AI Article Synopsis
- Faecal microbiota transplantation (FMT) is highly effective for treating recurrent Clostridioides difficile infections, showing over 80% cure rates, but some patients do not respond.
- This study analyzed samples from 16 patients and their donors to find predictors for FMT success, using advanced genetic and chemical analysis methods.
- The results identified lithocholic acid (LCA) levels in feces as a strong predictor of FMT response, achieving 95.2% accuracy on its own, and 100% when combined with urinary pCS levels, suggesting these biomarkers may help improve treatment outcomes.
Article Abstract
Background & Aims: Faecal microbiota transplantation (FMT) has proven high clinical efficacy in the management of recurrent Clostridioides difficile infection (rCDI) with cure rates of over 80% after a single treatment. Nevertheless, the reasons for failure in the remaining 20% remain elusive. The aim of the present study was to investigate different potential predictors of response to FMT.
Methods: Faecal specimens of sixteen patients undergoing FMT for rCDI, as well as samples from the respective donors were collected and analyzed by 16S rRNA gene profiling, bile acid-inducible (baiCD) gene specific qPCR, and liquid chromatography tandem-mass spectrometry (LC-MS/MS) to quantify the concentrations of primary and secondary bile acids.
Results: Using the faecal concentration of the secondary bile acid lithocholic acid (LCA)within the patient specimens, we were able to predict response to FMT (accuracy 95.2%, sensitivity 100%, specificity 90.9%). By combining the faecal LCA concentration with the urinary pCS concentration, an accuracy of 100% was achieved.
Conclusion: LCA appears to be a promising marker candidate for prediction of clinical response to FMT. Other makers, such as urinary concentration of pCS, but not 3-IS, might be used to improve accuracy of prediction. Further studies are warranted to validate these candidate markers.
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| http://dx.doi.org/10.1016/j.dld.2019.01.012 | DOI Listing |
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