RT Journal Article
SR Electronic
T1 Reconstitution of the gut microbiota of antibiotic-treated patients by autologous fecal microbiota transplant
JF Science Translational Medicine
FD American Association for the Advancement of Science
SP eaap9489
DO 10.1126/scitranslmed.aap9489
VO 10
IS 460
A1 Taur, Ying
A1 Coyte, Katharine
A1 Schluter, Jonas
A1 Robilotti, Elizabeth
A1 Figueroa, Cesar
A1 Gjonbalaj, Mergim
A1 Littmann, Eric R.
A1 Ling, Lilan
A1 Miller, Liza
A1 Gyaltshen, Yangtsho
A1 Fontana, Emily
A1 Morjaria, Sejal
A1 Gyurkocza, Boglarka
A1 Perales, Miguel-Angel
A1 Castro-Malaspina, Hugo
A1 Tamari, Roni
A1 Ponce, Doris
A1 Koehne, Guenther
A1 Barker, Juliet
A1 Jakubowski, Ann
A1 Papadopoulos, Esperanza
A1 Dahi, Parastoo
A1 Sauter, Craig
A1 Shaffer, Brian
A1 Young, James W.
A1 Peled, Jonathan
A1 Meagher, Richard C.
A1 Jenq, Robert R.
A1 van den Brink, Marcel R. M.
A1 Giralt, Sergio A.
A1 Pamer, Eric G.
A1 Xavier, Joao B.
YR 2018
UL http://stm.sciencemag.org/content/10/460/eaap9489.abstract
AB Patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) receive antibiotics to prevent and treat bacterial infections. Antibiotics, however, also damage the intestinal microbiota by killing beneficial commensal bacteria that inhibit pathogens and promote immune defenses. Loss of gut microbiota diversity increases the risk of adverse outcomes, including infections and graft-versus-host disease. Taur and colleagues conducted a randomized clinical trial to demonstrate the effectiveness of collecting and freezing feces before allo-HSCT, followed by fecal thawing and autologous fecal microbiota transplantation (auto-FMT) after stem cell engraftment. The authors show that auto-FMT reconstitutes major commensal bacterial populations, thereby reestablishing the patient’s gut microbiota diversity and composition.Antibiotic treatment can deplete the commensal bacteria of a patient’s gut microbiota and, paradoxically, increase their risk of subsequent infections. In allogeneic hematopoietic stem cell transplantation (allo-HSCT), antibiotic administration is essential for optimal clinical outcomes but significantly disrupts intestinal microbiota diversity, leading to loss of many beneficial microbes. Although gut microbiota diversity loss during allo-HSCT is associated with increased mortality, approaches to reestablish depleted commensal bacteria have yet to be developed. We have initiated a randomized, controlled clinical trial of autologous fecal microbiota transplantation (auto-FMT) versus no intervention and have analyzed the intestinal microbiota profiles of 25 allo-HSCT patients (14 who received auto-FMT treatment and 11 control patients who did not). Changes in gut microbiota diversity and composition revealed that the auto-FMT intervention boosted microbial diversity and reestablished the intestinal microbiota composition that the patient had before antibiotic treatment and allo-HSCT. These results demonstrate the potential for fecal sample banking and posttreatment remediation of a patient’s gut microbiota after microbiota-depleting antibiotic treatment during allo-HSCT.