ACG: Fecal Transplant Safe in Primary Sclerosing Cholangitis
MONDAY, Oct. 16, 2017 -- Fecal microbiota transplantation (FMT) from a rationally selected donor seems safe and effective for patients with primary sclerosing cholangitis (PSC), according to a study presented at the World Congress of Gastroenterology, being held in partnership with the American College of Gastroenterology's annual scientific meeting and postgraduate course Oct. 13 to 18 in Orlando, Florida.
Jessica R. Allegretti, M.D., M.P.H., from Brigham & Women's Hospital in Boston, and colleagues enrolled 10 PSC patients with concurrent inflammatory bowel disease to examine their safety, liver enzyme, and microbiome profiles after FMT. To date, six of the patients have undergone a single FMT by colonoscopy from a healthy donor, selected rationally.
The researchers found that by week 26, three of six patients had a ≥50 percent decrease in alkaline phosphatase (ALP), with an average decrease of 250 versus 10 for responders versus nonresponders. Pre-FMT alpha diversity was significantly less than that of controls; at one week post-FMT, microbiome diversity increased in all PSC patients, and it remained elevated in most patients. Variable taxonomic distributions were seen at the class level pre-FMT, while these distributions appeared more uniform post-FMT. Pre-FMT samples were enriched in Enterobacteriales and Fusobacterium compared with controls; in all post-FMT samples, Fusobacterium remained elevated, while Enterobacteriales exhibited a nonsignificant decrease.
"To our knowledge, this is the first study to demonstrate that FMT from a rationally selected donor is safe, increases microbial diversity, and may improve ALP among PSC patients," the authors write.
Several authors disclosed financial ties to pharmaceutical companies.
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Posted: October 2017