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update 1 november 2023: 

Uit een langjarig Aziatisch onderzoek  uitgevoerd in de klinische praktijk blijkt een poeptransplantatie (fecale microbiota-transplantatie (FMT) geen nieuwe aandoeningen te veroorzaken. Net als bij eerdere onderzoeken kwamen bijwerkingen op de korte termijn, zoals diarree en buikpijn, vaak voor, bij 24% van de behandelde patiënten maar waren er geen infectieuze complicaties.
Resultaten op langere termijn (langer dan 12 maanden) waren beschikbaar voor 84 patiënten en toonden geen nieuwe aandoeningen gerelateerd aan een poeptransplantatie (fecale microbiota-transplantatie (FMT) en geen significant verschil in de cumulatieve incidentie van nieuw gediagnosticeerde hart- en vaatziekten, diabetes mellitus en kanker vergeleken met de algemene bevolking in eerdere epidemiologische onderzoeken .

Figure thumbnail ga1

Interessant is dat de FMT-groep geassocieerd was met een significant hogere cumulatieve overlevingskans tijdens de follow-upperiode vergeleken met een historische controlegroep, die standaard antibioticatherapie kreeg.

Abstract van deze studie onderaan toegevoegd aan dit artikel

12 juli 2022: 

Een placebo gecontroleerde postpectieve studie (zie dit studieprotocol ) bewijst dat de werkzaamheid op lange termijn van een poeptransplantatie (fecale microbiota-transplantatie (FMT)) bij patiënten met het Prikkelbare Darm Syndroom (PDS)  deze patiënten blijft helpen in het onderdrukken van de symptomen. Ook hun kwaliteit van leven blijkt op 3-jaars meting stukken beter in vergelijking met de patiënten die een placebo kregen. Patiënten die een poeptransplantatie (FMT) ondergingen hadden minder IBS-symptomen en hogere Kwaliteit van Leven scores op zowel 2 als 3 jaar.

De onderzoekers identificeerden ook signalen van 10 bacteriemarkers die correleerden met IBS-symptomen bij patiënten die FMT ondergingen.

In eerdere studies is al bewezen dat een poeptransplantatie patiënten met de darminfectie Clostridium difficile snel kan genezen, zie daarvoor dit artikel waarin video opgenomen hoe een poeptransplantatie in zijn werk gaat: https://kanker-actueel.nl/ontlasting-vaccin-via-neussonde-geneest-darminfectie-clostridium-difficile-razendsnel-en-effectief-90-procent-van-de-patienten-herstelt-binnen-24-uur.html 

    Het studieverslag van de eerst genoemde studie is een vervolg op dit studierapport dat vorig jaar online werd gepubliceerd. Klik op de titel voor het abstract:

    . 2022 Jan;34(1):e14200.
     doi: 10.1111/nmo.14200. Epub 2021 Jun 18.

    Long-term effects of fecal microbiota transplantation (FMT) in patients with irritable bowel syndrome

    Magdy El-Salhy 1 2 3, Anja Bråthen Kristoffersen 4, Jørgen Valeur 5 6, Christina Casen 4, Jan Gunnar Hatlebakk 2 3, Odd Helge Gilja 2 3, Trygve Hausken 2 3
    Affiliations 

    Abstract

    Background: We recently found fecal microbiota transplantation (FMT) in irritable bowel syndrome (IBS) patients to be an effective and safe treatment after 3 months. The present follow-up study investigated the efficacy and safety of FMT at 1 year after treatment.

    Methods: This study included 77 of the 91 IBS patients who had responded to FMT in our previous study. Patients provided a fecal sample and completed five questionnaires to assess their symptoms and quality of life at 1 year after FMT. The dysbiosis index (DI) and fecal bacterial profile were analyzed using a 16S rRNA gene-based DNA probe hybridization. The levels of fecal short-chain fatty acids (SCFAs) were determined by gas chromatography.

    Results: There was a persistent response to FMT at 1 year after treatment in 32 (86.5%) and 35 (87.5%) patients who received 30-g and 60-g FMT, respectively. In the 30-g FMT group, 12 (32.4%) and 8 (21.6%) patients showed complete remission at 1 year and 3 months, respectively; the corresponding numbers in the 60-g FMT group were 18 (45%) and 11 (27.5%), respectively. Abdominal symptoms and the quality of life were improved at 1 year compared with after 3 months. These findings were accompanied by comprehensive changes in the fecal bacterial profile and SCFAs.

    Conclusions: Most of the IBS patients maintained a response at 1 year after FMT. Moreover, the improvements in symptoms and quality of life increased over time. Changes in DI, fecal bacterial profile and SCFAs were more comprehensive at 1 year than after 3 months. www.clinicaltrials.gov (NCT03822299).

    Keywords: fatigue; microbiome; short-chain fatty acids; superdonor; therapy.

    Ook uit deze twee studies blijkt de effectiviteit:

    1. Hugerth LW, Andreasson A, Talley NJ, et al. No distinct microbiome signature of irritable bowel syndrome found in a Swedish random population. Gut. 2020;69(6):1076-1084. https://gut.bmj.com/content/69/6/1076.citation-tools
    2. Zhao HJ, Zhang XJ, Zhang NN, et al. Fecal Microbiota Transplantation for Patients With Irritable Bowel Syndrome: A Meta-Analysis of Randomized Controlled Trials. Front Nutr. 2022;9:890357. https://www.frontiersin.org/articles/10.3389/fnut.2022.890357/full

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    This real-world study provides supporting evidence that FMT has an excellent short- and long-term safety profile.

