Abstract
Fecal transplantation or fecal microbiota transplantation (FMT) represents a therapeutic approach that has been applied in early Chinese medicine for diarrhea and has only recently found the way into medicine. However, while it is an intriguing concept that a disease such as Clostridium difficile-associated colitis can be “cured” by the FMT with a transferred intestinal microbiota, it became at the same time apparent that several factors have to be considered. While the data for C. difficile-associated colitis are based on a placebo-controlled trial, the data for many other indications including inflammatory bowel diseases are less clear. Thus, there is the risk of transferring potential infectious disease as well as phenotypic properties such as obesity. Consequently, the donor screening has to be clearly defined. The present book chapter will summarize the development of the field over the last decade and will provide an outlook about possible innovations in the foreseeable future.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Aas, J., Gessert, C. E., & Bakken, J. S. (2003). Recurrent Clostridium difficile colitis: Case series involving 18 patients treated with donor stool administered via a nasogastric tube. Clinical Infectious Diseases, 36, 580–585.
Alang, N., & Kelly, C. R. (2015). Weight gain after fecal microbiota transplantation. Open Forum Infectious Diseases, 2, ofv004.
Bercik, P., Denou, E., Collins, J., Jackson, W., Lu, J., Jury, J., et al. (2011). The intestinal microbiota affect central levels of brain-derived neurotropic factor and behavior in mice. Gastroenterology, 141, 599–609 609 e591–593.
Blossom, D. B., & McDonald, L. C. (2007). The challenges posed by reemerging Clostridium difficile infection. Clinical Infectious Diseases, 45, 222–227.
Borody, T. J., & Campbell, J. (2012). Fecal microbiota transplantation: Techniques, applications, and issues. Gastroenterology Clinics of North America, 41, 781–803.
Borody, T. J., Warren, E. F., Leis, S. M., Surace, R., Ashman, O., & Siarakas, S. (2004). Bacteriotherapy using fecal flora: Toying with human motions. Journal of Clinical Gastroenterology, 38, 475–483.
Brandt, L. J., Aroniadis, O. C., Mellow, M., Kanatzar, A., Kelly, C., Park, T., et al. (2012). Long-term follow-up of colonoscopic fecal microbiota transplant for recurrent Clostridium difficile infection. The American Journal of Gastroenterology, 107, 1079–1087.
Cammarota, G., Ianiro, G., Tilg, H., Rajilic-Stojanovic, M., Kump, P., Satokari, R., et al. (2017). European consensus conference on faecal microbiota transplantation in clinical practice. Gut, 66, 569–580.
Collins, S. M., Kassam, Z., & Bercik, P. (2013). The adoptive transfer of behavioral phenotype via the intestinal microbiota: Experimental evidence and clinical implications. Current Opinion in Microbiology, 16, 240–245.
Costello, S., Waters, O., Bryant, R., Katsikeros, R., Makanyanga, J., Schoeman, M., et al. (2017). OP36: Short duration, low intensity pooled faecal microbiota transplantation induces remission in patients with mild-moderately active ulcerative colitis: a randomized controlled trial. JCC, 11S1, S23.
Couturier-Maillard, A., Secher, T., Rehman, A., Normand, S., De Arcangelis, A., Haesler, R., et al. (2013). NOD2-mediated dysbiosis predisposes mice to transmissible colitis and colorectal cancer. The Journal of Clinical Investigation, 123, 700–711.
Deltheil, T., Guiard, B. P., Cerdan, J., David, D. J., Tanaka, K. F., Reperant, C., et al. (2008). Behavioral and serotonergic consequences of decreasing or increasing hippocampus brain-derived neurotrophic factor protein levels in mice. Neuropharmacology, 55, 1006–1014.
Eiseman, B., Silen, W., Bascom, G. S., & Kauvar, A. J. (1958). Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis. Surgery, 44, 854–859.
Ge, H. D. D. (2000). Zhou Hou Bei Ji Fang. Tianjin: Tianjin Science & Technology Press.
George, R. H., Symonds, J. M., Dimock, F., Brown, J. D., Arabi, Y., Shinagawa, N., et al. (1978a). Identification of Clostridium difficile as a cause of pseudomembranous colitis. British Medical Journal, 1, 695.
George, W. L., Sutter, V. L., Goldstein, E. J., Ludwig, S. L., & Finegold, S. M. (1978b). Aetiology of antimicrobial-agent-associated colitis. Lancet, 1, 802–803.
