Long-term microbiota and virome in a Zurich patient after fecal transplantation against Clostridium difficile infection
Long-term microbiota and virome in a Zurich patient after fecal transplantation against Clostridium difficile infection
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DOI：
10.1111/nyas.13100
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发表时间：
2016-01-01
期刊：
影响因子：
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通讯作者：
Moelling, Karin
中科院分区：
文献类型：
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作者：
Broecker, Felix;Klumpp, Jochen;Moelling, Karin
粪便微生物群移植（FMT）是一种新兴的治疗选择，用于治疗传统治疗难以治愈的艰难梭菌感染。 FMT 将粪便微生物引入患者肠道，防止艰难梭菌复发，从而导致健康微生物群特征的细菌快速扩增。然而，FMT 的长期影响仍然很大程度上未知。本文描述的艰难梭菌患者在 FMT 后 6 至 42 个月内表现出长期的微生物群适应过程。最终，细菌群落与供体相似，表明粪便植入可持续。由于对艰难梭菌感染过程中传播病毒的后果知之甚少，我们还研究了病毒组的变化。我们的方法可以在每个样本中识别出大约 10 种噬菌体类型，这些噬菌体类型代表了更大的病毒群落，并且发现治愈的患者和捐赠者中的噬菌体同样丰富。健康微生物群的特点似乎是噬菌体丰度低。尽管病毒可能被转移，但患者建立了与捐赠者不同的病毒组。令人惊讶的是，该患者体内含有藻类巨型病毒（氯病毒）序列，而此前在人类肠道中从未有过这种病毒的报道。氯病毒与肠道疾病无关，但它们在口咽部的存在可能会影响认知能力。研究结果表明，病毒组是健康或疾病的重要指标。更好地了解病毒在肠道生态系统中的作用可能会发现新的微生物群调节治疗策略。
Fecal microbiota transplantation (FMT) is an emerging therapeutic option for Clostridium difficile infections that are refractory to conventional treatment. FMT introduces fecal microbes into the patient's intestine that prevent the recurrence of C. difficile, leading to rapid expansion of bacteria characteristic of healthy microbiota. However, the long-term effects of FMT remain largely unknown. The C. difficile patient described in this paper revealed protracted microbiota adaptation processes from 6 to 42 months post-FMT. Ultimately, bacterial communities were donor similar, suggesting sustainable stool engraftment. Since little is known about the consequences of transmitted viruses during C. difficile infection, we also interrogated virome changes. Our approach allowed identification of about 10 phage types per sample that represented larger viral communities, and phages were found to be equally abundant in the cured patient and donor. The healthy microbiota appears to be characterized by low phage abundance. Although viruses were likely transferred, the patient established a virome distinct from the donor. Surprisingly, the patient had sequences of algal giant viruses (chloroviruses) that have not previously been reported for the human gut. Chloroviruses have not been associated with intestinal disease, but their presence in the oropharynx may influence cognitive abilities. The findings suggest that the virome is an important indicator of health or disease. A better understanding of the role of viruses in the gut ecosystem may uncover novel microbiota-modulating therapeutic strategies.