Journal Article Clinical Trial Epublish
PubMed: 42860401 DOI: 10.1038/s41467-026-77455-7
Fecal microbiota transplantation for the decolonization of mucosal adherent-invasive Escherichia coli in Crohn's disease: an open-label pilot study.
Nat Commun 17(1)
Authors: Zhilu Xu, Hui Jiang, Wenli Huang, Alicia Chan, Yu Lin, Tingting Chan, Rashid N Lui, Marc T L Wong, Joyce W Y Mak, Francis K L Chan, Caroline Chevarin, Jean-Frédéric Colombel, Anthony Buisson, Siew C Ng
Affiliations
- Microbiota I-Center (MagIC), Hong Kong SAR, China.
- Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Microbiota I-Center (MagIC), Hong Kong SAR, China. Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Microbiota I-Center (MagIC), Hong Kong SAR, China. Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Microbiota I-Center (MagIC), Hong Kong SAR, China. Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China. Center for Gut Microbiota Research, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Université Clermont Auvergne/Inserm U1071, USC INRAE 1382, Clermont-Ferrand, France.
- Department of Gastroenterology, Icahn School of Medicine, Mount Sinai, NY, USA.
- Service d'Hépato-Gastro Entérologie, Université Clermont Auvergne, Inserm, 3iHP, CHU Clermont-Ferrand, Clermont-Ferrand, France.
- Microbiota I-Center (MagIC), Hong Kong SAR, China. Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China. New Cornerstone Science Laboratory, The Chinese University of Hong Kong, Hong Kong SAR, China.
Abstract
Adherent-invasive Escherichia coli (AIEC) is implicated in Crohn's disease (CD) pathogenesis, but whether fecal microbiota transplantation (FMT) clears mucosal AIEC and alters fecal and mucosal microbiomes has not been studied. In this open-label pilot study, thirty adults with CD and seropositivity for serum anti-E.coli antibody (AEcAb) received a single colonoscopic FMT from one of two donors (ClinicalTrials.gov identifier NCT05611866). The primary outcome was adverse events (AEs) within 12 weeks after FMT; secondary outcomes included changes in mucosal AIEC, clinical measures, and fecal and mucosal microbiome profiles. Shotgun metagenomic sequencing for fecal samples and 16S rRNA sequencing for ileal mucosal samples were performed at baseline and after FMT. Baseline AEcAb levels were higher in patients with mucosal AIEC colonization (p = 0.019) and remained elevated after FMT. No FMT-related serious adverse events were reported. FMT was associated with mucosal AIEC decolonization in all 8 evaluable baseline-positive patients. Mucosal alpha diversity increased after FMT (p = 0.023), which correlated with reduced fecal calprotectin (p = 0.034). Microbial pathway profiles in CD patients resembled those of their respective donors with reduced donor-recipient dissimilarity post-FMT (p = 0.030), particularly among recipients with mucosal AIEC decolonization (p = 0.039). In conclusion, this open-label pilot study demonstrates the feasibility of FMT for modulating mucosal AIEC colonization in CD and highlights the importance of capturing microbial changes at the disease site that may be undetectable in fecal samples.
MeSH
Escherichia, Pilot Projects, Pilots, Fecal Microbiota Transplantation, Crohn Disease, Drug-Related Side Effects And Adverse Reactions, Escherichia Coli, Transplantation, Microbiota