El-Salhy M, Casen C, Valeur J, Hausken T, Hatlebakk JG. Responses to faecal microbiota transplantation in female and male patients with irritable bowel syndrome. World J Gastroenterol 2021; 27(18): 2219-2237 [PMID: 34025075 DOI: 10.3748/wjg.v27.i18.2219]
Corresponding Author of This Article
Magdy El-Salhy, BSc, MD, PhD, Chief Doctor, Professor, Department of Medicine, Stord Helse-Fonna Hospital, Tysevegen 64, Stord 5416, Norway. magdy.elsalhy@sklbb.no
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Clinical Trials Study
Open-Access Policy of This Article
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/
Table 2 The response rates of females and males in different irritable bowel syndrome-subtypes at different intervals after faecal microbiota transplantation
Time after FMT
IBS-D
IBS-C
IBS-M
Females
Males
P value
Females
Males
P value
Females
Males
P value
2 wk (%)
73
58
0.3
65
50
0.7
72
55
0.3
1 mo (%)
90
42
0.0003
69
75
0.7
65
60
0.9
3 mo (%)
90
42
0.0003
70
75
0.3
63
80
0.6
Table 3 The response rates in females and males with either moderate or severe irritable bowel syndrome symptoms
Table 4 Irritable bowel syndrome severity scoring system total scores of females and males in the two study groups at different times after faecal microbiota transplantation
Time
Placebo
P value
Active treated
P value
Females
Males
Females
Males
0
320 ± 78
287 ± 69
0.2
319 ± 77
297 ± 82
0.3
2 wk
254 ± 106
256 ± 90
0.9
199 ± 102
205 ± 95
0.6
1 mo
277 ± 98
272 ± 89
0.8
196 ± 108
193 ± 94
0.9
3 mo
288 ± 90
266 ± 100
0.6
173 ± 116
183 ± 105
0.5
Table 5 The irritable bowel syndrome severity scoring system total scores in females and males belonging to different irritable bowel syndrome-sub-types
Time after FMT
IBS-D
IBS-C
IBS-M
Females
Males
P value
Females
Males
P value
Females
Males
P value
2 wk
190.5 ± 191.4
204.0 ± 92.2
0.6
228.1 ± 116.2
239.2 ± 113.8
0.5
202.8 ± 121.3
225.0 ± 65.8
0.5
1 mo
177.8 ± 94.9
226.9 ± 73.3
0.02
228.8 ± 118.1
215.8 ± 115.7
0.6
219.9 ± 136.6
197.0 ± 65.2
0.8
3 mo
157.8 ± 102.9
212.3 ± 96.9
0.03
212.8 ± 124.0
234.6 ± 131.8
0.5
219.2 ± 146.3
149.0 ± 36.0
0.5
Table 6 Irritable bowel syndrome severity scoring system total scores in females and males with moderate or severe irritable bowel syndrome symptoms
Table 7 Fatigue Assessment Scale total scores of females and males in the two study groups at different times after faecal microbiota transplantation
Time
Placebo
Active treated
Females
Males
P value
Females
Males
P value
0
31 ± 5
29 ± 4
0.3
32 ± 5
30 ± 5
0.09
2 wk
31 ± 6
29 ± 6
0.2
28 ± 6
28 ± 5
0.5
1 mo
31 ± 6
27 ± 7
0.1
27 ± 7
29 ± 5
0.5
3 mo
30 ± 4
26 ± 4
0.01
29 ± 6
27 ± 5
0.7
Table 8 Fatigue Assessment Scale total scores of females and males irritable bowel syndrome patients belonging to different irritable bowel syndrome-subtypes
