Abstract
Dysbiosis plays a major role in the etiology of inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) is a new promising option for IBD treatment. We aimed to assess the effectiveness of a two-week FMT course in children with IBD. Ten patients, 10–17 years of age with moderate to severe IBD received a course of eight doses of freshly prepared FMT via a naso-duodenal tube or gastroscopy. All of the patients had pancolitis. There were eight cases of ulcerative colitis (UC) and two of Crohn’s disease (CD). Disease activity was evaluated using the Pediatric UC Activity Index (PUCAI) and Pediatric CD Activity Index (PCDAI) for UC and CD, respectively, CRP, and fecal calprotectin on the day before the first infusion and then on the day before the next course of FMT. Clinical response, defined as a decrease of 15 points in either index, was observed in 9/10 patients (seven UC and two CD). Clinical remission, defined as a PCDAI score ≤ 10 and PUCAI score < 10 measured at the same time point, was observed in 3/8 UC patients and 2/2 CD patients. Side effects observed were self-limiting and benign. We conclude that a short, intensive course of FMT has a beneficial effect on UC and CD colitis. FMT was well-tolerated and safe. Nonetheless, an optimal protocol of FMT administration is crucial for treatment efficacy.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Benchimol EI, Fortinsky KJ, Gozdyra P, Van den Heuvel M, Van Limbergen J, Griffiths AM (2011) Epidemiology of pediatric inflammatory bowel disease: a systematic review of international trends. Inflamm Bowel Dis 17(1):423–439
Bennet JD, Brinkmann M (1989) Treatment of ulcerative colitis by implantation of normal colonic flora. Lancet 1(8630):164
Borody TJ, Warren EF, Leis S, Surace R, Ashman O (2003) Treatment of ulcerative colitis using fecal bacteriotherapy. J Clin Gastroenterol 37(1):42–47
Campieri M, Gionchetti P (2001) Bacteria as the cause of ulcerative colitis. Gut 48(1):132–135
Colman RJ, Rubin DT (2014) Fecal microbiota transplantation as therapy for inflammatory bowel diseases: a systematic review and meta-analysis. J Crohns Colitis 8(12):1569–1568
Kaakoush NO, Day AS, Huinao KD, Leach ST, Lemberg DA, Dowd SE, Mitchell HM (2012) Microbial dysbiosis in pediatric patients with Crohn’s disease. J Clin Microbiol 50(10):3258–3266
Kellermayer R, Nagy-Szakal D, Harris RA, Luna RA, Pitashny M, Schady D, Mir SA, Lopez ME, Gilger MA, Belmont J, Hollister EB, Versalovic J (2015) Serial fecal microbiota transplantation alters mucosal gene expression in pediatric ulcerative colitis. Am J Gastroenterol 110(4):604–606
Kostic AD, Xavier RJ, Gevers D (2014) The microbiome in inflammatory bowel diseases: current status and the future ahead. Gastroenterology 146(6):1489–1499
Kunde S, Pham A, Bonczyk S, Crumb T, Duba M, Conrad H Jr, Cloney D, Kugathasan S (2013) Safety, tolerability and clinical response after fecal microbiota transplantation in children and young adults with ulcerative colitis. J Pediatr Gastroenterol Nutr 56(6):597–601
Levine A, Koletzko S, Turner D, Escher JC, Cucchiara S, de Ridder L, Kolho KL, Veres G, Russell RK, Paerregaard A, Buderus S, Greer ML, Dias JA, Veereman-Wauters G, Lionetti P, Sladek M, Martin de Carpi J, Staiano A, Ruemmele FM, Wilson DC, ESPGHAN (2014) ESPGHAN revised Porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr 58(6):795–806
Michail S, Durbin M, Turner D, Griffiths AM, Mack DR, Hyams J, Leleiko N, Kenche H, Stolfi A, Wine E (2012) Alterations in the gut microbiome of children with severe ulcerative colitis. Inflamm Bowel Dis 18(10):1799–1808
Moayyedi P, Surette MG, Kim PT, Libertucci J, Wolfe M, Onischi C, Armstrong D, Marshall JK, Kassam Z, Reinisch W, Lee CH (2015) Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized, controlled trial. Gastroenterology 149(1):102–109
Pariente B, Cosnes J, Danese S, Sandborn WJ, Lewin M, Fletcher JG, Chowers Y, D’Haens G, Feagan BG, Hibi T, Hommes DW, Irvine EJ, Kamm MA, Loftus EV Jr, Louis E, Michetti P, Munkholm P, Oresland T, Panés J, Peyrin-Biroulet L, Reinisch W, Sands BE, Schoelmerich J, Schreiber S, Tilg H, Travis S, van Assche G, Vecchi M, Mary JY, Colombel JF, Lémann M (2011) Development of the Crohn’s disease digestive damage score, the Lémann score. Inflamm Bowel Dis 17(6):1415–1422
Rossen NG, Fuentes S, van der Spek MJ, Tijssen JG, Hartman JH, Duflou A, Löwenberg M, van den Brink GR, Mathus-Vliegen EM, de Vos WM, Zoetendal EG, D’Haens GR, Ponsioen CY (2015) Findings from a randomized controlled trial of fecal transplantation for patients with ulcerative colitis. Gastroenterology 149(1):110–118
Suskind DL, Brittnacher MJ, Wahbeh G, Shaffer ML, Hayden HS, Qin X, Singh N, Damman CJ, Hager KR, Nielson H, Miller SI (2015a) Fecal microbial transplant effect on clinical outcomes and fecal microbiome in active Crohn’s disease. Inflamm Bowel Dis 21(3):556–563
Suskind DL, Sangh N, Nielson H, Wahbeh G (2015b) Fecal microbiota transplantation via nasogastric tube for active pediatric ulcerative colitis. J Pediatr Gastroenterol Nutr 60(1):27–29
Turner D (2014) Relapsing and refractory ulcerative colitis in children. Dig Dis 32(4):419–426
van Nood E, Vrieze A, Nieuwdorp M, Fuentes S, Zoetendal EG, de Vos WM, Visser CE, Kuijper EJ, Bartelsman JF, Tijssen JG, Speelman P, Dijkgraaf MG, Keller JJ (2013) Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med 386(5):407–415
Conflicts of Interest
The authors declare that they have no competing interests in relation to this article.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Karolewska-Bochenek, K. et al. (2017). A Two-Week Fecal Microbiota Transplantation Course in Pediatric Patients with Inflammatory Bowel Disease. In: Pokorski, M. (eds) Clinical Investigation. Advances in Experimental Medicine and Biology(), vol 1047. Springer, Cham. https://doi.org/10.1007/5584_2017_123
Download citation
DOI: https://doi.org/10.1007/5584_2017_123
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-74079-9
Online ISBN: 978-3-319-74080-5
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)