Clinicians at Seattle Children’s Hospital have found that fecal microbiota transplants (FMTs) may be a therapeutic option for patients with Crohn’s disease. Crohn’s disease (CD) is an inflammatory disease of the GI tract that is marked by an immune attack on a person’s own body, specifically in the gut. The microbiome of CD patients is altered compared to healthy indivduals, but it is not clear if this is a cause or effect of the immune attack. The group at Seattle Children’s Hospital hypothesized that if they could alter the microbiome of these patients that they would promote less inflammation resulting in fewer symptoms.
The successful results were published in the journal Inflammatory Bowel Disease. They conducted fecal microbiota transplants in 9 individuals with pediatric Crohn’s disease between the ages of 12 and 19. Patients received transplants from their parents, 7 from their mother and 2 from their father. After two weeks, 7 of the 9 patients were in remission and at weeks six and twelve, 5 of the 9 patients were still in remission. While the patients did have some side effects, almost all of them were mild.
The investigators looked at the differences in the microbiome between donor and recipient and what impact this had on disease. They found that the individual who received the transplant of a microbiome that was most similar resulted in the smallest change of clinical course and the FMT recipient whose microbiome was the most different resulted in the greatest change in clinical course. They also found that increased levels of Escherichia coli correlated with increased clinical symptoms and inflammatory markers. While it is not likely that E. coli is the cause of CD, it is an interesting observation that could be investigated to better understand what impact it has on disease progression.
This study provided evidence that the microbiome plays and important role in Crohn’s disease. The results of this small study were promising and show that fecal microbiota transplants were generally safe and should be further investigated as a potential therapeutic option for individuals with this inflammatory disease. Further longitudinal studies are important to understand the entire impact that the FMT has on an individual. As we have seen in previous blog posts, while it may cure the disease it is aiming to treat, there can also be other unintended consequences.