    ALIMENTARY TRACT|ARTICLES IN PRESS

    Long-Term Safety Outcomes of Fecal Microbiota Transplantation: Real-World Data Over 8 Years From the Hong Kong FMT Registry

    Published:September 19, 2023DOI:https://doi.org/10.1016/j.cgh.2023.09.001  

    Background and Aims

    Prospective long-term real-world safety data after fecal microbiota transplantation (FMT) remain limited. We reported long-term outcomes of FMT from a population-based FMT registry in Hong Kong.

    Methods

    We recruited patients undergoing FMT for recurrent Clostridioides difficile infection (CDI) and non-CDI indications from clinical trials, from June 2013 to April 2022 in Hong Kong. We captured data on demographics, FMT indications and procedures, clinical outcomes and short- to long-term safety. New medical diagnoses were obtained from electronic medical records and independently adjudicated by clinicians. Long-term safety in patients with recurrent CDI was compared with a control group treated with antibiotics.

    Results

    Overall, 123 subjects (median age 53 years, range 13–90 years; 52.0% male) underwent 510 FMTs and were prospectively followed up for a median of 30.3 (range, 1–57.9) months. The most common indication for FMT was type 2 diabetes mellitus. The most common short-term adverse events within 1 month of FMT included diarrhea and abdominal pain. At long-term follow-up beyond 12 months, 16 patients reported 21 new-onset medical conditions confirmed by electronic medical records. All were adjudicated to be unlikely to be related to FMT. There was no new case of inflammatory bowel disease, irritable bowel syndrome, allergy, diabetes mellitus, or psychiatric disorder. In a subgroup of patients with recurrent CDI, FMT was associated with a significantly higher cumulative survival probability compared with matched control subjects.

    Conclusions

    This prospective real-world data from Asia’s first FMT registry demonstrated that FMT has an excellent long-term safety profile. The risk of developing new medical conditions beyond 12 months after FMT is low.

    Graphical abstract

    Figure thumbnail ga1

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    Article info

    Publication history

    Published online: September 19, 2023

    Publication stage

    In Press Journal Pre-Proof

    Footnotes

    Conflicts of Interest These authors disclose the following: Francis Ka Leung Chan and Siew Chien Ng are the scientific cofounders and sit on the board of Directors of GenieBiome Ltd. Siew Chien Ng has served as an advisory board member for Pfizer, Ferring, Janssen, and AbbVie; and as a speaker for Ferring, Tillotts, Menarini, Janssen, AbbVie, and Takeda. Siew Chien Ng has received research grants from Olympus, Ferring, and AbbVie. Francis Ka Leung Chan has served as an advisor and lecture speaker for Eisai Co Ltd, AstraZeneca, Pfizer Inc, Takeda Pharmaceutical Co, and Takeda (China) Holdings Co Ltd. Siew Chien Ng and Francis Ka Leung Chan are named inventors of patent applications held by the Chinese University of Hong Kong and MagIC relating to fecal microbiota transplantation. Louis Ho Shing Lau has received research grant support from Asian Novel Bio-Imaging and Intervention Group and research product support from GenieBiome Ltd; and served as lecture speaker for Olympus, Boston Scientific, and GenieBiome Ltd. Rashid Nok Shun Lui has received speaker fees from Geniebiome Ltd. David T. Rubin has served as a consultant for AbbVie, Altrubio, Aslan Pharmaceuticals, Athos Therapeutics, Bellatrix Pharmaceuticals, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Chronicles, Syneos, ClostraBio, Connect BioPharma, Eco R1, Genentech/Roche, Gilead Sciences, Iterative Health, Janssen Pharmaceuticals, Kaleido Biosciences, Lilly, Pfizer, Prometheus Biosciences, Reistone, Seres Therapeutics, Takeda, Target RWE, and Trellus Health; and received grant support from Takeda. The remaining authors disclose no conflicts.

    Funding This study was funded by InnoHK, the Government of Hong Kong, Special Administrative Region of the People’s Republic of China. Siew Chien Ng is supported by the Croucher Senior Medical Research Fellowship.

    Identification

    DOI: https://doi.org/10.1016/j.cgh.2023.09.001

    Copyright

    © 2023 by the AGA Institute

    ScienceDirect

    Access this article on ScienceDirect

    Prikkelbare Darm Syndroom, PDS, poeptransplantatie, fecale microbiota-transplantatie- FMT, placebo, kwaliteit van leven


    Plaats een reactie ...

    1 Reactie op "Poeptransplantatie - fecale microbiota-transplantatie van gezonde donor blijft jarenlang effectief bij patienten met Prikkelbare Darm Syndroom. Kwaliteit van leven was veel beter in vergelijking met een placebo"

    • Pieter Pekelharing :
      12/07/2022
      Fecestransplantatie kan veel problemen oplossen. Al bij de geboorte wordt het microbioom van een baby verrijkt met stammen van de moeder door bacteriën uit het geboorte kanaal en heel vaak ook feces van de moeder. Helaas blijft hier nog bij wetenschappelijk onderzoek, want de weg naar een formele goedkeuring is vrijwel uitgesloten. Daarom zal de toekomst vooral blijven het begrijpen welke stammen en andere metabolieten hier het goede werk doen en die producten wel op een juridisch kloppende manier aanbieden.
      Comment

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