Potential biomarkers to predict outcome of faecal microbiota transfer for recurrent Clostridioides difficile infection

Farowski, Fedja; Solbach, Philipp; Tsakmaklis, Anastasia; Brodesser, Susanne; Aguilar, Rebeca Cruz; Cornely, Oliver A.; Dettmer, Katja; Higgins, Paul G.; Suerbaum, Sebastian; Jazmati, Nathalie; Oefner, Peter J. und Vehreschild, Maria J. G. T. (2019): Potential biomarkers to predict outcome of faecal microbiota transfer for recurrent Clostridioides difficile infection. In: Digestive and Liver Disease, Bd. 51, Nr. 7: S. 944-951

Abstract

Background & Aims: Faecal microbiota transplantation (FMT) has proven high clinical efficacy in the management of recurrent Clostridioides difficile infection (rCDI) with cure rates of over 80% after a single treatment. Nevertheless, the reasons for failure in the remaining 20% remain elusive. The aim of the present study was to investigate different potential predictors of response to FMT. Methods: Faecal specimens of sixteen patients undergoing FMT for rCDI, as well as samples from the respective donors were collected and analyzed by 16S rRNA gene profiling, bile acid-inducible (baiCD) gene specific qPCR, and liquid chromatography tandem-mass spectrometry (LC-MS/MS) to quantify the concentrations of primary and secondary bile acids. Results: Using the faecal concentration of the secondary bile acid lithocholic acid (LCA) within the patient specimens, we were able to predict response to FMT (accuracy 95.2%, sensitivity 100%, specificity 90.9%). By combining the faecal LCA concentration with the urinary pCS concentration, an accuracy of 100% was achieved. Conclusion: LCA appears to be a promising marker candidate for prediction of clinical response to FMT. Other makers, such as urinary concentration of pCS, but not 3-IS, might be used to improve accuracy of prediction. Further studies are warranted to validate these candidate markers. (C) 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1590-8658
• Sprache: Englisch