Time after FMT
IBS-D
IBS-C
IBS-M
Females
Males
P value
Females
Males
P value
Females
Males
P value
2 wk
30.1 ± 3.6
27.0 ± 3.6
0.04
28.0 ± 6.3
29.3 ± 7.4
0.5
26.7 ± 5.4
26.3 ± 2.1
0.9
1 mo
27.1 ± 5.2
26.6 ± 4.6
0.6
27.1 ± 6.7
31.3 ± 6.1
0.1
28.3 ± 8.3
28.3 ± 4.0
0.9
3 mo
27.5 ± 5.7
27.8 ± 5.0
0.4
26.0 ± 6.2
29.2 ± 5.0
0.2
26.8 ± 7.6
24.8 ± 2.2
0.7
Table 9 Irritable bowel syndrome quality of life scale total scores of females and males in the two study groups at different times after faecal microbiota transplantation
Time
Placebo
Active treated
Females
Males
P value
Females
Males
P value
0
116 ± 20
130 ± 11
0.03
111 ± 23
114 ± 21
0.9
2 wk
123 ± 29
120 ± 23
0.7
122 ± 24
118 ± 27
0.6
1 mo
123 ± 26
121 ± 26
0.8
126 ± 24
119 ± 29
0.4
3 mo
112 ± 24
118 ± 26
0.2
132 ± 23
131 ± 25
0.9
Table 10 Irritable bowel syndrome quality of life scale total scores of females and males irritable bowel syndrome patients belonging to different irritable bowel syndrome-subtypes
Time after FMT
IBS-D
IBS-C
IBS-M
Females
Males
P value
Females
Males
P value
Females
Males
P value
2 wk
123.3 ± 98
123.7 ± 25.5
0.8
120.5 ± 23.1
102.4 ± 28.0
0.06
123.1 ± 24.6
131.5 ± 13.0
0.4
1 mo
131.3 ± 20.8
129.6 ± 28.2
0.9
121.9 ± 24.4
111.4 ± 29.1
01
125.4 ± 25.2
130.5 ± 11.3
0.8
3 mo
136.4 ± 16.6
134.5 ± 22.7
0.9
128.7 ± 24.4
129.1 ± 31.3
0.6
129.5 ± 28.6
124.8 ± 22.0
0.5
Table 11 Faecal bacteria levels in the female and male irritable bowel syndrome patients in the placebo group at the baseline and 1 mo after faecal microbiota transplantation
Bacteria
Baseline
1 mo after FMT
Females
Males
Females
Males
Actinobacteria
-0.235 ± 0.763
-0.365 ± 0.768
-0.250 ± 0.954
-0.375 ± 0.838
Actinomycetales
0.118 ± 0.382
-0.212 ± 0.536
0.175 ± 0.594
0.100 ± 0.496
Bifidobacterium spp.
-0.020 ± 0.607
-0.154 ± 0.539
0.025 ± 0.660
-0.075 ± 0.572
Alistipes
-0.863 ± 0.895
-0.885 ± 0.900
-0.875 ± 0.853
-0.800 ± 0.709
Alistipes onderdonkii
-0.667 ± 0.792
-0.615 ± 0.718
-0.650 ± 0.834
-0.550 ± 0.783
Bacteroides fragilis
-0.255 ± 0.689
-0.212 ± 0.637
0.175 ± 0.501
0.050 ± 0.221
Bacteroides spp. and Prevotella spp.
-0.980 ± 1.157
-0.885 ± 1.182
-0.750 ± 1.032
-0.900 ± 0.687
Bacteroides stercoris
-0.137 ± 0.448
-0.154 ± 0.415
0.025 ± 0.158
0.100 ± 0.304
Bacteroides zoogleoformans
0.078 ± 0.272
0.038 ± 0.194
0.025 ± 0.158
0 ± 0
Parabacteroides johnsonii
0.039 ± 0.196
0.077 ± 0.269
0.050 ± 0.221
0.100 ± 0.304
Parabacteroides spp.
-0.451 ± 0.642
-0.327 ± 0.706
-0.425 ± 0.747
-0.225 ± 0.480
Firmicutes
-0.431 ± 0.575
-0.385 ± 0.566
-0.325 ± 0.526
-0.400 ± 0.591
Bacilli
0.235 ± 1.124
0.192 ± 0.991
0.271 ± 1.132
0.150 ± 1.001
Catenibacterium mitsuokai
0.000 ± 0.400
0.135 ± 0.525
0.050 ± 0.289
0.100 ± 0.441
Clostridia
-0.020 ± 0.244
-0.077 ± 0.269
-0.025 ± 0.276
0.0 ± 0.036
Clostridium spp.
