Limited engraftment of donor microbiome via one-time fecal microbial transplantation in treated HIV-infected individuals
Limited engraftment of donor microbiome via one-time fecal microbial transplantation in treated HIV-infected individuals
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DOI：
10.1080/19490976.2017.1334034
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发表时间：
2017-01-01
期刊：
影响因子：
12.2
通讯作者：
Somsouk, Ma
中科院分区：
文献类型：
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作者：
Vujkovic-Cvijin, Ivan;Rutishauser, Rachel L.;Somsouk, Ma
许多接受抗逆转录病毒治疗（ART）的HIV感染者表现出持续的全身炎症，这预示着发病率和死亡率。ART治疗的受试者同时表现出肠道细菌微生物群的显著组成变化，并且生态失调的程度与全身性炎症相关。调节微生物组的干预措施是否会影响全身性炎症尚不清楚。开放标签粪便微生物移植（FMT）是通过结肠镜提供给无症状的HIV感染ART抑制个体，而无需抗生素预处理。在FMT前后评估粪便中供体微生物的植入，并测定外周血中的免疫活化生物标志物。6名参与者接受FMT，2名参与者作为对照。在24周的随访期间没有发生严重的不良反应。在基线时，HIV感染者表现出与未感染供体不同的微生物群特征。在FMT后8周期间，受体显示供体微生物组的部分植入（P < 0.05）。与FMT治疗C.艰难感染全身炎症标志物在FMT后无显著变化。FMT在ART治疗的HIV感染者中耐受良好。植入是可检测的，但适度的，似乎是有限的特定的细菌类群。抗生素调节是否可以增强植入和微生物群调节炎症的能力仍有待研究。
Many HIV-infected individuals on antiretroviral therapy (ART) exhibit persistent systemic inflammation, which predicts morbidity and mortality. ART-treated subjects concurrently exhibit marked compositional alterations in the gut bacterial microbiota and the degree of dysbiosis correlates with systemic inflammation. Whether interventions to modulate the microbiome can affect systemic inflammation is unknown. An open-label fecal microbial transplantation (FMT) was delivered by colonoscopy to asymptomatic HIV-infected ART-suppressed individuals without antibiotic pre-treatment. Stool was assessed before and after FMT for engraftment of donor microbes, and peripheral blood was assayed for immune activation biomarkers. Six participants received FMT and 2 participants served as controls. No serious adverse effects occurred during 24 weeks of follow-up. At baseline, HIV-infected individuals exhibited microbiota profiles distinct from uninfected donors. During the 8 weeks post-FMT, recipients demonstrated partial engraftment of the donor microbiome (P < 0.05). Recipient microbiota remained significantly distant from donors, unlike that observed following FMT for treatment of C. difficile infection. Systemic inflammatory markers showed no significant change post-FMT. FMT was well-tolerated in ART-treated, HIV-infected individuals. Engraftment was detectable but modest, and appeared to be limited to specific bacterial taxa. Whether antibiotic conditioning can enhance engraftment and the capacity of microbiota to modulate inflammation remains to be investigated.