Effect of Fecal Microbiota Transplantation on Non-Alcoholic Fatty Liver Disease: A Randomized Clinical Trial - PubMed (original) (raw)

Randomized Controlled Trial

Effect of Fecal Microbiota Transplantation on Non-Alcoholic Fatty Liver Disease: A Randomized Clinical Trial

Lanfeng Xue et al. Front Cell Infect Microbiol. 2022.

Abstract

Background and aims: The clinical efficacy of fecal microbiota transplantation (FMT) in patients with non-alcoholic fatty liver disease (NAFLD) and the variant effects of FMT on lean and obese NAFLD patients remain elusive. Our study aimed to determine the clinical efficacy and safety of FMT for patients with NAFLD, elucidating its different influences on lean and obese patients with NAFLD.

Methods: We performed a randomized and controlled clinical trial. Patients in the non-FMT group were administered oral probiotics. In the FMT group, patients were randomized to receive FMT with donor stool (heterologous) via colonoscopy, followed by three enemas over 3 days. Both groups were also required to maintain a healthy diet and keep regular exercise for more than 40 min every day. They returned to the hospital for reexamination 1 month after treatment.

Results: FMT can decrease the fat accumulation in the liver by improving the gut microbiota dysbiosis, thus attenuating fatty liver disease. Significant differences in the clinical features and gut microbiota between lean and obese NAFLD patients were unveiled. Moreover, FMT had better effects on gut microbiota reconstruction in lean NAFLD than in obese NAFLD patients.

Conclusions: FMT could successfully improve the therapeutic effects on patients with NAFLD, and its clinical efficacy was higher in lean NAFLD than in obese NAFLD patients.

Keywords: fecal microbiota transplantation; gut microbiota; lean NAFLD; non-alcoholic fatty liver disease; obese NAFLD.

Copyright © 2022 Xue, Deng, Luo, He and Chen.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1

Figure 1

Enrollment and outcomes. NAFLD, non-alcoholic fatty liver disease; FMT, fecal microbiota transplantation.

Figure 2

Figure 2

Specific 16S rRNA analysis steps.

Figure 3

Figure 3

Venn diagram of patients with non-alcoholic fatty liver disease (NAFLD) and healthy individuals.

Figure 4

Figure 4

Percentage of each phylum in patients with non-alcoholic fatty liver disease (NAFLD) and healthy individuals. An increasing trend of Bacteroidetes and Bacteroidetes/Firmicutes (B/F) ratio was observed from the pre-fecal microbiota transplantation (pri-FMT) group to the healthy group.

Figure 5

Figure 5

Comparison of the decrease in fat attenuation before and after fecal microbiota transplantation (FMT) between the two groups. * meaning Lean NAFLD vs obese NAFLD had statistical difference, P < 0.05.

Figure 6

Figure 6

Venn diagram of lean and obese patients with non-alcoholic fatty liver disease (NAFLD) before and after fecal microbiota transplantation (FMT). A total of 654 operational taxonomic units (OTUs) were detected in the four groups, of which 101 OTUs were shared by B1 and B2 and 135 OTUs were shared by C1 and C2. One hundred ninety-seven different OTUs were found between C1 and B1, while 175 OTUs were detected in C2 and B2.

Figure 7

Figure 7

Diagram of the Bray–Curtis distance principal coordinate analysis.

Comment in

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