Plain language summary
This retrospective study investigated the safety and efficacy of faecal microbiota transplantation (FMT) in infants with allergic colitis (AC), which is characterised by severe diarrhoea and haemtochezia (the passing of fresh blood with stools). Out of 19 infants selected for FMT, 17 experienced a remission within 1-2 days and stayed in remission for at least 15 months, although 14 needed more than one FMT to maintain remission. The other two also went into remission but were lost to follow-up within less than one month. The donors included the infants’ mothers or their relatives, or healthy infants. For ten patients, faecal microbiota was analysed before FMT and during follow-ups. Microbiota diversity increased in six and decreased in three patients. Firmicutes (a phylum of bacteria which includes Lactobacilli) were increased in all ten patients, whilst in six of the ten patients Proteobacteria (which include many opportunistic pathogens) decreased after FMT. The authors conclude that there is a positive effect on FMT in the treatment of infantile AC and called for more research.
Abstract
AIM: To investigate the impact of fecal microbiota transplantation (FMT) treatment on allergic colitis (AC) and gut microbiota (GM). METHODS We selected a total of 19 AC infants, who suffered from severe diarrhea/hematochezia, did not relieve completely after routine therapy or cannot adhere to the therapy, and were free from organ congenital malformations and other contraindications for FMT. Qualified donor-derived stools were collected and injected to the AC infants via a rectal tube. Clinical outcomes and follow-up observations were noted. Stools were collected from ten AC infants before and after FMT, and GM composition was assessed for infants and donors using 16S rDNA sequencing analysis. RESULTS After FMT treatment, AC symptoms in 17 infants were relieved within 2 d, and no relapse was observed in the next 15 mo. Clinical improvement was also detected in the other two AC infants who were lost to follow-up. During follow-up, one AC infant suffered from mild eczema and recovered shortly after hormone therapy. Based on the 16S rDNA analysis in ten AC infants, most of them (n = 6) had greater GM diversity after FMT. As a result, Proteobacteria decreased (n = 6) and Firmicutes increased (n = 10) in post-FMT AC infants. Moreover, Firmicutes accounted for the greatest proportion of GM in the patients. At the genus level, Bacteroides (n = 6), Escherichia (n = 8), and Lactobacillus (n = 4) were enriched in some AC infants after FMT treatment, but the relative abundances of Clostridium (n = 5), Veillonella (n = 7), Streptococcus (n = 6), and Klebsiella (n = 8) decreased dramatically. CONCLUSION FMT is a safe and effective method for treating pediatric patients with AC and restoring GM balance.
Methodological quality
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