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Matching between Donors and Ulcerative Colitis Patients Is Important for Long-Term Maintenance after Fecal Microbiota Transplantation

We previously demonstrated that fresh fecal microbiota transplantation (FMT) following triple antibiotic therapy (amoxicillin, fosfomycin, metronidazole (AFM); A-FMT) resulted in effective colonization of Bacteroidetes species, leading to short-term clinical response in ulcerative colitis (UC). Its...

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Autores principales: Okahara, Koki, Ishikawa, Dai, Nomura, Kei, Ito, Shoko, Haga, Keiichi, Takahashi, Masahito, Shibuya, Tomoyoshi, Osada, Taro, Nagahara, Akihito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355579/
https://www.ncbi.nlm.nih.gov/pubmed/32486476
http://dx.doi.org/10.3390/jcm9061650
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author Okahara, Koki
Ishikawa, Dai
Nomura, Kei
Ito, Shoko
Haga, Keiichi
Takahashi, Masahito
Shibuya, Tomoyoshi
Osada, Taro
Nagahara, Akihito
author_facet Okahara, Koki
Ishikawa, Dai
Nomura, Kei
Ito, Shoko
Haga, Keiichi
Takahashi, Masahito
Shibuya, Tomoyoshi
Osada, Taro
Nagahara, Akihito
author_sort Okahara, Koki
collection PubMed
description We previously demonstrated that fresh fecal microbiota transplantation (FMT) following triple antibiotic therapy (amoxicillin, fosfomycin, metronidazole (AFM); A-FMT) resulted in effective colonization of Bacteroidetes species, leading to short-term clinical response in ulcerative colitis (UC). Its long-term efficacy and criteria for donor selection are unknown. Here, we analyzed the long-term efficacy of A-FMT compared to AFM monotherapy (mono-AFM). AFM was administered to patients with mild to severe UC for 2 weeks until 2 days before fresh FMT. Clinical response and efficacy maintenance were defined by the decrease and no exacerbation in clinical activity index. The population for intention-to-treat analysis comprised 92 patients (A-FMT, n = 55; mono-AFM, n = 37). Clinical response was observed at 4 weeks post-treatment (A-FMT, 56.3%; mono-AFM, 48.6%). Maintenance rate of responders at 24 months post-treatment was significantly higher with A-FMT than mono-AFM (p = 0.034). Significant differences in maintenance rate according to the age difference between donors and patients were observed. Additionally, sibling FMT had a significantly higher maintenance rate than parent–child FMT. Microbial analysis of patients who achieved long-term maintenance showed that some exhibited similarity to their donors, particularly Bacteroidetes species. Thus, A-FMT exhibited long-term efficacy. Therefore, matching between donors and UC patients may be helpful in effectively planning the FMT regimen.
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spelling pubmed-73555792020-07-23 Matching between Donors and Ulcerative Colitis Patients Is Important for Long-Term Maintenance after Fecal Microbiota Transplantation Okahara, Koki Ishikawa, Dai Nomura, Kei Ito, Shoko Haga, Keiichi Takahashi, Masahito Shibuya, Tomoyoshi Osada, Taro Nagahara, Akihito J Clin Med Article We previously demonstrated that fresh fecal microbiota transplantation (FMT) following triple antibiotic therapy (amoxicillin, fosfomycin, metronidazole (AFM); A-FMT) resulted in effective colonization of Bacteroidetes species, leading to short-term clinical response in ulcerative colitis (UC). Its long-term efficacy and criteria for donor selection are unknown. Here, we analyzed the long-term efficacy of A-FMT compared to AFM monotherapy (mono-AFM). AFM was administered to patients with mild to severe UC for 2 weeks until 2 days before fresh FMT. Clinical response and efficacy maintenance were defined by the decrease and no exacerbation in clinical activity index. The population for intention-to-treat analysis comprised 92 patients (A-FMT, n = 55; mono-AFM, n = 37). Clinical response was observed at 4 weeks post-treatment (A-FMT, 56.3%; mono-AFM, 48.6%). Maintenance rate of responders at 24 months post-treatment was significantly higher with A-FMT than mono-AFM (p = 0.034). Significant differences in maintenance rate according to the age difference between donors and patients were observed. Additionally, sibling FMT had a significantly higher maintenance rate than parent–child FMT. Microbial analysis of patients who achieved long-term maintenance showed that some exhibited similarity to their donors, particularly Bacteroidetes species. Thus, A-FMT exhibited long-term efficacy. Therefore, matching between donors and UC patients may be helpful in effectively planning the FMT regimen. MDPI 2020-05-31 /pmc/articles/PMC7355579/ /pubmed/32486476 http://dx.doi.org/10.3390/jcm9061650 Text en © 2020 by the authors. 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 (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Okahara, Koki
Ishikawa, Dai
Nomura, Kei
Ito, Shoko
Haga, Keiichi
Takahashi, Masahito
Shibuya, Tomoyoshi
Osada, Taro
Nagahara, Akihito
Matching between Donors and Ulcerative Colitis Patients Is Important for Long-Term Maintenance after Fecal Microbiota Transplantation
title Matching between Donors and Ulcerative Colitis Patients Is Important for Long-Term Maintenance after Fecal Microbiota Transplantation
title_full Matching between Donors and Ulcerative Colitis Patients Is Important for Long-Term Maintenance after Fecal Microbiota Transplantation
title_fullStr Matching between Donors and Ulcerative Colitis Patients Is Important for Long-Term Maintenance after Fecal Microbiota Transplantation
title_full_unstemmed Matching between Donors and Ulcerative Colitis Patients Is Important for Long-Term Maintenance after Fecal Microbiota Transplantation
title_short Matching between Donors and Ulcerative Colitis Patients Is Important for Long-Term Maintenance after Fecal Microbiota Transplantation
title_sort matching between donors and ulcerative colitis patients is important for long-term maintenance after fecal microbiota transplantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355579/
https://www.ncbi.nlm.nih.gov/pubmed/32486476
http://dx.doi.org/10.3390/jcm9061650
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