Fecal Microbiota Transplantation for Ulcerative Colitis: An Evolving Therapy. Issue 4 (15th August 2020)

• Record Type: Journal Article
• Authors: Sood, Ajit; Singh, Arshdeep; Midha, Vandana; Mahajan, Ramit; Kao, Dina; Rubin, David T; Bernstein, Charles N
• Is Part Of: Crohn's & colitis 360. Volume 2:Issue 4(2020)
• Publication Date: 2020-08-15
• Subjects: fecal microbiome transfer -- fecal microbial transplantation -- ulcerative colitis -- randomized controlled trial; Crohn's disease -- Periodicals; Colitis -- Periodicals; 616.344
• DOI: 10.1093/crocol/otaa067
• Languages: English
• ISSNs: 2631-827X

Abstract

Abstract: Background: Fecal microbiota transplantation (FMT) is currently an approved treatment for recurrent and refractory Clostridioides difficile infection. However, its use in ulcerative colitis is at an early stage and significant gaps remain in our understanding of the mechanisms and logistics of its practical application. Methods and results: This article aims to look into specific issues which remain unsettled for use of FMT in ulcerative colitis including donor and recipient selection, route of administration, and duration of therapy. We also discuss optimal ways to assess response to FMT and the current state of FMT regulations. In addition, we postulate the impact of diet on the microbiome profile of the donor and recipient. We also suggest a change in the nomenclature from FMT to fecal microbiome transfer. Conclusion: FMT is an evolving therapy. There are several considerations for its use in UC but its use and role should be directed by further clinical trials. Lay Summary: This article explores fecal microbiota transplantation (FMT) in the treatment of ulcerative colitis in regards to donor and recipient selection, administration route, therapy duration, and donor diet. We discuss assessment of FMT response and the current state of FMT regulation.