MedicalResearch.com Interview with:
Michael J Sadowsky Ph.D
Director, BioTechnology Institute
University of Minnesota
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Sadowsky: Fecal microbiota transplantation (FMT) has become increasingly common in the treatment of patients with refractory Clostridium difficile infection (CDI). It also holds promise for the treatment of medical conditions ranging from inflammatory bowel and Crohn’s disease to diabetes and metabolic syndrome. In contrast to standard antibiotic therapies, which further disrupt intestinal microflora and may contribute to the recurrence of CDI, FMT restores intestinal microbiome and healthy gut function.
Despite therapeutic successes, little is known about the stability of transplanted microbiota over time. This report contributes to our understanding of the short-and long-term composition of gut microbiota following Fecal microbiota transplantation.
In this study, fecal samples collected before and after treatment were compared with data from the Human Microbiome Project (HMP). Treatment using FMT resulted in the rapid normalization of microbial composition in the patient, with the post-treatment profiles closely resembling the normal distribution of fecal microbiota from the donor. While the composition of fecal microbiota in the donor and recipient varied over time, both remained in the large band characterized as normal in hundreds of healthy individuals collected as part of the HMP. Furthermore, while the composition of the microflora in Fecal microbiota transplantation recipients and donors diverges over time, the recipient profiles stay within the same dynamic range as the original implanted donor material.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Sadowsky: Change in fecal microbial composition is an intrinsic and expected outcome. It is consistent with normal responsiveness to shifts in the diet and other environment factors. Variability should be taken into account when comparing microbial composition in normal individuals and in those with dysbiosis characteristic of disease states, especially when considering therapeutic interventions and assessing outcomes.
As the field evolves, it may also have implications of diagnostic predictors of dysbiosis, especially in patients with multiple gastrointestinal or other medical conditions.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Sadowsky: Significantly, the performance of frozen and fresh preparations of fecal material was indistinguishable in our limited sample. This finding warrants further study with a larger cohort, but has several implications for the widespread adoption of Fecal microbiota transplantation.
First, the frozen preparation greatly simplifies the standardization and distribution of the fecal material.
Second, it facilitates long-term storage of donor material for future study.
Finally, it has potential over fresh material in the testing of fecal samples for pathogens, since some tests take several weeks to complete.
Dynamic changes in short- and long-term bacterial composition following fecal microbiota transplantation for recurrent Clostridium difficile infection.
Alexa Weingarden, Antonio González, Yoshiki Vázquez-Baeza, Sophie Weiss, Gregory Humphry, Donna Berg-Lyons, Dan Knights, Tatsuya Unno, Aleh Bobr, Johnthomas Kang, Alexander Khoruts, Rob Knight Microbiome, 2015; 3 (1) DOI: 10.1186/s40168-015-0070-0
MedicalResearch.com Interview with: Michael J Sadowsky Ph.D (2015). Fecal Microbiota Transplantation May Normalize Intestinal Microbiome