0.039 ± 0.196
0.038 ± 0.194
0.0 ± 0.0
0.050 ± 0.316
Dialister invisus
0.118 ± 0.381
-0.173 ± 0.474
0.200 ± 0.405
0.225 ± 0.158
Dialister invisus and Megasphaera micronuciformis
0.059 ± 0.238
0.173 ± 0.474
0.125 ± 0.335
0.025 ± 0.158
Dorea spp.
0.569 ± 0.700
0.500 ± 0.700
0.625 ± 0.628
0.667 ± 0.806
Eubacterium biforme
0.412 ± 0.753
0.269 ± 0.598
0.275 ± 0.640
0.400 ± 0.633
Eubacterium hallii
0.804 ± 0.939
0.673 ± 0.879
0.655 ± 0.730
0.650 ± 0.597
Eubacterium rectale
0.078 ± 0.337
0.058 ± 0.235
0.050 ± 0.221
0.025 ± 0.158
Eubacterium siraeum
-1.412 ± 0.963
-1.288 ± 0.161
-1.475 ± 1.086
-1.200 ± 1.265
Faecalibacterium prausnitzii
-0.431 ± 0.671
-0.500 ± 0.804
-0.550 ± 0.745
-0.500 ± 0.599
Lachnospiraceae
0.196 ± 0.566
0.269 ± 0.630
0.325 ± 0.730
0.275 ± 0.640
Lactobacillus ruminis and Pediococcus acidilactici
0.059 ± 0.311
0.077 ± 0.334
0.0 ± 0.0
0.025 ± 0.158
Lactobacillus spp.
0.353 ± 0.594
0.269 ± 0.528
0.325 ± 0.616
0.475 ± 0.680
Phascolarctobacterium spp.
0.078 ± 0337
0.077 ± 0.337
0.125 ± 0.404
0.075 ± 0.350
Ruminococcus albus and Ruminococcus bromii
0.353 ± 0.658
0.404 ± 0.721
0.325 ± 0.616
0.450 ± 0.749
Ruminococcus gnavus
0.431 ± 0.878
0.577 ± 0.878
0.450 ± 0.815
0.325 ± 0.764
Streptococcus agalactiae & Eubacterium rectale
0.157 ± 0.367
0.250 ± 0.480
0.110 ± 0.304
0.125 ± 0.345
Streptococcus salivarius ssp. Thermophilus and Streptococcus sanguinis
0.412 ± 0.606
0.346 ± 0.556
0.675 ± 0.888
0.475 ± 0.751
Streptococcus salivarius ssp. thermophilus
0.628 ± 0.871
0.577 ± 0.915
0.500 ± 0.934
0.600 ± 0.928
Streptococcus spp.
0.471 ± 0.833
0.423 ± 0.696
0.400 ± 0.709
0.450 ± 0.815
Veillonella spp.
-0.177 ± 0.518
-0.173 ± 0.648
-0.175 ± 0.385
-0.150 ± 0.534
Proteobacteria
0.294 ± 0.576
0.289 ± 0.499
0.275 ± 0.599
0.325 ± 0.616
Shigella spp. and Escherichia spp.
-0.275 ± 0.940
-0.212 ± 0.893
-0.200 ± 0.853
-0.335 ± 0.920
Mycoplasma hominis
-0.451 ± 0.503
-0.404 ± 0.496
-0.450 ± 0.504
-0.450 ± 0.503
Akkermansia muciniphila
0.471 ± 0.644
0.365 ± 0.627
0.450 ± 0.714
0.650 ± 0.802
Table 12 Gut bacteria levels in female and male irritable bowel syndrome patients in the active treated group at the baseline and 1 mo after faecal microbiota transplantation
Bacteria
Baseline
1 mo after FMT
Females
Males
Females
Males
Actinobacteria
-0.250 ± 0.954
-0.375 ± 0.838
-0.250 ± 0.719
-0.2350 ± 0.636
Actinomycetales
0.175 ± 0.594
0.100 ± 0.496
0.068 ± 0255
0.145 ± 0.412
Bifidobacterium spp.
