title: Fecal microbiota transplantation for patients with steroid-resistant acute graft-versus-host disease of the gut.
abstract: Increasing evidence indicates that the gut microbiota is closely associated with acute graft-versus-host disease (aGVHD) in stem cell transplantation (SCT). Fecal microbiota transplantation (FMT) could represent an alternative treatment option for aGVHD. However, FMT for SCT patients carries a potential risk of infection by infused microbiota because of the severely immunosuppressed status. We therefore conducted a pilot study to evaluate the safety of FMT in SCT. A total of 4 patients with steroid-resistant (n = 3) or steroid-dependent gut aGVHD (n = 1) received FMT. No severe adverse events attributed to FMT were observed. All patients responded to FMT, with 3 complete responses and 1 partial response. Temporal dynamics of microbiota seemed to be linked to the gut condition of patients and peripheral effector regulatory T cells also increased during response to FMT. FMT was safely performed in our patients and might offer a novel therapeutic option for aGVHD. This trial was registered at the University Hospital Medical Information Network (https://upload.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000017575) as #UMIN000015115.
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Kazuhiko
authors.identifier: 0000-0001-5062-5795
authors.initials: K
authors.lastname: Kakihana
authors.affiliation: Division of Cancer Immunology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan.|Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fujioka
authors.affiliation: Graduate School of Frontier Sciences, The University of Tokyo, Chiba, Japan.|Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Suda
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Yuho
authors.initials: Y
authors.lastname: Najima
authors.affiliation: Gastroenterology Division, Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Kuwata
authors.affiliation: Center for Integrative Medical Sciences, RIKEN, Kanagawa, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sasajima
authors.affiliation: Graduate School of Environmental and Life Science, Okayama University, Okayama, Japan.
authors.forename: Iyo
authors.initials: I
authors.lastname: Mimura
authors.affiliation: Graduate School of Environmental and Life Science, Okayama University, Okayama, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Morita
authors.affiliation: Division of Cancer Immunology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sugiyama
authors.affiliation: Division of Cancer Immunology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Nishikawa
authors.affiliation: Graduate School of Frontier Sciences, The University of Tokyo, Chiba, Japan.|Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan.
authors.forename: Masahira
authors.initials: M
authors.lastname: Hattori
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Hino
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Ikegawa
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Hematology and Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan; and.
authors.forename: Takashi
authors.initials: T
authors.lastname: Toya
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Doki
authors.affiliation: Gastroenterology Division, Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Koizumi
authors.affiliation: Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo, Japan.|Center for Integrative Medical Sciences, RIKEN, Kanagawa, Japan.|Japan Agency for Medical Research and Development-Core Research for Evolutional Science and Technology, Tokyo, Japan.
authors.forename: Kenya
authors.initials: K
authors.lastname: Honda
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Ohashi
mesh_terms: D000208:Acute Disease; D000328:Adult; D064591:Allografts; D000069467:Fecal Microbiota Transplantation; D005260:Female; D000069196:Gastrointestinal Microbiome; D006086:Graft vs Host Disease / Q000276:immunology / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016867:Immunocompromised Host; D007410:Intestinal Diseases / Q000276:immunology / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D015470:Leukemia, Myeloid, Acute / Q000276:immunology / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D050378:T-Lymphocytes, Regulatory / Q000276:immunology / Q000473:pathology