A multi-factorial observational study on sequential fecal microbiota transplant in patients with medically refractory Clostridioides difficile infection
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Supplementary information
Published version
Author(s)
Type
Journal Article
Abstract
Fecal microbiota transplantation (FMT) is highly effective in recurrent Clostridioides difficile infection (CDI); increasing evidence supports FMT in severe or fulminant Clostridioides difficile infection (SFCDI). However, the multifactorial mechanisms that underpin the efficacy of FMT are not fully understood. Systems biology approaches using high-throughput technologies may help with mechanistic dissection of host-microbial interactions. Here, we have undertaken a deep phenomics study on four adults receiving sequential FMT for SFCDI, in which we performed a longitudinal, integrative analysis of multiple host factors and intestinal microbiome changes. Stool samples were profiled for changes in gut microbiota and metabolites and blood samples for alterations in targeted epigenomic, metabonomic, glycomic, immune proteomic, immunophenotyping, immune functional assays, and T-cell receptor (TCR) repertoires, respectively. We characterised temporal trajectories in gut microbial and host immunometabolic data sets in three responders and one non-responder to sequential FMT. A total of 562 features were used for analysis, of which 78 features were identified, which differed between the responders and the non-responder. The observed dynamic phenotypic changes may potentially suggest immunosenescent signals in the non-responder and may help to underpin the mechanisms accompanying successful FMT, although our study is limited by a small sample size and significant heterogeneity in patient baseline characteristics. Our multi-omics integrative longitudinal analytical approach extends the knowledge regarding mechanisms of efficacy of FMT and highlights preliminary novel signatures, which should be validated in larger studies.
Date Issued
2021-11-19
Date Acceptance
2021-11-17
Citation
Cells, 2021, 10 (11)
ISSN
2073-4409
Publisher
MDPI AG
Journal / Book Title
Cells
Volume
10
Issue
11
Copyright Statement
© 2021 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/)
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/)
License URL
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
Identifier
https://www.mdpi.com/2073-4409/10/11/3234/htm
Grant Number
RDA02
Subjects
Science & Technology
Life Sciences & Biomedicine
Cell Biology
fecal microbiota transplantation
Clostridioides difficile
immunosenescence
host-microbial interactions
systems biology
MEMORY B-CELLS
GUT MICROBIOTA
HEALTH
RECURRENT
DISEASE
EPIDEMIOLOGY
ANTIBODIES
RESOLUTION
SOFTWARE
FIBROSIS
Clostridioides difficile
fecal microbiota transplantation
host-microbial interactions
immunosenescence
systems biology
Publication Status
Published
Article Number
ARTN 3234