0.025 ± 0.660
-0.075 ± 0.572
-0.045 ± 0.526
-0.063 ± 0.433
Alistipes
-0.875 ± 0.853
-0.800 ± 0.709
-0.886 ± 0.869
-0.783 ± 0.821
Alistipes onderdonkii
-0.650 ± 0.834
-0.550 ± 0.783
-0.523 ± 0.699
-0.354 ± 0.565
Bacteroides fragilis
0.175 ± 0.501
0.050 ± 0.221
0.159 ± 0.480
0.104 ± 0.371
Bacteroides spp. and Prevotella spp.
-0.750 ± 1.032
-0.800 ± 0.687
-1.091 ± 1.996
-0.708 ± 0.967
Bacteroides stercoris
0.025 ± 0.158
0.100 ± 0.304
0.023 ± 0.151
0.146 ± 0.357
Bacteroides zoogleoformans
0.025 ± 0.158
0 ± 0
0.091 ± 0.291
0.083 ± 0.347
Parabacteroides johnsonii
0.050 ± 0.221
0.100 ± 0.304
0.045 ± 0.302
0.021 ± 0.144
Parabacteroides spp.
-0.425 ± 0.747
-0.225 ± 0.480
-0.455 ± 0.504
-0.313 ± 0.468
Firmicutes
-0.325 ± 0.526
-0.400 ± 0.591
-0.546 ± 0.627
-0.454 ± 0.483
Bacilli
0.271 ± 1.132
0.150 ± 1.001
0.205 ± 1.047
0.042 ± 0.824
Catenibacterium mitsuokai
0.050 ± 0.289
0.100 ± 0.441
0.023 ± 0.151
0.104 ± 0.515
Clostridia
-0.025 ± 0.276
0.0 ± 0.036
0.068 ± 0.255
0.021 ± 252
Clostridium spp.
0.0 ± 0.0
0.050 ± 0.316
0.223 ± 0.151
0.063 ± 0.245
Dialister invisus
0.200 ± 0.405
0.225 ± 0.158
0.091 ± 0.362
0.146 ± 0.505
Dialister invisus and Megasphaera micronuciformis
0.125 ± 0.335
0.025 ± 0.158
0.068 ± 0.034
0.104 ± 0.308
Dorea spp.
0.625 ± 0.628
0.667 ± 0.806
0.727 ± 0.758
0.663 ± 0.796
Eubacterium biforme
0.275 ± 0.640
0.400 ± 0.633
0.477 ± 0.791
0.563 ± 0.769
Eubacterium hallii
0.655 ± 0.730
0.550 ± 0.597
0.886 ± 0.993
0.979 ± 1.021
Eubacterium rectale
0.050 ± 0.221
0.025 ± 0.158
0-068 ± 0.255
0.042 ± 0.202
Eubacterium siraeum
-1.475 ± 1.086
-1.200 ± 1.265
-1.295 ± 0.930
-1.208 ± 0.988
Faecalibacterium prausnitzii
-0.550 ± 0.745
-0.500 ± 0.599
-0.568 ± 0.759
-0.521 ± 0.825
Lachnospiraceae
0.325 ± 0.730
0.275 ± 0.640
0.205 ± 0.553
0.125 ± 0.489
Lactobacillus ruminis and Pediococcus acidilactici
0.0 ± 0.0
0.025 ± 0.158
0.021 ± 0.146
0.188 ± 0.571
Lactobacillus spp.
0.325 ± 0.616
0.475 ± 0.680
0.500 ± 0.731
0.583 ± 0.679
Phascolarctobacterium spp.
