Faecal microbiota transplantation (FMT) is emerging as a new therapeutic approach to restore normal function in the intestinal microbiota. In this study, we demonstrate alternations of intestinal microbiota and immune response in ulcerative colitis (UC) patients treated with a sequential therapy involving FMT following a combination of antibiotics.
Methods:
An antibiotic combination therapy with oral amoxicillin 1500mg/day, fosfomycin 3000mg/day and metronidazole 750mg/day was administered to UC patients for two weeks prior to FMT. Faecal microbiota of the donors and the patients after or before treatment (8 samples from each group, total 32 samples) were processed by sequencing and analysis of the 16S rRNA gene using a Next-generation sequencer MIseq (Illmina). Cytokine and chemokine in their blood samples were analyzed by Multiplex Immunoassays (Bioplex).
Results:
After a two-week-antibiotics therapy, the proportion of phylum Bacteroidetes significantly decreased (P<0.01), while the proportion of phylum Proteobacteria significantly increased (P<0.001). In half of the post-FMT patients, the proportion of phylum Bacteroidetes increased up to the level of donor. Further, along with the recovery of the Bacteroidetes strains after FMT, a trend toward an improvement in patients’ clinical symptoms score was noted.
Conclusion:
To our knowledge, this is the first clinical study of a sequential therapy involving FMT following a combination of antibiotics. We hope that the strategy we have applied may serve as the basis for further progress in understanding how alterations of the intestinal microbiota and immune response may become an effective therapeutic strategy for UC patients.