Abstract

Background

Previous studies showed that patients with Severe IBS respond better to fecal microbiota transplantation (FMT) than do those with Moderate IBS.

Aims

The present study aimed to determine the effects of the transplant dose, route of administering it and repeating FMT on this difference.

Methods

This study included 186 patients with IBS randomized 1:1:1 into groups with a 90-g transplant administered once to the colon (LI), once to the duodenum (SI), or twice to the distal duodenum twice (repeated SI). The patients provided a fecal sample and were asked to complete three questionnaires at baseline and at 3, 6, and 12 months after FMT. The fecal bacteria composition and Dysbiosis index were analyzed using 16 S rRNA gene PCR DNA amplification/probe hybridization covering regions V3–V9.

Results

There was no difference in the response rates between severe IBS and moderate IBS for SI and repeated SI at all observation intervals after FMT. In the LI group, the response rate at 3 months after FMT was higher for moderate IBS than for severe IBS. The levels of Dorea spp. were higher and those of Streptococcus salivarius subsp. Thermophilus, Alistipes spp., Bacteroides and Prevotella spp., Parabacteroides johnsoni and Parabacteroides spp. were lower in moderate IBS than in severe IBS.

Conclusions

There was no difference in the response to FMT between severe and moderate IBS when a 90-g transplant was administered to the small intestine. The difference in the bacterial profile between severe and moderate IBS may explain the difference in symptoms between these patients. (www.clinicaltrials.gov: NCT04236843).

中文翻译：

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重度和中度症状 IBS 患者对粪便微生物群移植反应差异的因素

摘要

背景

先前的研究表明，重度 IBS 患者比中度 IBS 患者对粪便微生物群移植 (FMT) 的反应更好。

目标

本研究旨在确定移植剂量、给药途径和重复 FMT 对这种差异的影响。

方法

这项研究将 186 名 IBS 患者按 1:1:1 随机分为几组，分别对结肠（LI）、十二指肠（SI）进行一次 90 克移植，或对远端十二指肠进行两次（重复 SI）。患者提供了粪便样本，并被要求在基线以及 FMT 后 3、6 和 12 个月时完成三份问卷。使用覆盖 V3-V9 区域的 16 S rRNA 基因 PCR DNA 扩增/探针杂交分析粪便细菌组成和生态失调指数。

结果

在 FMT 后的所有观察间隔内，重度 IBS 和中度 IBS 对于 SI 和重复 SI 的反应率没有差异。在 LI 组中，FMT 后 3 个月时中度 IBS 的缓解率高于重度 IBS。Dorea spp的水平。唾液链球菌亚种的含量较高。嗜热菌属、Alistipes spp.、拟杆菌属和普氏菌属、Parabacteroides johnsoni和Parabacteroides spp.。中度 IBS 患者的患病率低于重度 IBS 患者。

结论

当小肠接受 90 克移植物时，重度和中度 IBS 之间对 FMT 的反应没有差异。重度和中度IBS之间细菌特征的差异可以解释这些患者之间症状的差异。（www.clinicaltrials.gov：NCT04236843）。