Study On The Treatment Effect Of Fecal Microbiota Transplantation Of Ulcerative Colitis

Objective Through clinical and basic research,to explore the unique intervention effect of fecal microbiota transplantation(FMT)on the intestinal flora of patients with ulcerative colitis(UC)and the effect of frozen stool on the efficacy of FMT in the treatment of UC.Methods(1)The UC model in rats were intervened with mesalazine,fresh fecal FMT and frozen fecal FMT respectively.The general behavior index,disease activity index,colon length and histological analysis,serum tumor necrosis factor-α(TNF-α)level and intestinal flora structure of rats with different intervention methods were compared to explore the effect of frozen fecal on the efficacy of FMT in the treatment of UC.(2)A total of 16 chronic recurrent UC patients who had been treated with FMT combined with 5-aminosalicylic acid preparation or only 5-aminosalicylic acid preparation were enrolled.According to whether they received FMT treatment or not,they were divided into FMT treatment group and traditional treatment group.Healthy volunteers were also included as normal group.The clinical symptoms,blood biochemical indexes,fecal occult blood and Mayo score of UC patients in the FMT group before and after FMT treatment were analyzed to evaluate the efficacy of FMT treatment.Further analysis of the changes of intestinal flora in patients with UC in FMT group before and after FMT treatment,and the difference of intestinal flora structure between FMT treatment group and traditional treatment group in remission stage of UC patients and normal people to explore the intervention effect of FMT on intestinal flora.Results(1)Compared with UC model group,frozen fecal FMT treatment could improve the general behavior index of UC model rats,decrease the disease activity index of UC rats(P<0.001),and down-regulate the level of serum TNF-α expression(P<0.008).(2)Compared with fresh fecal FMT treatment,the rats treated with frozen fecal FMT had lower disease activity index(P=0.007)and longer colon length(P=0.037).(3)After frozen fecal FMT treatment,the proportion of Firmicutes(P=0.011)abundance in intestinal flora of rats decreased while that of Bacteroidetes(P=0.011)abundance increased.(4)After FMT treatment,the frequency of defecation decreased(P<0.001),the symptoms of hematochezia improved(P<0.001),and the Mayo score decreased(P<0.001)in patients with UC.The number of leukocytes,the proportion of neutrophils and ESR in serum were slightly lower than those before treatment,but the difference was not statistically significant(P>0.05).(5)The intestinal flora of UC patients after FMT treatment had higher abundance of Actinobacteria(P=0.048)and lower abundance of Verrucomicrobia(P=0.025)than that that before FMT treatment.At the same time,the abundance proportion of Prevotella 9 and Bifidobacterium increased after FMT treatment.(6)The intestinal microflora of patients with UC in the traditional treatment group had a higher abundance of Escherichia-Shigella(P=0.019),Klebsiella(P=0.007)and Haemophilus(P=0.042)than the normal group and FMT treatment group.Conclusion the efficacy of FMT treatment of UC with frozen feces is not inferior to that of FMT treatment with fresh fecal bacteria,suggesting that frozen feces have no effect on the efficacy of FMT in the treatment of UC.At the same time,FMT treatment can significantly improve the clinical symptomsof UC patients.By providing exogenous flora,such as Bifidobacterium,it can regulate the disordered intestinal flora of UC patients and reduce the chance of pathogenic bacteria growth.FMT treatment with frozen fecal in rats with UC can change intestinal bacteria structure and has good therapeutic effect,and the therapeutic effect is not inferior to the use of fresh fecal for FMT treatment.