The Effectiveness of Multi-Session FMT Treatment in Active Ulcerative Colitis Patients: A Pilot Study

Abstract

The modification of the microbiome through fecal microbiota transplantation (FMT) is becoming a very promising therapeutic option for inflammatory bowel disease (IBD) patients. Our pilot study aimed to assess the effectiveness of multi-session FMT treatment in active ulcerative colitis (UC) patients. Ten patients with UC were treated with multi-session FMT (200 mL) from healthy donors, via colonoscopy/gastroscopy. Patients were evaluated as follows: at baseline, at week 7, and after 6 months, routine blood tests (including C reactive protein (CRP) and calprotectin) were performed. 16S rRNA gene (V3V4) sequencing was used for metagenomic analysis. The severity of UC was classified based on the Truelove-Witts index. The assessment of microbial diversity showed significant differences between recipients and healthy donors. FMT contributed to long-term, significant clinical and biochemical improvement. Metagenomic analysis revealed an increase in the amount of <i>Lactobacillaceaea</i>, <i>Micrococcaceae</i>, <i>Prevotellaceae</i>, and <i>TM7 phylum</i>sp.<i>oral clone EW055</i> during FMT, whereas <i>Staphylococcaceae</i> and <i>Bacillaceae</i> declined significantly. A positive increase in the proportion of the genera <i>Bifidobacterium</i>, <i>Lactobacillus</i>, <i>Rothia</i>, <i>Streptococcus</i>, and <i>Veillonella</i> and a decrease in <i>Bacillus</i>, <i>Bacteroides</i>, and <i>Staphylococcus</i> were observed based on the correlation between calprotectin and <i>Bacillus</i> and <i>Staphylococcus;</i> ferritin and <i>Lactobacillus</i>, <i>Veillonella,</i> and <i>Bifidobacterium</i> abundance was indicated. A positive change in the abundance of <i>Firmicutes</i> was observed during FMT and after 6 months. The application of multi-session FMT led to the restoration of recipients' microbiota and resulted in the remission of patients with active UC.