Failure of Fecal Microbiota Transplantation in a Three-Year-Old Child with Severe Refractory Ulcerative Colitis
0
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Fecal microbiota transplantation (FMT) is a treatment designed to correct gut dysbiosis by administration of feces from a healthy volunteer. It is still unclear whether FMT for children with ulcerative colitis (UC) is effective or hazardous. Here we describe a young patient to have received FMT for UC. A three-year-old girl was admitted to our hospital with severe active UC, and treated with aminosalicylates and various immunosuppressive drugs. As remission was not achieved, we decided to try FMT before colectomy. We administered donor fecal material a total of six times by retention enema (×2) and via a nasoduodenal tube (×4) within 10 days. The patient developed abdominal pain and pyrexia after each FMT session. Analyses revealed the transferred donor fecal microbiota had not been retained by the patient, who ultimately underwent colectomy. The severity of the UC and/or timing of FMT may have partly accounted for the poor outcome.
Abstract
Fecal microbiota transplantation (FMT) is a treatment designed to correct gut dysbiosis by administration of feces from a healthy volunteer. It is still unclear whether FMT for children with ulcerative colitis (UC) is effective or hazardous. Here we describe a young patient to have received FMT for UC. A three-year-old girl was admitted to our hospital with severe active UC, and treated with aminosalicylates and various immunosuppressive drugs. As remission was not achieved, we decided to try FMT before colectomy. We administered donor fecal material a total of six times by retention enema (×2) and via a nasoduodenal tube (×4) within 10 days. The patient developed abdominal pain and pyrexia after each FMT session. Analyses revealed the transferred donor fecal microbiota had not been retained by the patient, who ultimately underwent colectomy. The severity of the UC and/or timing of FMT may have partly accounted for the poor outcome.
참고문헌 (18)
- Qin J, "A human gut microbial gene catalogue established by metagenomic sequencing", Nature, 464, pp.59~65 (2010)
- Takaishi H, "Imbalance in intestinal microflora constitution could be involved in the pathogenesis of inflammatory bowel disease", Int J Med Microbiol, 298, pp.463~472 (2008)
- Talley NJ, "American College of Gastroenterology IBD Task Force. An evidence-based systematic review on medical therapies for inflammatory bowel disease", Am J Gastroenterol, 106(Suppl 1), pp.S2~S25 (2011)
- Moayyedi P, "Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial", Gastroenterology, 149, pp.102~109 (2015)
- Kanai T, "A breakthrough in probiotics: Clostridium butyricum regulates gut homeostasis and anti-inflammatory response in inflammatory bowel disease", J Gastroenterol, 50, pp.928~939 (2015)
- Bakken JS, "Fecal Microbiota Transplantation Workgroup. Treating Clostridium difficile infection with fecal microbiota transplantation", Clin Gastroenterol Hepatol, 9, pp.1044~1049 (2011)
- Matsuki T, "Development of 16S rRNA-gene-targeted group-specific primers for the detection and identification of predominant bacteria in human feces", Appl Environ Microbiol, 68, pp.5445~5451 (2002)
- Hayashi H, "Fecal microbial diversity in a strict vegetarian as determined by molecular analysis and cultivation", Microbiol Immunol, 46, pp.819~831 (2002)
- Sakamoto M, "Terminal restriction fragment length polymorphism analysis for human fecal microbiota and its application for analysis of complex bifidobacterial communities", Microbiol Immunol, 47, pp.133~142 (2003)
- Kumagai H, "Intestinal microbiota and secretory immunoglobulin A in feces of exclusively breast-fed infants with blood-streaked stools", Microbiol Immunol, 56, pp.657~663 (2012)
- Damman CJ, "Low level engraftment and improvement following a single colonoscopic administration of fecal microbiota to patients with ulcerative colitis", PLoS One, 10, pp.e0133925~ (2015)
- Kunde S, "Safety, tolerability, and clinical response after fecal transplantation in children and young adults with ulcerative colitis", J Pediatr Gastroenterol Nutr, 56, pp.597~601 (2013)
- Li H, "The outer mucus layer hosts a distinct intestinal microbial niche", Nat Commun, 6, pp.8292~ (2015)
- Angelberger S, "Temporal bacterial community dynamics vary among ulcerative colitis patients after fecal microbiota transplantation", Am J Gastroenterol, 108, pp.1620~1630 (2013)
- Vandenplas Y, "Fecal microbial transplantation in early-onset colitis: caution advised", J Pediatr Gastroenterol Nutr, 61, pp.e12~e14 (2015)
- Vandenplas Y, "Fecal microbiota transplantation: just a fancy trend", J Pediatr Gastroenterol Nutr, 61, pp.4~7 (2015)
- Vermeire S, "Pilot study on the safety and efficacy of faecal microbiota transplantation in refractory Crohn’s disease", Gastroenterol, 142(Suppl 1), pp.S360~ (2012)
- Quera R, "Bacteremia as an adverse event of fecal microbiota transplantation in a patient with Crohn's disease and recurrent Clostridium difficile infection", J Crohns Colitis, 8, pp.252~253 (2014)
