Copyright
©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
Fecal microbiota transplantation induces remission of infantile allergic colitis through gut microbiota re-establishment
Sheng-Xuan Liu, Yin-Hu Li, Wen-Kui Dai, Xue-Song Li, Chuang-Zhao Qiu, Meng-Ling Ruan, Biao Zou, Chen Dong, Yan-Hong Liu, Jia-Yi He, Zhi-Hua Huang, Sai-Nan Shu
Sheng-Xuan Liu, Xue-Song Li, Meng-Ling Ruan, Biao Zou, Chen Dong, Jia-Yi He, Zhi-Hua Huang, Sai-Nan Shu, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Yin-Hu Li, Chuang-Zhao Qiu, Yan-Hong Liu, Department of Microbial Research, WeHealthGene Institute, Shenzhen 518000, Guangdong Province, China
Wen-Kui Dai, Department of Computer Science, College of Science and Engineering, City University of Hong Kong, Hong Kong, China
Author contributions: Liu SX and Li YH contributed equally to this work; Shu SN and Huang ZH designed the research; Dai WK designed the follow-up plans and collected patients’ information with Li XS, Ruan ML, Zou B and Dong C after FMT; Qiu CZ, Liu YH and He JY performed bioinformatics analysis; Ruan ML and Zou B recorded patients’ and donors’ clinical data; Shu SN and Huang ZH conducted FMT.
Supported by National Clinical Key Specialty Construction Project (Pediatric Digestive Disease), No. [2011]873.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (IRB ID: TJ-C20140712).
Informed consent statement: All studied participants, or their legal guardians, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no competing interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sai-Nan Shu, MD, PhD, Associate Professor, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Road, Wuhan 430030, Hubei Province, China.
snshu@tjh.tjmu.edu.cn
Telephone: +86-27-83662688 Fax: +86-27-83662640
Received: September 5, 2017
Peer-review started: September 5, 2017
First decision: September 27, 2017
Revised: November 2, 2017
Accepted: November 8, 2017
Article in press: November 8, 2017
Published online: December 28, 2017
Processing time: 114 Days and 2.6 Hours
AIM
To investigate the impact of fecal microbiota transplantation (FMT) treatment on allergic colitis (AC) and gut microbiota (GM).
METHODS
We selected a total of 19 AC infants, who suffered from severe diarrhea/hematochezia, did not relieve completely after routine therapy or cannot adhere to the therapy, and were free from organ congenital malformations and other contraindications for FMT. Qualified donor-derived stools were collected and injected to the AC infants via a rectal tube. Clinical outcomes and follow-up observations were noted. Stools were collected from ten AC infants before and after FMT, and GM composition was assessed for infants and donors using 16S rDNA sequencing analysis.
RESULTS
After FMT treatment, AC symptoms in 17 infants were relieved within 2 d, and no relapse was observed in the next 15 mo. Clinical improvement was also detected in the other two AC infants who were lost to follow-up. During follow-up, one AC infant suffered from mild eczema and recovered shortly after hormone therapy. Based on the 16S rDNA analysis in ten AC infants, most of them (n = 6) had greater GM diversity after FMT. As a result, Proteobacteria decreased (n = 6) and Firmicutes increased (n = 10) in post-FMT AC infants. Moreover, Firmicutes accounted for the greatest proportion of GM in the patients. At the genus level, Bacteroides (n = 6), Escherichia (n = 8), and Lactobacillus (n = 4) were enriched in some AC infants after FMT treatment, but the relative abundances of Clostridium (n = 5), Veillonella (n = 7), Streptococcus (n = 6), and Klebsiella (n = 8) decreased dramatically.
CONCLUSION
FMT is a safe and effective method for treating pediatric patients with AC and restoring GM balance.
Core tip: This retrospective study explored the therapeutic effects and safety of fecal microbiota transplantation (FMT) treatment in 19 allergic colitis (AC) infants who were younger than 1 year old. After FMT treatment, AC symptoms were relieved in the patients rapidly, and no patient relapsed within 15 mo. With gut microbiota (GM) analysis, six of ten patients exhibited higher microbial diversity after FMT treatment. Moreover, decreased Proteobacteria and increased Firmicutes supplied the hints of GM re-establishment in the patients after FMT treatment. Therefore, this work showed the curative effects of FMT in AC infants and its possible mechanism.
