title: Donor Species Richness Determines Faecal Microbiota Transplantation Success in Inflammatory Bowel Disease.
abstract: OBJECTIVE
  Faecal microbiota transplantation is a successful therapy for patients with refractory Clostridium difficile infections. It has also been suggested as a treatment option for inflammatory bowel disease, given the role of the intestinal microbiota in this disease. We assessed the impact of faecal microbiota transplantation in patients with inflammatory bowel disease and studied predictors of clinical (non-)response in microbial profiles of donors and patients.
  
  
  METHODS
  Fourteen refractory patients (8 with ulcerative colitis and 6 with Crohn's disease) underwent ileocolonoscopy with faecal microbiota transplantation through a nasojejunal (n = 9) or rectal (n = 5) tube. Efficacy was assessed by endoscopic healing at week 8, clinical activity scores and C-reactive protein measurement. Faecal microbiota was analysed by 16S rDNA pyrosequencing.
  
  
  RESULTS
  There was no significant improvement among the 6 patients with Crohn's disease at week 8 following faecal microbiota transplantation. One patient experienced temporary clinical remission for 6 weeks. In contrast, 2/8 patients with ulcerative colitis had endoscopic remission at week 8, and of the 6 remaining patients with ulcerative colitis, 1 reported temporary remission for 6 weeks. The donor microbiota richness and the number of transferred phylotypes were associated with treatment success. Persistent increased C-reactive protein 2 weeks after transplantation was predictive of failure of response.
  
  
  CONCLUSIONS
  Faecal microbiota transplantation led to endoscopic and long-term (>2 years) remission in 2 out of 8 ulcerative colitis patients. Higher donor richness was associated with successful transplant. Therefore, faecal microbiota transplantation with donor prescreening could be a treatment option for selected refractory ulcerative colitis patients.
authors.affiliation: KU Leuven, Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospitals Leuven, Leuven, Belgium Severine.Vermeire@uzleuven.be.
authors.forename: Severine
authors.initials: S
authors.lastname: Vermeire
authors.forename: Marie
authors.initials: M
authors.lastname: Joossens
authors.affiliation: KU Leuven, Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospitals Leuven, Leuven, Belgium.
authors.forename: Kristin
authors.initials: K
authors.lastname: Verbeke
authors.affiliation: KU Leuven, Department of Microbiology and Immunology, Rega Institute, Leuven, Belgium VIB, Center for the Biology of Disease, Leuven, Belgium.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: KU Leuven, Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospitals Leuven, Leuven, Belgium.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Machiels
authors.affiliation: KU Leuven, Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospitals Leuven, Leuven, Belgium.
authors.forename: João
authors.initials: J
authors.lastname: Sabino
authors.affiliation: KU Leuven, Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospitals Leuven, Leuven, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Ferrante
authors.affiliation: KU Leuven, Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospitals Leuven, Leuven, Belgium.
authors.forename: Gert
authors.initials: G
authors.lastname: Van Assche
authors.affiliation: KU Leuven, Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospitals Leuven, Leuven, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: Rutgeerts
authors.affiliation: KU Leuven, Department of Microbiology and Immunology, Rega Institute, Leuven, Belgium VIB, Center for the Biology of Disease, Leuven, Belgium.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Raes
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D003093:Colitis, Ulcerative / Q000628:therapy; D003113:Colonoscopy; D003424:Crohn Disease / Q000628:therapy; D000069467:Fecal Microbiota Transplantation; D005260:Female; D000069196:Gastrointestinal Microbiome / Q000502:physiology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000382:microbiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein
keywords: Faecal microbiota transplantation (FMT); Oscillibacter; Roseburia