Gilbert, D. N., Moellering, R. C., Eliopoulos, G. M., & Sande, M. A. (2004). The Sanford guide to antimicrobial therapy (34th ed.). Sperryville, VA: Antimicromial Therapy, Inc..
Hamilton, M. J., Weingarden, A. R., Sadowsky, M. J., & Khoruts, A. (2012). Standardized frozen preparation for transplantation of fecal microbiota for recurrent Clostridium difficile infection. The American Journal of Gastroenterology, 107, 761–767.
Johnsen, P. H., Hilpusch, F., Cavanagh, J. P., Leikanger, I. S., Kolstad, C., Valle, P. C., et al. (2018). Faecal microbiota transplantation versus placebo for moderate-to-severe irritable bowel syndrome: a double-blind, randomised, placebo-controlled, parallel-group, single-centre trial. The Lancet Gastroenterology and Hepatology, 3, 17–24.
Kelly, C. P. (1996). Immune response to Clostridium difficile infection. European Journal of Gastroenterology and Hepatology, 8, 1048–1053.
Khoruts, A., & Sadowsky, M. J. (2011). Therapeutic transplantation of the distal gut microbiota. Mucosal Immunology, 4, 4–7.
Koo, H. L., Van, J. N., Zhao, M., Ye, X., Revell, P. A., Jiang, Z. D., et al. (2014). Real-time polymerase chain reaction detection of asymptomatic Clostridium difficile colonization and rising C. difficile-associated disease rates. Infection Control and Hospital Epidemiology, 35, 667–673.
Kootte, R. S., Levin, E., Salojarvi, J., Smits, L. P., Hartstra, A. V., Udayappan, S. D., et al. (2017). Improvement of insulin sensitivity after lean donor feces in metabolic syndrome is driven by baseline intestinal microbiota composition. Cell Metabolism, 26, 611–619 e616.
Kump, P., Wurm, P., Grochenig, H. P., Wenzl, H., Petritsch, W., Halwachs, B., et al. (2018). The taxonomic composition of the donor intestinal microbiota is a major factor influencing the efficacy of faecal microbiota transplantation in therapy refractory ulcerative colitis. Alimentary Pharmacology and Therapeutics, 47, 67–77.
Kyne, L., Warny, M., Qamar, A., & Kelly, C. P. (2000). Asymptomatic carriage of Clostridium difficile and serum levels of IgG antibody against toxin A. The New England Journal of Medicine, 342, 390–397.
Kyne, L., Warny, M., Qamar, A., & Kelly, C. P. (2001). Association between antibody response to toxin A and protection against recurrent Clostridium difficile diarrhoea. Lancet, 357, 189–193.
Larson, H. E., Price, A. B., Honour, P., & Borriello, S. P. (1978). Clostridium difficile and the aetiology of pseudomembranous colitis. Lancet, 1, 1063–1066.
Lee, C. H., Steiner, T., Petrof, E. O., Smieja, M., Roscoe, D., Nematallah, A., et al. (2016). Frozen vs fresh fecal microbiota transplantation and clinical resolution of diarrhea in patients with recurrent clostridium difficile infection: A randomized clinical trial. JAMA, 315, 142–149.
Leffler, D. A., & Lamont, J. T. (2015). Clostridium difficile infection. The New England Journal of Medicine, 372, 1539–1548.
Lewin, R. A. (2001). More on Merde. Perspectives in Biology and Medicine, 44, 594–607.
Li, S. M. D. (2011). Ben Cao Gang Mu. Bejing: Huaxia Press.
Miller, B. A., Chen, L. F., Sexton, D. J., & Anderson, D. J. (2011). Comparison of the burdens of hospital-onset, healthcare facility-associated Clostridium difficile Infection and of healthcare-associated infection due to methicillin-resistant Staphylococcus aureus in community hospitals. Infection Control and Hospital Epidemiology, 32, 387–390.
Moayyedi, P., Surette, M. G., Kim, P. T., Libertucci, J., Wolfe, M., Onischi, C., et al. (2015). Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial. Gastroenterology, 149, 102–109 e106.
Ott, S. J., Waetzig, G. H., Rehman, A., Moltzau-Anderson, J., Bharti, R., Grasis, J. A., et al. (2017). Efficacy of sterile fecal filtrate transfer for treating patients with Clostridium difficile Infection. Gastroenterology, 152, 799–811 e797.
Paramsothy, S., Kamm, M. A., Kaakoush, N. O., Walsh, A. J., van den Bogaerde, J., Samuel, D., et al. (2017). Multidonor intensive faecal microbiota transplantation for active ulcerative colitis: A randomised placebo-controlled trial. Lancet, 389, 1218–1228.
