Changes in microbiota composition, bile and fatty acid metabolism, in successful faecal microbiota transplantation for Clostridioides difficile infection

dc.contributor.authorBrown, Jillian R.-M.
dc.contributor.authorFlemer, Burkhardt
dc.contributor.authorJoyce, Susan A.
dc.contributor.authorZulquernain, Akbar
dc.contributor.authorSheehan, Donal
dc.contributor.authorShanahan, Fergus
dc.contributor.authorO'Toole, Paul W.
dc.contributor.funderScience Foundation Irelanden
dc.date.accessioned2019-11-25T10:40:34Z
dc.date.available2019-11-25T10:40:34Z
dc.date.issued2018-08-28
dc.description.abstractBackground: Alteration of the gut microbiota by repeated antibiotic treatment increases susceptibility to Clostridioides difficile infection. Faecal microbiota transplantation from donors with a normal microbiota effectively treats C. difficile infection. Methods: The study involved 10 patients with recurrent C. difficile infection, nine of whom received transplants from individual donors and one who received a donor unit from a stool bank (OpenBiome). Results: All individuals demonstrated enduring post-transplant resolution of C. difficile- associated diarrhoea. Faecal microbiota diversity of recipients significantly increased, and the composition of the microbiota resembled that of the donor. Patients with C. difficile infection exhibited significantly lower faecal levels of secondary/ bile acids and higher levels of primary bile acids. Levels of secondary bile acids were restored in all transplant recipients, but to a lower degree with the OpenBiome transplant. The abundance increased of bacterial genera known from previous studies to confer resistance to growth and germination of C. difficile. These were significantly negatively associated with primary bile acid levels and positively related with secondary bile acid levels. Although reduced levels of the short chain fatty acids, butyrate, propionate and acetate, have been previously reported, here we report elevations in SCFA, pyruvic and lactic fatty acids, saturated, ω-6, monounsaturated, ω-3 and ω-6 polyunsaturated fatty acids (PUFA) in C. difficile infection. This potentially indicates one or a combination of increased dietary FA intake, microbial modification of FAs or epithelial cell damage and inflammatory cell recruitment. No reversion to donor FA profile occurred post-FMT but ω-3 to ω-6 PUFA ratios were altered in the direction of the donor. Archaeal metabolism genes were found in some samples post FMT. Conclusion: A consistent metabolic signature was identified in the post-transplant microbiota, with reduced primary bile acids and substantial restoration of secondary bile acid production capacity. Total FA levels were unchanged but the ratio of inflammatory to non-inflammatory FAs decreased.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid131en
dc.identifier.citationBrown, J.R.M., Flemer, B., Joyce, S.A., Zulquernain, A., Sheehan, D., Shanahan, F. and O’Toole, P.W., 2018. Changes in microbiota composition, bile and fatty acid metabolism, in successful faecal microbiota transplantation for Clostridioides difficile infection. BMC gastroenterology, 18(1), (131). DOI:10.1186/s12876-018-0860-5en
dc.identifier.doi10.1186/s12876-018-0860-5en
dc.identifier.eissn1471-230X
dc.identifier.endpage15en
dc.identifier.issued1en
dc.identifier.journaltitleBMC Gastroenterologyen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/9214
dc.identifier.volume18en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.projectinfo:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2273/IE/Alimentary Pharmabiotic Centre (APC) - Interfacing Food & Medicine/en
dc.relation.urihttps://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-018-0860-5
dc.rights© The Author(s) 2018en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectClostridioides difficileen
dc.subjectFaecal microbiota transplantationen
dc.subjectBile acidsen
dc.subjectFatty acidsen
dc.subjectArchaeaen
dc.titleChanges in microbiota composition, bile and fatty acid metabolism, in successful faecal microbiota transplantation for Clostridioides difficile infectionen
dc.typeArticle (peer-reviewed)en
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