Reconstitution of the gut microbiota of antibiotic-treated patients by autologous fecal microbiota transplant

• Published in: Science translational medicine Vol. 10; no. 460
• Main Authors: Taur, Ying, Coyte, Katharine, Schluter, Jonas, Robilotti, Elizabeth, Figueroa, Cesar, Gjonbalaj, Mergim, Littmann, Eric R, Ling, Lilan, Miller, Liza, Gyaltshen, Yangtsho, Fontana, Emily, Morjaria, Sejal, Gyurkocza, Boglarka, Perales, Miguel-Angel, Castro-Malaspina, Hugo, Tamari, Roni, Ponce, Doris, Koehne, Guenther, Barker, Juliet, Jakubowski, Ann, Papadopoulos, Esperanza, Dahi, Parastoo, Sauter, Craig, Shaffer, Brian, Young, James W, Peled, Jonathan, Meagher, Richard C, Jenq, Robert R, van den Brink, Marcel R M, Giralt, Sergio A, Pamer, Eric G, Xavier, Joao B
• Format: Journal Article
• Language: English
• Published: United States 26.09.2018
• Subjects: Anti-Bacterial Agents - pharmacology; Biodiversity; Fecal Microbiota Transplantation; Gastrointestinal Microbiome - drug effects; Hematopoietic Stem Cell Transplantation; Humans; Longitudinal Studies; Transplantation, Autologous
• ISSN: 1946-6242
• DOI: 10.1126/scitranslmed.aap9489

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.