0.125 ± 0.404
0.075 ± 0.350
0.091 ± 0.362
0.083 ± 0.347
Ruminococcus albus and Ruminococcus bromii
0.325 ± 0.616
0.450 ± 0.749
0.205 ± 0.553
0.271 ± 0.574
Ruminococcus gnavus
0.450 ± 0.815
0.325 ± 0.764
0.364 ± 0.810
0.250 ± 0.636
Streptococcus agalactiae & Eubacterium rectale
0.110 ± 0.304
0.125 ± 0.345
0.267 ± 0.495
0.083 ± 0.279
Streptococcus salivarius ssp. thermophilus and Streptococcus sanguinis
0.675 ± 0.888
0.475 ± 0.751
0.455 ± 0.504
0.292 ± 0.459
Streptococcus salivarius ssp. thermophilus
0.500 ± 0.934
0.600 ± 0.928
0.523 ± 0.821
0.604 ± 0.844
Streptococcus spp.
0.400 ± 709
0.450 ± 0.815
0.444 ± 0.841
0.396 ± 0.610
Veillonella spp.
-0.175 ± 0.385
-0.150 ± 0.534
-0.273 ± 0.544
-0.208 ± 0.504
Proteobacteria
0.275 ± 0.599
0.325 ± 0.616
0.717 ± 0.750
0.583 ± 0.498
Shigella spp. and Escherichia spp.
-0.200 ± 0.853
-0.335 ± 0.920
-0.151 ± 1.077
-0.188 ± 0.790
Mycoplasma hominis
-0.450 ± 0.504
-0.450 ± 0.503
-0.500 ± 0.506
-0.479 ± 0.505
Akkermansia muciniphila
0.450 ± 0.714
0.650 ± 0.802
0.741 ± 0.713
0.813 ± 0.915
Table 13 The short-chain fatty acids concentration in the faeces of the placebo group and the patients that received donor’s faecs (faecal microbiota transplantation) at the baseline and 1 mo after faecal microbiota transplantation
Acids
Placebo
Active treated
Baseline
1 mo after FMT
Baseline
1 mo after FMT
Females
Males
Females
Males
Females
Males
Females
Males
Total SCFAs
72 ± 37
69 ± 23.
73 ± 37
69 ± 23
77 ± 40
72 ± 40
87 ± 42
89 ± 26
Acetic acid
42 ± 18
40 ± 15
41 ± 17
40 ± 14
44 ± 21
44 ± 20
46 ± 13
40.2 ± 15.0
Propionic acid
12 ± 8
11 ± 5
12 ± 8
11 ± 5
13 ± 10
13 ± 8
14 ± 4
11 ± 7
Iso-butyric acid
2 ± 2
1 ± 1
1 ± 2
1 ± 1
1 ± 1
1 ± 1
2 ± 2
1 ± 1
Butyric acid
14 ± 9
12 ± 6
13 ± 8
12 ± 6
11 ± 8
12 ± 9
18 ± 14
16 ± 10
Iso-valeric acid
2 ± 2
2 ± 1
2 ± 2
2 ± 1
2 ± 1
2 ± 2
2 ± 2
2 ± 1
Valeric acid
2 ± 2
1 ± 1
2 ± 2
1 ± 1
2 ± 2
2 ± 2
2 ± 1
2 ± 1
Iso-capronic acid
0.1 ± 0.04
0.01 ± 0.07
0.5 ± 0.7
0.4 ± 0.7
0.0 ± 0.0
0.02 ± 0.08
0.01 ± 0.04
0.0 ± 0.0
Capronic acid
0.5 ± 0.7
0.5 ± 0.7
0.01 ± 0.04
0.1 ± 0.08
0.7 ± 1.3
0.6 ± 0.8
0.6 ± 0.9
0.5 ± 0.9
Citation: El-Salhy M, Casen C, Valeur J, Hausken T, Hatlebakk JG. Responses to faecal microbiota transplantation in female and male patients with irritable bowel syndrome. World J Gastroenterol 2021; 27(18): 2219-2237