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Donor fecal microbi...
Donor fecal microbiota transplantation ameliorates intestinal graft-versus-host disease in allogeneic hematopoietic cell transplant recipients
- Article/chapterEnglish2020
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American Association for the Advancement of Science (AAAS),2020
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LIBRIS-ID:oai:gup.ub.gu.se/296463
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https://gup.ub.gu.se/publication/296463URI
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https://doi.org/10.1126/scitranslmed.aaz8926DOI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Disruption of the intestinal microbiota occurs frequently in allogeneic hematopoietic cell transplantation (allo-HCT) recipients and predisposes them to development of graft-versus-host disease (GvHD). In a prospective, single-center, single-arm study, we investigated the effect of donor fecal microbiota transplantation (FMT) on symptoms of steroid-refractory or steroid-dependent, acute or late-onset acute intestinal GvHD in 15 individuals who had undergone allo-HCT. Study participants received a fecal suspension from an unrelated healthy donor via nasoduodenal infusion. Donor FMT was well tolerated, and infection-related adverse events did not seem to be related to the FMT procedure. In 10 of 15 study participants, a complete clinical response was observed within 1 month after FMT, without additional interventions to alleviate GvHD symptoms. This response was accompanied by an increase in gut microbial a-diversity, a partial engraft-ment of donor bacterial species, and increased abundance of butyrate-producing bacteria, including Clostridiales and Blautia species. In 6 of the 10 responding donor FMT recipients, immunosuppressant drug therapy was successfully tapered. Durable remission of steroid-refractory or steroid-dependent GvHD after donor FMT was associated with improved survival at 24 weeks after donor FMT. This study highlights the potential of donor FMT as a treatment for steroid-refractory or steroid-dependent GvHD, but larger clinical trials are needed to confirm the safety and efficacy of this procedure.
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Davids, M.
(author)
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Haverkate, N. J. E.
(author)
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de Groot, P. F.
(author)
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Donker, M. L.
(author)
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Meijer, E.
(author)
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Heubel-Moenen, Fcji
(author)
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Nur, E.
(author)
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Zeerleder, S. S.
(author)
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Nieuwdorp, MaxGothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Wallenberg Laboratory(Swepub:gu)xnieum
(author)
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Blom, B.
(author)
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Hazenberg, M. D.
(author)
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Göteborgs universitetWallenberglaboratoriet
(creator_code:org_t)
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In:Science Translational Medicine: American Association for the Advancement of Science (AAAS)12:5561946-62341946-6242
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van Lier, Y. F.
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Davids, M.
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Haverkate, N. J. ...
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de Groot, P. F.
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Donker, M. L.
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Meijer, E.
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Heubel-Moenen, F ...
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Nur, E.
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Zeerleder, S. S.
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Nieuwdorp, Max
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Blom, B.
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Hazenberg, M. D.
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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University of Gothenburg