The following is a summary of “Fecal transplantation for ulcerative colitis from diet-conditioned donors followed by dietary intervention results in favorable gut microbial profile compared to fecal transplantation alone,” published in the May 2024 issue of Gastroenterology by Leibovitzh et al.
A study CRAFT-UC investigated combining fecal microbiota transplantation (FMT) with the UC Exclusion Diet (UCED) for ulcerative colitis (UC), following up on prior research with varying results.
Researchers conducted a retrospective study to assess the impact of FMT with and without the UCED on gut microbial communities in UC.
They enrolled subjects from the CRAFT-UC study with both pre-and post-intervention fecal samples available. Donors underwent a 14-day diet conditioning based on UCED principles. Group 1 (N=11) underwent single FMT via colonoscopy (Day 1) and enemas (Days 2 and 14) without donors’ dietary conditioning. Group 2 (N=10) received FMT with donors’ dietary preconditioning and patients for UCED. Fecal samples were evaluated using DNA shotgun metagenomic sequencing.
The results showed decreased metabolic pathways related to sulfur-containing amino acid biosynthesis after diet conditioning. Group 2 exhibited notable changes in the donors’ microbial composition (ADONIS: R2=0.15, P=0.008) and a significant increase in Eubacterium_sp_AF228LB after the intervention (β-coefficient 2.66, 95%CI 2.1-3.3, q<0.05), which was negatively linked to fecal calprotectin levels (rho=-0.52, P=0.035). Additionally, pathways associated with gut inflammation and barrier function, such as branched-chain amino acids, were enhanced in Group-2 post-intervention and had a significant negative correlation with fecal calprotectin.
Investigators found that FMT from donors on a specific diet followed by the UCED led to positive changes in gut microbes linked with reduced gut inflammation, suggesting that dietary interventions for donors and recipients warrant further investigation as a potential UC treatment.
Source: academic.oup.com/ecco-jcc/advance-article-abstract/doi/10.1093/ecco-jcc/jjae062/7667479