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Faecal microbiota transfer in patients with microscopic colitis: A proof-of-concept study in collagenous colitis
Örebro University, School of Medical Sciences. (Nutrition-Gut-Brain Interactions Research Centre)ORCID iD: 0000-0002-4204-6811
Örebro University, School of Medical Sciences. (Nutrition-Gut-Brain Interactions Research Centre,)
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Gastroenterology.
Örebro University, School of Medical Sciences. (Cardiovascular Research Centre)ORCID iD: 0000-0002-2244-9816
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(English)Manuscript (preprint) (Other academic)
National Category
General Practice
Identifiers
URN: urn:nbn:se:oru:diva-78659OAI: oai:DiVA.org:oru-78659DiVA, id: diva2:1379007
Available from: 2019-12-16 Created: 2019-12-16 Last updated: 2019-12-16Bibliographically approved
In thesis
1. Faecal Microbiota Transfer in Irritable Bowel Syndrome and Collagenous Colitis: Clinical outcomes and host-microbe interactions
Open this publication in new window or tab >>Faecal Microbiota Transfer in Irritable Bowel Syndrome and Collagenous Colitis: Clinical outcomes and host-microbe interactions
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Faecal microbiota transfer (FMT) aims at restoring a disturbed gut microbiotaby introducing faecal material from a healthy donor into a patient’s intestine. This approach is known as a safe and effective treatment in patients with recurrent Clostridioides difficile infection. This thesis describes the outcomes of two clinical studies in which FMT was investigated as a therapy for irritable bowel syndrome (IBS) patients andin collagenous colitis (CC) patients. Paper I showed that there were no significant differences in IBS symptom scores between patients receiving faecal material from a healthy donor (allogenic FMT) and patients receiving their own faecal material back (autologous FMT). However, unlike autologous FMT, allogenic FMT significantly decreased symptom scores compared to baseline. Additionally, allogenic FMT wasshown to alter the faecal as well as the mucosal microbiota of the IBSpatients. However, also the autologous FMT had an effect on the faecal and mucosal microbiota indicating that the bowel cleansing and/or theprocessing of the autologous faecal material affected the gut microbiota. Paper II showed that the allogenic FMT evoked a clearly different host response in IBS patients than the autologous FMT. Paper III showedthat allogenic FMT did not result in altered faecal metabolite profilesbut in disturbed interactions between the gut microbiota and its metabolites compared to autologous FMT. Paper IV describes the outcomes of the second clinical study in which repeated FMTs resulted inless diarrhoea in a subset of the treated CC patients.

Although symptoms improved in both clinical studies, the introduction of a new microbiota by FMT did not seem to be the miracle curefor IBS and CC. However, a subset of patients could benefit from FMT, and a future challenge is to identify this subset. The findings of this thesis are essential for designing further studies aimed at increasing FMT efficacy.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2020. p. 76
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 204
Keywords
Faecal microbiota transfer, irritable bowel syndrome, collagenous colitis, gut microbiota, visceral sensitivity, host-microbe interactions, gene expression, metabolites
National Category
General Practice
Identifiers
urn:nbn:se:oru:diva-77633 (URN)978-91-7529-316-5 (ISBN)
Public defence
2020-01-17, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 09:00 (English)
Opponent
Supervisors
Available from: 2019-10-28 Created: 2019-10-28 Last updated: 2019-12-16Bibliographically approved

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Holster, SavanneRode, JuliaBohr, JohanKumawat, Ashok KumarHultgren Hörnquist, ElisabethBrummer, Robert JanKönig, Julia

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Holster, SavanneRode, JuliaBohr, JohanKumawat, Ashok KumarHultgren Hörnquist, ElisabethBrummer, Robert JanKönig, Julia
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