Imperial College London
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Dr Benjamin Mullish

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

IPPRF Research Fellow
 
 
 
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Contact

 

b.mullish

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Allegretti:2019:10.14309/ajg.0000000000000115,
author = {Allegretti, JA and Kassam, Z and Carrellas, M and Mullish, BH and Marchesi, JR and Pechlivanis, A and Smith, M and Gerardin, Y and Timberlake, S and Pratt, DS and Korzenik, JR},
doi = {10.14309/ajg.0000000000000115},
journal = {American Journal of Gastroenterology},
pages = {1071--1079},
title = {Fecal microbiota transplantation in patients with primary sclerosing cholangitis: A pilot clinical trial},
url = {http://dx.doi.org/10.14309/ajg.0000000000000115},
volume = {114},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Primary sclerosing cholangitis (PSC) is a cholestatic liver disease with no effective medical therapies. A perturbation of the gut microbiota has been described in association with PSC, and fecal microbiota transplantation (FMT) has been reported to restore the microbiome in other disease states. Accordingly, we aimed to evaluate the safety, change in liver enzymes, microbiota and metabolomic profiles in PSC patients after FMT.Methods: Open-label pilot study of PSC patients with concurrent inflammatory bowel disease (IBD) and ALP > 1.5X the upper limit of normal. Participants underwent a single FMT by colonoscopy. Liver enzyme profiles and stool microbiome and metabolomic analysis was conducted at baseline and week 1, 4, 8, 12 and 24 post-FMT. The primaryoutcome was safety and secondary outcomes include a decrease in ALP ≥50% from baseline by week 24 post-FMT, as well as stool microbiota (by 16S rRNA gene profiling) and metabonomic dynamics were assessed.Results. Ten patients underwent FMT. Nine patients had ulcerative colitis and 1 with Crohn’s colitis. The mean baseline ALP was 489 U/L. There were no related adverse events. Overall, 30% (3/10) experienced a ≥50% decrease ALP. The diversity increased in all patients post-FMT, as early as week 1 (p<0.01). Importantly, abundance of engrafter operational taxanomic units (OTUs) in patients post-FMT correlated with decreased ALP (p=0.02).Conclusion: To our knowledge, this first study to demonstrate that FMT in PSC is safe. Additionally, increases in bacterial diversity and engraftment may correlate with an improvement in ALP among PSC patients.
AU  - Allegretti,JA
AU  - Kassam,Z
AU  - Carrellas,M
AU  - Mullish,BH
AU  - Marchesi,JR
AU  - Pechlivanis,A
AU  - Smith,M
AU  - Gerardin,Y
AU  - Timberlake,S
AU  - Pratt,DS
AU  - Korzenik,JR
DO  - 10.14309/ajg.0000000000000115
EP  - 1079
PY  - 2019///
SN  - 1572-0241
SP  - 1071
TI  - Fecal microbiota transplantation in patients with primary sclerosing cholangitis: A pilot clinical trial
T2  - American Journal of Gastroenterology
UR  - http://dx.doi.org/10.14309/ajg.0000000000000115
UR  - http://hdl.handle.net/10044/1/66365
VL  - 114
ER  -
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