Faecal microbial transplantation (FMT) in IBS

Irritable bowel syndrome (IBS) is characterised by chronic abdominal symptoms such as pain, discomfort, and altered bowel habits. It has a prevalence of 10-20% and strongly affects the patients’ quality of life. Even though its aetiology and pathophysiology are complex and still not well understood, there is growing evidence pointing to a dysbalanced intestinal microbiota composition in IBS patients. IBS symptoms can be improved using antibiotics, prebiotics and probiotics, however, effects are usually only moderate and transient. This is probably due to the fact that only a small part of the complex microbial ecosystem is affected by these treatments.

Faecal transplantation is a treatment that aims at re-establishing a healthy intestinal microbiota by infusing suspended stool from a healthy donor into the intestine of patients with a disturbed intestinal microbiota. Nowadays, it is established as a highly efficient treatment for recurrent Clostridium difficile infection, where perturbations of the intestinal microbiota are responsible for the overgrowth of pathogenic Clostridium difficile strains. In this disorder, faecal transplantation has a cure rate of over 90%, and has been proven to be a durable and safe method according to a recent multicentre long-term follow-up study.

The aim of this project is to develop a successful faecal transplantation protocol in IBS patients, based on the butyrate hypothesis. The project will focus on the microbe-gut-brain interaction mechanisms when the microbial ecosystem of IBS patients with relatively low amount of butyrate producing bacteria is exchanged with a high butyrate producing microbiota. The additional effects of prebiotic and/or probiotic treatment will also be investigated.

Publications

S Holster, D Repsilber, D Geng , T Hyötyläinen, A Salonen, C M Lindqvist, S K Rajan, W M de Vos, R J Brummer, J König. Correlations between microbiota and metabolites after faecal microbiota transfer in irritable bowel syndrome. Benef Microbes. 2021 Feb 24;12(1):17-30.

Savanne Holster, Guido J Hooiveld, Dirk Repsilber, Willem M de Vos, Robert J Brummer, Julia König. Allogenic Faecal Microbiota Transfer Induces Immune-Related Gene Sets in the Colon Mucosa of Patients with Irritable Bowel Syndrome. Biomolecules. 2019 Oct 8;9(10):586.

Savanne Holster, Carl Mårten Lindqvist, Dirk Repsilber, Anne Salonen, Willem M de Vos , Julia König, Robert J Brummer. The Effect of Allogenic Versus Autologous Fecal Microbiota Transfer on Symptoms, Visceral Perception and Fecal and Mucosal Microbiota in Irritable Bowel Syndrome: A Randomized Controlled Study. Clin Transl Gastroenterol. 2019 Apr;10(4):e00034.

Julia König, Robert Jan Brummer, Faecal microbiota transplantation in IBS - new evidence for success? Nat Rev Gastroenterol Hepatol. 2020 Apr;17(4):199-200.