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Is Autologous Fecal Microbiota Transfer after Exclusive Enteral Nutrition in Pediatric Crohn’s Disease Patients Rational and Feasible? Data from a Feasibility Test
Background: Exclusive enteral nutrition (EEN) is a highly effective therapy for remission induction in pediatric Crohn’s disease (CD), but relapse rates after return to a regular diet are high. Autologous fecal microbiota transfer (FMT) using stool collected during EEN-induced clinical remission mig...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10096730/ https://www.ncbi.nlm.nih.gov/pubmed/37049583 http://dx.doi.org/10.3390/nu15071742 |
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author | Hoelz, Hannes Heetmeyer, Jeannine Tsakmaklis, Anastasia Hiergeist, Andreas Siebert, Kolja De Zen, Federica Häcker, Deborah Metwaly, Amira Neuhaus, Klaus Gessner, André Vehreschild, Maria J. G. T. Haller, Dirk Schwerd, Tobias |
author_facet | Hoelz, Hannes Heetmeyer, Jeannine Tsakmaklis, Anastasia Hiergeist, Andreas Siebert, Kolja De Zen, Federica Häcker, Deborah Metwaly, Amira Neuhaus, Klaus Gessner, André Vehreschild, Maria J. G. T. Haller, Dirk Schwerd, Tobias |
author_sort | Hoelz, Hannes |
collection | PubMed |
description | Background: Exclusive enteral nutrition (EEN) is a highly effective therapy for remission induction in pediatric Crohn’s disease (CD), but relapse rates after return to a regular diet are high. Autologous fecal microbiota transfer (FMT) using stool collected during EEN-induced clinical remission might represent a novel approach to maintaining the benefits of EEN. Methods: Pediatric CD patients provided fecal material at home, which was shipped at 4 °C to an FMT laboratory for FMT capsule generation and extensive pathogen safety screening. The microbial community composition of samples taken before and after shipment and after encapsulation was characterized using 16S rRNA amplicon sequencing. Results: Seven pediatric patients provided fecal material for nine test runs after at least three weeks of nutritional therapy. FMT capsules were successfully generated in 6/8 deliveries, but stool weight and consistency varied widely. Transport and processing of fecal material into FMT capsules did not fundamentally change microbial composition, but microbial richness was <30 genera in 3/9 samples. Stool safety screening was positive for potential pathogens or drug resistance genes in 8/9 test runs. Conclusions: A high pathogen burden, low-diversity microbiota, and practical deficiencies of EEN-conditioned fecal material might render autologous capsule-FMT an unsuitable approach as maintenance therapy for pediatric CD patients. |
format | Online Article Text |
id | pubmed-10096730 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100967302023-04-13 Is Autologous Fecal Microbiota Transfer after Exclusive Enteral Nutrition in Pediatric Crohn’s Disease Patients Rational and Feasible? Data from a Feasibility Test Hoelz, Hannes Heetmeyer, Jeannine Tsakmaklis, Anastasia Hiergeist, Andreas Siebert, Kolja De Zen, Federica Häcker, Deborah Metwaly, Amira Neuhaus, Klaus Gessner, André Vehreschild, Maria J. G. T. Haller, Dirk Schwerd, Tobias Nutrients Article Background: Exclusive enteral nutrition (EEN) is a highly effective therapy for remission induction in pediatric Crohn’s disease (CD), but relapse rates after return to a regular diet are high. Autologous fecal microbiota transfer (FMT) using stool collected during EEN-induced clinical remission might represent a novel approach to maintaining the benefits of EEN. Methods: Pediatric CD patients provided fecal material at home, which was shipped at 4 °C to an FMT laboratory for FMT capsule generation and extensive pathogen safety screening. The microbial community composition of samples taken before and after shipment and after encapsulation was characterized using 16S rRNA amplicon sequencing. Results: Seven pediatric patients provided fecal material for nine test runs after at least three weeks of nutritional therapy. FMT capsules were successfully generated in 6/8 deliveries, but stool weight and consistency varied widely. Transport and processing of fecal material into FMT capsules did not fundamentally change microbial composition, but microbial richness was <30 genera in 3/9 samples. Stool safety screening was positive for potential pathogens or drug resistance genes in 8/9 test runs. Conclusions: A high pathogen burden, low-diversity microbiota, and practical deficiencies of EEN-conditioned fecal material might render autologous capsule-FMT an unsuitable approach as maintenance therapy for pediatric CD patients. MDPI 2023-04-02 /pmc/articles/PMC10096730/ /pubmed/37049583 http://dx.doi.org/10.3390/nu15071742 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Hoelz, Hannes Heetmeyer, Jeannine Tsakmaklis, Anastasia Hiergeist, Andreas Siebert, Kolja De Zen, Federica Häcker, Deborah Metwaly, Amira Neuhaus, Klaus Gessner, André Vehreschild, Maria J. G. T. Haller, Dirk Schwerd, Tobias Is Autologous Fecal Microbiota Transfer after Exclusive Enteral Nutrition in Pediatric Crohn’s Disease Patients Rational and Feasible? Data from a Feasibility Test |
title | Is Autologous Fecal Microbiota Transfer after Exclusive Enteral Nutrition in Pediatric Crohn’s Disease Patients Rational and Feasible? Data from a Feasibility Test |
title_full | Is Autologous Fecal Microbiota Transfer after Exclusive Enteral Nutrition in Pediatric Crohn’s Disease Patients Rational and Feasible? Data from a Feasibility Test |
title_fullStr | Is Autologous Fecal Microbiota Transfer after Exclusive Enteral Nutrition in Pediatric Crohn’s Disease Patients Rational and Feasible? Data from a Feasibility Test |
title_full_unstemmed | Is Autologous Fecal Microbiota Transfer after Exclusive Enteral Nutrition in Pediatric Crohn’s Disease Patients Rational and Feasible? Data from a Feasibility Test |
title_short | Is Autologous Fecal Microbiota Transfer after Exclusive Enteral Nutrition in Pediatric Crohn’s Disease Patients Rational and Feasible? Data from a Feasibility Test |
title_sort | is autologous fecal microbiota transfer after exclusive enteral nutrition in pediatric crohn’s disease patients rational and feasible? data from a feasibility test |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10096730/ https://www.ncbi.nlm.nih.gov/pubmed/37049583 http://dx.doi.org/10.3390/nu15071742 |
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