Wie advies wilt over hoe het microbioom te verbeteren zou contact op kunnen nemen met deze website: Www.microbiome-Center.nl Voor zowel artsen als individuele burgers staat een groep van artsen en wetenschappers klaar om u een persoonlijk advies te geven.

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

    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

    Similar articles

    References

      1. El-Salhy M, Mazzawi T. Fecal microbiota transplantation for managing irritable bowel syndrome. Expert Rev Gastroenterol Hepatol. 2018;12(5):439-445.
      1. El-Salhy M. Irritable bowel syndrome: diagnosis and pathogenesis. World J Gastroenterol. 2012;18:5151-5163.
      1. Talley NJ, Gabriel SE, Harmsen WS, Zinsmeister AR, Evans RW. Medical costs in community subjects with irritable bowel syndrome. Gastroenterology. 1995;109:1736-1741.
      1. Jones R, Lydeard S. Irritable bowel syndrome in the general population. BMJ. 1992;304:87-90.
      1. Hungin AP, Whorwell PJ, Tack J, Mearin F. The prevalence, patterns and impact of irritable bowel syndrome: an international survey of 40,000 subjects. Aliment Pharmacol Ther. 2003;17:643-650.
      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.
      1. El-Salhy M, Hatlebakk JG, Gilja OH, Brathen Kristoffersen A, Hausken T. Efficacy of faecal microbiota transplantation for patients with irritable bowel syndrome in a randomised, double-blind, placebo-controlled study. Gut. 2020;69(5):856-867.
      1. Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment pharmacol Ther. 1997;11(2):395-402.
      1. Hendriks C, Drent M, Elfferich M, De Vries J. The fatigue assessment scale: quality and availability in sarcoidosis and other diseases. Curr Opin Pulm Med. 2018;24(5):495-503.
      1. Drossman DA, Patrick DL, Whitehead WE, et al. Further validation of the IBS-QOL: a disease-specific quality-of-life questionnaire. American J Gastroenterol. 2000;95:999-1007.
      1. Wong RK, Drossman DA. Quality of life measures in irritable bowel syndrome. Expert Rev Gastroenterol Hepatol. 2010;4(3):277-284.
      1. Arslan G, Lind R, Olafsson S, Florvaag E, Berstad A. Quality of life in patients with subjective food hypersensitivity: applicability of the 10-item short form of the Nepean dyspepsia Index. Dig Dis Sci. 2004;49:680-687.
      1. Casén C, Vebø HC, Sekelja M, et al. Deviations in human gut microbiota: a novel diagnostic test for determining dysbiosis in patients with IBS or IBD. Aliment Pharmacol Ther. 2015;42(1):71-83.
      1. Enck P, Mazurak N. Dysbiosis in functional bowel disorders. Ann Nutr Metab. 2018;72(4):296-306.
      1. Zijlstra JB, Beukema J, Wolthers BG, Byrne BM, Groen A, Dankert J. Pretreatment methods prior to gaschromatographic analysis of volatile fatty acids from faecal samples. Clin Chim Acta. 1977;78(2):243-250.
      1. Hoverstad T, Fausa O, Bjorneklett A, Bohmer T. Short-chain fatty acids in the normal human feces. Scand J Gastroenterol. 1984;19(3):375-381.
      1. Holvoet T, Joossens M, Vázquez-Castellanos JF, et al. Fecal microbiota transplantation reduces symptoms in some patients with irritable bowel syndrome with predominant abdominal bloating: short- and long-term results from a placebo-controlled randomized trial. Gastroenterology. 2021;160(1):145-157.e8. https://doi.org/10.1053/j.gastro.2020.07.013
      1. Mishra AK, Gimenez G, Lagier JC, Robert C, Raoult D, Fournier PE. Genome sequence and description of Alistipes senegalensis sp. nov. Stand Genomic Sci. 2012;6(3):1-16.
      1. Sun Q, Jia Q, Song L, Duan L. Alterations in fecal short-chain fatty acids in patients with irritable bowel syndrome: a systematic review and meta-analysis. Medicine. 2019;98(7):e14513.
      1. El-Salhy M, Valeur J, Hausken T, Gunnar HJ. Changes in fecal short-chain fatty acids following fecal microbiota transplantation in patients with irritable bowel syndrome. Neurogastroenterol Motil. 2021;33(2):13983.
      1. Tana C, Umesaki Y, Imaoka A, Handa T, Kanazawa M, Fukudo S. Altered profiles of intestinal microbiota and organic acids may be the origin of symptoms in irritable bowel syndrome. Neurogastroenterol Motil. 2010;22(5):512-519, e114-515.
      1. Winston J, Shenoy M, Medley D, Naniwadekar A, Pasricha PJ. The vanilloid receptor initiates and maintains colonic hypersensitivity induced by neonatal colon irritation in rats. Gastroenterology. 2007;132(2):615-627.
      1. Valeur J, Roseth AG, Knudsen T, et al. Fecal fermentation in irritable bowel syndrome: influence of dietary restriction of fermentable oligosaccharides, disaccharides, monosaccharides and polyols. Digestion. 2016;94:50-56.
      1. Halder SL, Locke GR 3rd, Schleck CD, Zinsmeister AR, Melton LJ 3rd, Talley NJ. Natural history of functional gastrointestinal disorders: a 12-year longitudinal population-based study. Gastroenterology. 2007;133(3):799-807.




