Fäkaler Mikrobiom-Transfer bei therapierefraktärem Diarrhoe-betontem Reizdarmsyndrom

Zusammenfassung

Das Reizdarmsyndrom (Reizdarmsyndrom) ist eine Erkrankung des Gastrointestinaltrakts mit unklarer Ätiologie. Aus mehreren Studien wissen wir, dass beim Reizdarmsyndrom unter anderem eine Veränderung der Darmflora mit einer verringerten Biodiversität vorliegt. Ob diese Veränderungen der Mikrobiota ursächlich sind oder Folge der Erkrankung sind, ist unklar.

Ein fäkaler Mikrobiom-Transfer (FMT) wird bei Patienten mit therapierefraktärer Clostridium difficile- assoziierter Diarrhoe erfolgreich eingesetzt. Kasuistisch sind auch Therapieerfolge bei Reizdarmpatienten beschrieben.

Wir berichten über einen 47-jährigen Patienten mit einem therapierefraktärem Diarrhoe-betontem Reizdarmsyndrom, bei dem mit Hilfe eines FMT eine deutliche Verbesserung der klinischen Symptomatik erreicht werden konnte. Diese war von Veränderungen der Zusammensetzung des Empfängerstuhlmikrobioms begleitet. Post-FMT ähnelte das Empfängermikrobiom dem Mikrobiom des Donorstuhls.

Abstract

Irritable bowel syndrome is a disorder of the gastrointestinal tract with unknown etiology. Recent clinical data support a link between changes in fecal microbiota with decreased biodiversity and the development of irritable bowel syndrome. Whether these changes of the microbiota are caused by the disease or whether they develop during the course of the disease remains unclear.

Several studies demonstrated that fecal microbiota transfer (FMT) successfully attenuates Clostridium difficile infection by restoring the disturbed bacterial flora of the gut and case reports suggest that FMT may relief symptoms in patients with irritable bowel syndrome (IBS).

Here we report a 47-year-old male patient with longstanding refractory diarrhea predominant IBS, who was successfully treated with a single FMT. The beneficial effect on the patient’s symptoms was associated with changes of the stool microbiome. Post-FMT the recipient’s microbiome resembled the donor´s microbiome.

Schlüsselwörter

Reizdarmsyndrom - fäkaler Mikrobiomtransfer - Darmflora - Mikrobiota - Mikrobiomanalyse

Keywords

irritable bowel syndrome - fecal microbiota transfer - gut flora - microbiota - microbiome analysis

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