VIENNA, Austria — Fecal microbiota transplants (FMT) can reset gut microbiota leading to strengthened gut barrier function and mucosal immunity, along with improved ammonia metabolism in patients with cirrhosis, show data from a pilot study now expanded into a large multisite UK trial.
Genome sequencing found that FMT increased the richness of species with significant donor engraftment. E. faecalis and other harmful species were reduced, as were biomarkers of inflammation; in contrast, markers of gut barrier repair rose. After 1 month, ammonia levels in the plasma were lower but higher in the feces, findings that were further enhanced at 3 months.
Modifying the microbial-associated ammonia production and utilization could reduce hepatic encephalopathy and deadly infections, said Lindsey A. Edwards, PhD, from the Institute of Liver Studies, King's College London, England, and co-lead investigator on the PROFIT trial, presenting here at the International Liver Congress of the European Association for the Study of the Liver (EASL) 2023.
Edwards' co-investigator, Debbie L. Shawcross, MD, also from King's College London, added: "This landmark trial provides evidence that a fecal transplant can improve gut health by modifying the gut microbiome and reducing ammonia levels in patients with cirrhosis. Initial findings from PROFIT are promising news for patients with chronic liver disease who are in desperate need of alternative treatment options."
