Further investigation of fecal microbiota transplantation to treat ulcerative colitis

Amsterdam researchers recently published an investigation of fecal microbiota transplantation (FMT) for the treatment of ulcerative colitis (UC). The TURN trial — Transplantation of feces in Ulcerative colitis; Returning Nature’s homeostasis — was a double-blind randomized trial with 48 subjects who had mild to moderatively active UC.

Participants received either a healthy donor’s feces or their own feces (i.e. autologous FMT) via naso-duodenal tube.

No significant difference was observed between groups. In the per protocol analysis, 41.2% of patients in the donor group and 25% of controls achieved the primary endpoint, which was clinical remission of UC. Serious adverse events occurred in 4 patients but these were not considered related to the FMT.

Patients who responded to FMT donor treatment showed a shift toward a donor-like microbiota composition. The microbiota of responders had distinct features from that of nonresponders after FMT.

This study contrasts with a recent study from Canada (covered here on GMFH) in which 24% of the FMT group and 5% of the placebo group achieved remission.

In the Canadian study, the placebo group received a water treatment, while in the Dutch study the placebo group received autologous FMT. Mode of administration was also different — enema and naso-duodenal tube, respectively. Also, while the Canadian study showed a possible donor effect, this was not assessed in the Dutch study because of low numbers in each subgroup.

Reference:

Rossen NG, et al. (2015) Findings from a Randomized Controlled Trial of Fecal Transplantation for Patients with Ulcerative Colitis. Gastroenterology DOI: http://dx.doi.org/10.1053/j.gastro.2015.03.045

Paul Enck
Paul Enck
Prof. Dr. Paul Enck, Director of Research, Dept. of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany. His main interests are gut functions in health and disease, including functional and inflammatory bowel disorders, the role of the gut microbiota, regulation of eating and food intake and its disorders, of nausea, vomiting and motion sickness, and the psychophysiology and neurobiology of the placebo response, with specific emphasis on age and gender contributions. He has published more than 170 original data paper in scientific, peer-reviewed journals, and more than 250 book chapters and review articles. He is board member/treasurer of the European Society of Neurogastroenterology and Motility and of the German Society of Neurogastroenterology and Motility, and has served as reviewer for many international journals and grant agencies.