in 18 (66.7%); no significant difference was seen between the two methods. 76.9% of gastroscopy group patients and 64.3% of colonoscopy group patients experienced mild adverse events during or shortly after treatment. Microbiota diversity analyses showed that, in comparison with the donors, patients had lower operational taxonomic units (OTU; 117 vs. 258, p < 0.05) and Shannon diversity index (2.05 vs. 3.46, p < 0.05). The CD patients showed a significant increase in OTU and Shannon diversity index 2 weeks after FMT. In comparison with the donors, CD patients had lower levels of Bacteroides, Eubacterium, faecalibacterium, and Roseburia, and higher levels of Clostridium, Cronobacter, Fusobacterium, and Streptococcus.

Conclusions

FMT was seen to be safe and effective in this cohort of patients with CD. No significant differences in clinical remission rate and adverse events were seen between the gastroscopy and colonoscopy groups. FMT was seen to increase the species richness in CD patients.

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Funding

This work was supported by grants from General Program of National Science Foundation of China (NSFC) (Grant No: 81272736).

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Authors and Affiliations

  1. Department of Gastroenterology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China

    Zhenyu Yang, Chibin Bu, Wei Yuan, Zhaohua Shen, Yongsheng Quan, Shuai Wu, Changxin Zhu & Xiaoyan Wang

  2. Hunan Key Laboratory of Non-resolving Inflammation and Cancer, Changsha, Hunan, China

    Zhenyu Yang, Chibin Bu, Wei Yuan, Zhaohua Shen, Yongsheng Quan, Shuai Wu, Changxin Zhu & Xiaoyan Wang

Authors
  1. Zhenyu Yang
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  2. Chibin Bu
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  3. Wei Yuan
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  4. Zhaohua Shen
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  5. Yongsheng Quan
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  6. Shuai Wu
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  7. Changxin Zhu
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  8. Xiaoyan Wang
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Correspondence to Xiaoyan Wang.

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The authors declare that they have no conflict of interests.

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The ethical approval was supported by Institutional Review Board of Third Xiangya Hospital, Central South University.

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Yang, Z., Bu, C., Yuan, W. et al. Fecal Microbiota Transplant via Endoscopic Delivering Through Small Intestine and Colon: No Difference for Crohn’s Disease. Dig Dis Sci 65, 150–157 (2020). https://doi.org/10.1007/s10620-019-05751-y

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  • DOI: https://doi.org/10.1007/s10620-019-05751-y

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