Postigo, R., & Kim, J. H. (2012). Colonoscopic versus nasogastric fecal transplantation for the treatment of Clostridium difficile infection: A review and pooled analysis. Infection, 40, 643–648.
Ratner, M. (2014). Fecal transplantation poses dilemma for FDA. Nature Biotechnology, 32, 401–402.
Ridaura, V. K., Faith, J. J., Rey, F. E., Cheng, J., Duncan, A. E., Kau, A. L., et al. (2013). Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science, 341, 1241214.
Rossen, N. G., Fuentes, S., van der Spek, M. J., Tijssen, J. G., Hartman, J. H., Duflou, A., et al. (2015). Findings from a randomized controlled trial of fecal transplantation for patients with ulcerative colitis. Gastroenterology, 149, 110–118 e114.
Sambol, S. P., Merrigan, M. M., Tang, J. K., Johnson, S., & Gerding, D. N. (2002). Colonization for the prevention of Clostridium difficile disease in hamsters. The Journal of Infectious Diseases, 186, 1781–1789.
Sandler, R. H., Finegold, S. M., Bolte, E. R., Buchanan, C. P., Maxwell, A. P., Vaisanen, M. L., et al. (2000). Short-term benefit from oral vancomycin treatment of regressive-onset autism. Journal of Child Neurology, 15, 429–435.
Satokari, R., Mattila, E., Kainulainen, V., & Arkkila, P. E. (2015). Simple faecal preparation and efficacy of frozen inoculum in faecal microbiota transplantation for recurrent Clostridium difficile infection – An observational cohort study. Alimentary Pharmacology and Therapeutics, 41, 46–53.
Sepehri, S., Kotlowski, R., Bernstein, C. N., & Krause, D. O. (2007). Microbial diversity of inflamed and noninflamed gut biopsy tissues in inflammatory bowel disease. Inflammatory Bowel Diseases, 13, 675–683.
Siegmund, B. (2017). Is intensity the solution for FMT in ulcerative colitis? Lancet, 389, 1170–1172.
Smith, M., Kassam, Z., Edelstein, C., Burgess, J., & Alm, E. (2014). OpenBiome remains open to serve the medical community. Nature Biotechnology, 32, 867.
Sokol, H., Seksik, P., Furet, J. P., Firmesse, O., Nion-Larmurier, I., Beaugerie, L., et al. (2009). Low counts of Faecalibacterium prausnitzii in colitis microbiota. Inflammatory Bowel Diseases, 15, 1183–1189.
Surawicz, C. M., & Alexander, J. (2011). Treatment of refractory and recurrent Clostridium difficile infection. Nature reviews. Gastroenterology and Hepatology, 8, 330–339.
Turnbaugh, P. J., Ley, R. E., Mahowald, M. A., Magrini, V., Mardis, E. R., & Gordon, J. I. (2006). An obesity-associated gut microbiome with increased capacity for energy harvest. Nature, 444, 1027–1031.
van Nood, E., Vrieze, A., Nieuwdorp, M., Fuentes, S., Zoetendal, E. G., de Vos, W. M., et al. (2013). Duodenal infusion of donor feces for recurrent Clostridium difficile. The New England Journal of Medicine, 368, 407–415.
Walker, A. W., Sanderson, J. D., Churcher, C., Parkes, G. C., Hudspith, B. N., Rayment, N., et al. (2011). High-throughput clone library analysis of the mucosa-associated microbiota reveals dysbiosis and differences between inflamed and non-inflamed regions of the intestine in inflammatory bowel disease. BMC Microbiology, 11, 7.
Zhang, F., Luo, W., Shi, Y., Fan, Z., & Ji, G. (2012). Should we standardize the 1,700-year-old fecal microbiota transplantation? The American Journal of Gastroenterology, 107, 1755 author reply pp. 1755–1756.
Zuo, T., Wong, S. H., Lam, K., Lui, R., Cheung, K., Tang, W., et al. (2018, April). Bacteriophage transfer during faecal microbiota transplantation in Clostridium difficile infection is associated with treatment outcome. Gut, 67(4), 634–643.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Schmidt, F., Siegmund, B. (2018). Fecal Transplantation. In: Haller, D. (eds) The Gut Microbiome in Health and Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-90545-7_20
Download citation
DOI: https://doi.org/10.1007/978-3-319-90545-7_20
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-90544-0
Online ISBN: 978-3-319-90545-7
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)