Fecal Microbiota Transplantation in Patients With Primary Sclerosing Cholangitis: A Pilot Clinical Trial.
RESULTS: Ten patients underwent FMT. Nine patients had ulcerative colitis, and 1 had Crohn’s colitis. The mean baseline ALP level was 489 U/L. There were no related adverse events. Overall, 30% (3/10) experienced a ≥50% decrease in ALP levels.
While this is a small group of patients from which to draw conclusions, FMT appears to be an alternative means to achieve a shift in fecal microbiota. It has previously been hypothesized that probiotics may be able to play a similar role in PSC, though a variety of studies suggest no consistent and clear consequence of their use, likely secondary to a variety of treatment durations and varying compositions of probiotics [81]. FMT may more easily and directly affect microbiota than probiotics in PSC. A recent clinical trial at Brigham and Women’s Hospital in the USA evaluated the impact of FMT in PSC patients. The study’s primary outcome measures include genotyping and a comparison of recipient microbiota before and after FMT in addition comparison with the donor’s microbiota. Liver chemistry was measured over 3 months, with success defined as a 50% reduction in the levels of ALP, alanine transaminase, aspartate aminotransferase, and total bilirubin. This study concluded in April 2017
The authors concluded that FMT in PSC patient is safe. I agree with this one but not sure about anything else since I haven’t read the full article yet. One critical information I want to know is that how the authors can contribute all those changes to be effects of one single FMT two years ago.
RESULTS: Ten patients underwent FMT. Nine patients had ulcerative colitis, and 1 had Crohn’s colitis. The mean baseline ALP level was 489 U/L. There were no related adverse events. Overall, 30% (3/10) experienced a ≥50% decrease in ALP levels. The diversity increased in all patients post-FMT, as early as week 1 ( P < 0.01). Importantly, abundance of engrafter operational taxonomic units in patients post-FMT correlated with decreased ALP levels ( P = 0.02).