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Faecal microbiota transfer in patients with microscopic colitis: a pilot study in collagenous colitis
Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden. (Nutrition-Gut-Brain Interactions Research Centre)
Örebro University, School of Medical Sciences. (Nutrition-Gut-Brain Interactions Research Centre)ORCID iD: 0000-0001-9402-4756
Örebro University, School of Health 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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2020 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 55, no 12, p. 1454-1466Article in journal (Refereed) Published
Abstract [en]

Objectives: Faecal microbiota transfer (FMT) consists of the infusion of donor faecal material into the intestine of patients with the aim to restore a disturbed gut microbiota.

Methods: In this pilot study (NCT03275467), the effect of three repeated FMTs (day 0, two weeks, four weeks) was studied and followed up for six months in nine collagenous colitis (CC) patients, using two stool donors.

Results: Five patients had an active disease at the time of baseline sampling. The primary endpoint (remission at six weeks, defined as <3 stools whereof <1 watery stool per day) was achieved by two of these patients, and by one at eight weeks. Overall, in all nine patients, FMT did not result in a significant reduction of watery stools, assessed by daily diary. However, diarrhoea (assessed by gastrointestinal symptom rating scale) was significantly improved at four (p = .038) and eight weeks (p = .038), indigestion at eight (p = .045) and 12 weeks (p = .006), disease-related worries at four (p = .027) and eight weeks (p = .027), and quality of life at six months (p = .009). FMT resulted in an increased number of lamina propria lymphocytes, possibly indicating an initial mucosal immune activation. No serious adverse events, no systemic effects, and no changes in faecal calprotectin and psychological symptoms were observed.

Conclusions: FMT is able to improve symptoms in a yet undefined subset of CC patients. Further studies could help to characterise this subset and to understand if these results can be generalised to all microscopic colitis patients.

Place, publisher, year, edition, pages
Taylor & Francis, 2020. Vol. 55, no 12, p. 1454-1466
Keywords [en]
Faecal microbiota transplantation, microscopic colitis, collagenous colitis, gut microbiota
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-87120DOI: 10.1080/00365521.2020.1839544ISI: 000584733600001PubMedID: 33142068Scopus ID: 2-s2.0-85095747650OAI: oai:DiVA.org:oru-87120DiVA, id: diva2:1492966
Note

Funding Agency:

Faculty of Medicine and Health, Örebro University, Sweden

Available from: 2020-11-04 Created: 2020-11-04 Last updated: 2022-09-12Bibliographically approved
In thesis
1. Gut microbiota, its modifications and the gut-brain axis
Open this publication in new window or tab >>Gut microbiota, its modifications and the gut-brain axis
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The human intestinal microbiota has a major impact on host physiology and might play an important role in several diseases. Therapeutic interventions aimed at modifying the gut microbiota might exert their effects locally as well as systemically, for example via the gut-brain axis, a bidirectional communication system.

The overall aim of this thesis was to investigate potential modes of action via which modifications of the gut microbiota might influence health and disease. Paper I shows that faecal microbiota transfer could improve gastrointestinal symptoms in a subset of patients with collagenous colitis– a chronic low-grade inflammation of the large intestine. Papers II – IV describe the effects of an oral probiotic intervention on different aspects of the gut-brain axis in young, healthy adults. Paper II shows that brainactivity and functional connectivity during negative emotional stimuli were altered after probiotic intervention without major effects on the gut microbiota composition itself. Paper III shows that brain response patterns to an acute stressor were altered, whereas cortisol stress response, autonomic nervous system function and cognitive performance were not affected by the probiotic intervention. Paper IV describes the effect of the probiotic intervention on mental health in daily life. Amongst others, altered resting state brain function, slight improvements in depression symptoms and sleep quality were observed. Furthermore, serum levels of serotonin were slightly altered, indicating a potential mechanism of how probiotics might affect brain function. Paper V is an in vitro study that aimed to further elucidate a potential mechanism behind the microbiota-gut-brain axis. The short-chain fatty acid butyrate, an important microbial metabolite, rescued the disturbed uptake of the serotonin precursor tryptophan into fibroblasts mimicking cells of the nervous system.

This thesis provides insights into whether and how gut microbiota modifications could improve health by affecting the gut-brain axis. Uncovering the underlying mechanisms might facilitate the development of personalised medicine. 

Place, publisher, year, edition, pages
Örebro: Örebro University, 2021. p. 95
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 232
Keywords
gut microbiota, gut-brain axis, faecal microbiota transfer, probiotics, butyratFunctional magnetic resonance imaging, mental health, collagenous colitis
National Category
General Practice
Identifiers
urn:nbn:se:oru:diva-88466 (URN)978-91-7529-373-8 (ISBN)
Public defence
2021-03-08, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 09:30 (English)
Opponent
Supervisors
Available from: 2021-01-12 Created: 2021-01-12 Last updated: 2022-09-12Bibliographically approved

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Rode, JuliaBohr, JohanKumawat, Ashok KumarHultgren Hörnquist, ElisabethBrummer, Robert JanKönig, Julia

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