Dysbiosis before Fecal Microbiota Transplantation Is a Positive Predictor for a Favorable Outcome in Ulcerative Colitis Patients.

Sowon Park; Yunkoo Kang; Minji Kim; Seung Kim; Hong Koh

Background/Aims Fecal microbiota transplantation (FMT) can induce remission in patients with ulcerative colitis (UC). However, it is not clear which factors influence the outcomes of FMT. Our study aimed to investigate the predictive biomarkers of good prognosis and adverse outcomes by analyzing the microbial changes and clinical outcomes in UC patients after FMT. Methods Ten UC patients received FMT twice with a month of interval. Frozen donor solution was given after extensive work-up, and fecal microbiota of donor and recipients along with the clinical and laboratory outcomes were analyzed. Results According to the dysbiosis, the patients were categorized into two groups: dysbiosis (DUC) and non-dysbiosis (NUC). There was no significant difference in disease activity in the two groups (p=0.41). Three out of seven DUC group showed response after FMT whereas three patients showed adverse events at the first FMT to receive immunomodulatory therapy. When the latter received second FMT after lessening the inflammatory burden, there was a response after second FMT. One patient did not respond to the FMT in DUC group. In NUC group, none of the patients either showed responses or adverse events. The responders showed decrease in number of diarrhea and microbial shift towards the donor within a week after FMT, and the patients who showed adverse event also experienced hematochezia or increase in diarrhea within a week along with significant increase in Proteobacteria phylum. The microbial composition of the donor did not show significant difference according to the responses. Conclusions Regardless of disease activity, UC can be divided into two groups. In patients without dysbiosis, less efficacy of FMT can be predicted. In DUC, patients can respond differently according to the disease activity before FMT, and the prognosis can be improved by lessening the inflammatory burden before FMT.

FECAL microbiota transplantation; ULCERATIVE colitis

Gut & Liver, 2019, Vol 13, Issue 6(suppl. 1), p38

1976-2283

Academic Journal