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Colonic distribution of FMT by different enema procedures compared to colonoscopy – proof of concept study using contrast fluid
BACKGROUND: Fecal microbiota transplantation (FMT) has become an important treatment method in recurrent Clostridioides difficile infections and is under investigation as a treatment for several other diseases. FMT’s mechanism of action is assumed to be through alterations of the colon microbiota. F...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594821/ https://www.ncbi.nlm.nih.gov/pubmed/37872499 http://dx.doi.org/10.1186/s12876-023-02979-x |
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author | Skjevling, Linn Kallbekken Hanssen, Hege Marie Valle, Per Christian Goll, Rasmus Juul, Frederik Emil Arlov, Øystein Johnsen, Peter Holger |
author_facet | Skjevling, Linn Kallbekken Hanssen, Hege Marie Valle, Per Christian Goll, Rasmus Juul, Frederik Emil Arlov, Øystein Johnsen, Peter Holger |
author_sort | Skjevling, Linn Kallbekken |
collection | PubMed |
description | BACKGROUND: Fecal microbiota transplantation (FMT) has become an important treatment method in recurrent Clostridioides difficile infections and is under investigation as a treatment for several other diseases. FMT’s mechanism of action is assumed to be through alterations of the colon microbiota. FMT can be delivered by several methods, but few studies have directly compared how FMT is distributed in the colon by different methods. Specifically, the proximal distribution of FMT delivered by enema is unknown. METHODS: In eight participants, we administered contrast fluid (CF) with viscosity similar to an FMT in a crossover study design. First, CF was administered by colonoscopy, followed by an abdominal X-ray to visualize the CF distribution. Next, after four to eight weeks, participants were given CF, but as an enema, followed by a positioning procedure. X-rays were obtained before (enema ÷) and after (enema +) the positioning procedure. CONCLUSION: Proportion of participants with CF in cecum were 100% after colonoscopy, 50% after enema + and 38% after enema ÷. In the transverse colon, proportions were 100% (colonoscopy), 88% (enema +) and 63% (enema ÷). There were no adverse events. INTERPRETATION: This study shows proof of concept for the distribution of FMT to proximal colon when delivered by enema. A positioning procedure after the enema slightly improves the proximal distribution. However, colonoscopy is the only method that ensures delivery to the cecum. Studies are needed to see if FMT colon distribution correlates with treatment effectiveness. TRIAL REGISTRATION: The study was retrospectively registered at ClinicalTrials.gov (NCT05121285) (16/11/2021). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-023-02979-x. |
format | Online Article Text |
id | pubmed-10594821 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-105948212023-10-25 Colonic distribution of FMT by different enema procedures compared to colonoscopy – proof of concept study using contrast fluid Skjevling, Linn Kallbekken Hanssen, Hege Marie Valle, Per Christian Goll, Rasmus Juul, Frederik Emil Arlov, Øystein Johnsen, Peter Holger BMC Gastroenterol Research BACKGROUND: Fecal microbiota transplantation (FMT) has become an important treatment method in recurrent Clostridioides difficile infections and is under investigation as a treatment for several other diseases. FMT’s mechanism of action is assumed to be through alterations of the colon microbiota. FMT can be delivered by several methods, but few studies have directly compared how FMT is distributed in the colon by different methods. Specifically, the proximal distribution of FMT delivered by enema is unknown. METHODS: In eight participants, we administered contrast fluid (CF) with viscosity similar to an FMT in a crossover study design. First, CF was administered by colonoscopy, followed by an abdominal X-ray to visualize the CF distribution. Next, after four to eight weeks, participants were given CF, but as an enema, followed by a positioning procedure. X-rays were obtained before (enema ÷) and after (enema +) the positioning procedure. CONCLUSION: Proportion of participants with CF in cecum were 100% after colonoscopy, 50% after enema + and 38% after enema ÷. In the transverse colon, proportions were 100% (colonoscopy), 88% (enema +) and 63% (enema ÷). There were no adverse events. INTERPRETATION: This study shows proof of concept for the distribution of FMT to proximal colon when delivered by enema. A positioning procedure after the enema slightly improves the proximal distribution. However, colonoscopy is the only method that ensures delivery to the cecum. Studies are needed to see if FMT colon distribution correlates with treatment effectiveness. TRIAL REGISTRATION: The study was retrospectively registered at ClinicalTrials.gov (NCT05121285) (16/11/2021). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-023-02979-x. BioMed Central 2023-10-23 /pmc/articles/PMC10594821/ /pubmed/37872499 http://dx.doi.org/10.1186/s12876-023-02979-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Skjevling, Linn Kallbekken Hanssen, Hege Marie Valle, Per Christian Goll, Rasmus Juul, Frederik Emil Arlov, Øystein Johnsen, Peter Holger Colonic distribution of FMT by different enema procedures compared to colonoscopy – proof of concept study using contrast fluid |
title | Colonic distribution of FMT by different enema procedures compared to colonoscopy – proof of concept study using contrast fluid |
title_full | Colonic distribution of FMT by different enema procedures compared to colonoscopy – proof of concept study using contrast fluid |
title_fullStr | Colonic distribution of FMT by different enema procedures compared to colonoscopy – proof of concept study using contrast fluid |
title_full_unstemmed | Colonic distribution of FMT by different enema procedures compared to colonoscopy – proof of concept study using contrast fluid |
title_short | Colonic distribution of FMT by different enema procedures compared to colonoscopy – proof of concept study using contrast fluid |
title_sort | colonic distribution of fmt by different enema procedures compared to colonoscopy – proof of concept study using contrast fluid |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594821/ https://www.ncbi.nlm.nih.gov/pubmed/37872499 http://dx.doi.org/10.1186/s12876-023-02979-x |
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