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.
Keywords
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Article info
Publication history
Published online: January 26, 2019
Accepted:
January 17,
2019
Received:
November 6,
2018
Identification
Copyright
© 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