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

    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

    References

      • van Nood E.
      • Vrieze A.
      • Nieuwdorp M.
      • et al.
      Duodenal infusion of donor feces for recurrent Clostridium difficile.
      N Engl J Med. 2013; 368407-415
      • Mullish B.H.
      • Quraishi M.N.
      • Segal J.P.
      • et al.
      The use of faecal microbiota transplant as treatment for recurrent or refractory Clostridium difficile infection and other potential indications: joint British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) guidelines.
      Gut. 2018; 671920-1941
      • Moayyedi P.
      • Surette M.G.
      • Kim P.T.
      • et al.
      Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial.
      Gastroenterology. 2015; 149102-109.e6
      • Chen C.
      • Chen L.
      • Sun D.
      • et al.
      Adverse events of intestinal microbiota transplantation in randomized controlled trials: a systematic review and meta-analysis.
      Gut Pathog. 2022; 1420
      • DeFilipp Z.
      • Bloom P.P.
      • Torres Soto M.
      • et al.
      Drug-resistant E. coli bacteremia transmitted by fecal microbiota transplant.
      N Engl J Med. 2019; 3812043-2050
      • Foop and Drug Administration
      Enforcement Policy Regarding Investigational New Drug Requirements for Use of Fecal Microbiota for Transplantation to Treat Clostridium difficile Infection Not Responsive to Standard Therapies: Guidance for Industry.
      (Available at:) (Accessed •••)
      • Saha S.
      • Mara K.
      • Pardi D.S.
      • et al.
      Long-term safety of fecal microbiota transplantation for recurrent Clostridioides difficile infection.
      Gastroenterology. 2021; 1601961-1969.e3
      • Perler B.K.
      • Chen B.
      • Phelps E.
      • et al.
      Long-term efficacy and safety of fecal microbiota transplantation for treatment of recurrent Clostridioides difficile infection.
      J Clin Gastroenterol. 2020; 54701-706
      • Kelly C.R.
      • Yen E.F.
      • Grinspan A.M.
      • et al.
      Fecal microbiota transplantation is highly effective in real-world practice: initial results from the FMT National Registry.
      Gastroenterology. 2021; 160183-192.e3
      • Yau Y.K.
      • Mak W.Y.J.
      • Lui N.S.R.
      • et al.
      High prevalence of extended-spectrum beta-lactamase organisms and the COVID-19 pandemic impact on donor recruitment for fecal microbiota transplantation in Hong Kong.
      United European Gastroenterol J. 2021; 91027-1038
      • Wang S.
      • Xu M.
      • Wang W.
      • et al.
      Systematic review: adverse events of fecal microbiota transplantation.
      PLoS One. 2016; 11e0161174
      • Boven A.
      • Vlieghe E.
      • Engstrand L.
      • et al.
      Clostridioides difficile infection-associated cause-specific and all-cause mortality: a population-based cohort study.
      Clin Microbiol Infect. Published online July. 2023; 19https://doi.org/10.1016/j.cmi.2023.07.008
      • Takahashi M.
      • Mori N.
      • Bito S.
      Multi-institution case–control and cohort study of risk factors for the development and mortality of Clostridium difficile infections in Japan.
      BMJ Open. 2014; 4e005665
      • Gorkiewicz G.
      • Moschen A.
      Gut microbiome: a new player in gastrointestinal disease.
      Virchows Archiv. 2018; 472159-172
      • Ng S.C.
      • Xu Z.
      • Mak J.W.Y.
      • et al.
      Microbiota engraftment after faecal microbiota transplantation in obese subjects with type 2 diabetes: a 24-week, double-blind, randomised controlled trial.
      Gut. 2022; 71716-723
      • Liu S.
      • Guo R.
      • Liu F.
      • et al.
      Gut microbiota regulates depression-like behavior in rats through the neuroendocrine-immune-mitochondrial pathway.
      Neuropsychiatr Dis Treat. 2020; 16859-869
      • Vrieze A.
      • Van Nood E.
      • Holleman F.
      • et al.
      Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome.
      Gastroenterology. 2012; 143913-916.e7
      • Li J.
      • Zou B.
      • Yeo Y.H.
      • et al.
      Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999–2019: a systematic review and meta-analysis.
      Lancet Gastroenterol Hepatol. 2019; 4389-398
      • Leem A.Y.
      • Park B.
      • Kim Y.S.
      • et al.
      Incidence and risk of chronic obstructive pulmonary disease in a Korean community-based cohort.
      Int J Chron Obstruct Pulmon Dis. 2018; 13509-517
      • Liang Y.
      • Liu R.
      • Du S.
      • et al.
      Trends in incidence of hypertension in Chinese adults, 1991–2009: the China Health and Nutrition Survey.
      Int J Cardiol. 2014; 17596-101
      • Hocquart M.
      • Lagier J.C.
      • Cassir N.
      • et al.
      Early fecal microbiota transplantation improves survival in severe Clostridium difficile infections.
      Clin Infect Dis. 2018; 66645-650

    References

    1. Authority TH. Hospital authority statistical report 2012–2013. Volume 2023. •••



    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 :
      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.

    Gerelateerde artikelen
     

    Gerelateerde artikelen

    Poeptransplantatie: Ontlasting >> Een poeptransplantatie als >> Ziekte van Crohn artikelen >>