Multiple fresh fecal microbiota transplants induces and maintains clinical remission in Crohn’s disease complicated with inflammatory mass

Abstract The ancient Chinese medical literature, as well as our prior clinical experience, suggests that fecal microbiota transplantation (FMT) could treat the inflammatory mass. We aimed to evaluate the efficacy and safety of multiple fresh FMTs for Crohn’s disease (CD) complicated with intraabdomi...

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Main Authors: Zhi He, Pan Li, Jianguo Zhu, Bota Cui, Lijuan Xu, Jie Xiang, Ting Zhang, Chuyan Long, Guangming Huang, Guozhong Ji, Yongzhan Nie, Kaichun Wu, Daiming Fan, Faming Zhang
Format: Article
Language:English
Published: Nature Portfolio 2017-07-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-017-04984-z
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author Zhi He
Pan Li
Jianguo Zhu
Bota Cui
Lijuan Xu
Jie Xiang
Ting Zhang
Chuyan Long
Guangming Huang
Guozhong Ji
Yongzhan Nie
Kaichun Wu
Daiming Fan
Faming Zhang
author_facet Zhi He
Pan Li
Jianguo Zhu
Bota Cui
Lijuan Xu
Jie Xiang
Ting Zhang
Chuyan Long
Guangming Huang
Guozhong Ji
Yongzhan Nie
Kaichun Wu
Daiming Fan
Faming Zhang
author_sort Zhi He
collection DOAJ
description Abstract The ancient Chinese medical literature, as well as our prior clinical experience, suggests that fecal microbiota transplantation (FMT) could treat the inflammatory mass. We aimed to evaluate the efficacy and safety of multiple fresh FMTs for Crohn’s disease (CD) complicated with intraabdominal inflammatory mass. The "one-hour FMT protocol" was followed in all patients. Twenty-five patients were diagnosed with CD and related inflammatory mass by CT or MRI. All patients received the initial FMT followed by repeated FMTs every 3 months. The primary endpoint was clinical response (improvement and remission) and sustained clinical remission at 12 months. Secondary endpoints were improvement in size of phegmon/abscess based upon cross-sectional imaging and safety of FMT. 68.0% (17/25) and 52.0% (13/25) of patients achieved clinical response and clinical remission at 3 months post the initial FMT, respectively. The proportion of patients at 6 months, 12 months and 18 months achieving sustained clinical remission with sequential FMTs was 48.0% (12/25), 32.0% (8/25) and 22.7% (5/22), respectively. 9.5% (2/21) of patients achieved radiological healing and 71.4% (15/21) achieved radiological improvement. No severe adverse events related to FMT were observed. This pragmatic study suggested that sequential fresh FMTs might be a promising, safe and effective therapy to induce and maintain clinical remission in CD with intraabdominal inflammatory mass.
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spelling doaj.art-719bee55394f45ccb1b0d332a4959ad82022-12-21T20:35:57ZengNature PortfolioScientific Reports2045-23222017-07-017111010.1038/s41598-017-04984-zMultiple fresh fecal microbiota transplants induces and maintains clinical remission in Crohn’s disease complicated with inflammatory massZhi He0Pan Li1Jianguo Zhu2Bota Cui3Lijuan Xu4Jie Xiang5Ting Zhang6Chuyan Long7Guangming Huang8Guozhong Ji9Yongzhan Nie10Kaichun Wu11Daiming Fan12Faming Zhang13Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical UniversityMedical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical UniversityDepartment of Radiology, the Second Affiliated Hospital of Nanjing Medical UniversityMedical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical UniversityMedical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical UniversityMedical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical UniversityMedical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical UniversityMedical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical UniversityMedical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical UniversityMedical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical UniversityState Key Laboratory of Cancer Biology & Xijing Hospital of Digestive Diseases, the Fourth Military Medical UniversityState Key Laboratory of Cancer Biology & Xijing Hospital of Digestive Diseases, the Fourth Military Medical UniversityState Key Laboratory of Cancer Biology & Xijing Hospital of Digestive Diseases, the Fourth Military Medical UniversityMedical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical UniversityAbstract The ancient Chinese medical literature, as well as our prior clinical experience, suggests that fecal microbiota transplantation (FMT) could treat the inflammatory mass. We aimed to evaluate the efficacy and safety of multiple fresh FMTs for Crohn’s disease (CD) complicated with intraabdominal inflammatory mass. The "one-hour FMT protocol" was followed in all patients. Twenty-five patients were diagnosed with CD and related inflammatory mass by CT or MRI. All patients received the initial FMT followed by repeated FMTs every 3 months. The primary endpoint was clinical response (improvement and remission) and sustained clinical remission at 12 months. Secondary endpoints were improvement in size of phegmon/abscess based upon cross-sectional imaging and safety of FMT. 68.0% (17/25) and 52.0% (13/25) of patients achieved clinical response and clinical remission at 3 months post the initial FMT, respectively. The proportion of patients at 6 months, 12 months and 18 months achieving sustained clinical remission with sequential FMTs was 48.0% (12/25), 32.0% (8/25) and 22.7% (5/22), respectively. 9.5% (2/21) of patients achieved radiological healing and 71.4% (15/21) achieved radiological improvement. No severe adverse events related to FMT were observed. This pragmatic study suggested that sequential fresh FMTs might be a promising, safe and effective therapy to induce and maintain clinical remission in CD with intraabdominal inflammatory mass.https://doi.org/10.1038/s41598-017-04984-z
spellingShingle Zhi He
Pan Li
Jianguo Zhu
Bota Cui
Lijuan Xu
Jie Xiang
Ting Zhang
Chuyan Long
Guangming Huang
Guozhong Ji
Yongzhan Nie
Kaichun Wu
Daiming Fan
Faming Zhang
Multiple fresh fecal microbiota transplants induces and maintains clinical remission in Crohn’s disease complicated with inflammatory mass
Scientific Reports
title Multiple fresh fecal microbiota transplants induces and maintains clinical remission in Crohn’s disease complicated with inflammatory mass
title_full Multiple fresh fecal microbiota transplants induces and maintains clinical remission in Crohn’s disease complicated with inflammatory mass
title_fullStr Multiple fresh fecal microbiota transplants induces and maintains clinical remission in Crohn’s disease complicated with inflammatory mass
title_full_unstemmed Multiple fresh fecal microbiota transplants induces and maintains clinical remission in Crohn’s disease complicated with inflammatory mass
title_short Multiple fresh fecal microbiota transplants induces and maintains clinical remission in Crohn’s disease complicated with inflammatory mass
title_sort multiple fresh fecal microbiota transplants induces and maintains clinical remission in crohn s disease complicated with inflammatory mass
url https://doi.org/10.1038/s41598-017-04984-z
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