title: Alteration of intestinal dysbiosis by fecal microbiota transplantation does not induce remission in patients with chronic active ulcerative colitis.
abstract: BACKGROUND
  In patients with ulcerative colitis (UC), alterations of the intestinal microbiota, termed dysbiosis, have been postulated to contribute to intestinal inflammation. Fecal microbiota transplantation (FMT) has been used as effective therapy for recurrent Clostridium difficile colitis also caused by dysbiosis. The aims of the present study were to investigate if patients with UC benefit from FMT and if dysbiosis can be reversed.
  
  
  METHODS
  Six patients with chronic active UC nonresponsive to standard medical therapy were treated with FMT by colonoscopic administration. Changes in the colonic microbiota were assessed by 16S rDNA-based microbial community profiling using high-throughput pyrosequencing from mucosal and stool samples.
  
  
  RESULTS
  All patients experienced short-term clinical improvement within the first 2 weeks after FMT. However, none of the patients achieved clinical remission. Microbiota profiling showed differences in the modification of the intestinal microbiota between individual patients after FMT. In 3 patients, the colonic microbiota changed toward the donor microbiota; however, this did not correlate with clinical response. On phylum level, there was a significant reduction of Proteobacteria and an increase in Bacteroidetes after FMT.
  
  
  CONCLUSIONS
  FMT by a single colonoscopic donor stool application is not effective in inducing remission in chronic active therapy-refractory UC. Changes in the composition of the intestinal microbiota were significant and resulted in a partial improvement of UC-associated dysbiosis. The results suggest that dysbiosis in UC is at least in part a secondary phenomenon induced by inflammation and diarrhea rather than being causative for inflammation in this disease.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Patrizia K
authors.initials: PK
authors.lastname: Kump
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Gröchenig
authors.forename: Stefan
authors.initials: S
authors.lastname: Lackner
authors.forename: Slave
authors.initials: S
authors.lastname: Trajanoski
authors.forename: Gerhard
authors.initials: G
authors.lastname: Reicht
authors.forename: K Martin
authors.initials: KM
authors.lastname: Hoffmann
authors.forename: Andrea
authors.initials: A
authors.lastname: Deutschmann
authors.forename: Heimo H
authors.initials: HH
authors.lastname: Wenzl
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Petritsch
authors.forename: Guenter J
authors.initials: GJ
authors.lastname: Krejs
authors.forename: Gregor
authors.initials: G
authors.lastname: Gorkiewicz
authors.forename: Christoph
authors.initials: C
authors.lastname: Högenauer
mesh_terms: D000293:Adolescent; D000328:Adult; D001691:Biological Therapy; D002908:Chronic Disease; D003015:Clostridium Infections / Q000235:genetics / Q000382:microbiology / Q000628:therapy*; D003093:Colitis, Ulcerative / Q000235:genetics / Q000382:microbiology / Q000628:therapy*; D064806:Dysbiosis / Q000235:genetics / Q000382:microbiology / Q000517:prevention & control*; D005243:Feces / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007422:Intestines / Q000382:microbiology; D008297:Male; D054892:Metagenome / Q000235:genetics*; D064307:Microbiota; D008875:Middle Aged; D010802:Phylogeny; D011379:Prognosis; D012336:RNA, Ribosomal, 16S / Q000032:analysis; D012074:Remission Induction; D014180:Transplantation
chemical_list: D012336:RNA, Ribosomal, 16S