Allogenic Fecal Microbiota Transplantation in Patients with Nonalcoholic Fatty Liver Disease Improves Abnormal Small Intestinal Permeability: A Randomized Control Trial

Laura Craven, Adam Rahman, Seema Nair Parvathy, Melanie Beaton, Justin Silverman, Karim Qumosani, Irene Hramiak, Rob Hegele, Tisha Joy, Jon Meddings, Brad Urquhart, Ruth Harvie, Charles McKenzie, Kelly Summers, Gregor Reid, Jeremy P. Burton, Michael Silverman

    Research output: Contribution to journalArticlepeer-review

    37 Scopus citations

    Abstract

    INTRODUCTION:Nonalcoholic fatty liver disease (NAFLD) is an obesity-related disorder that is rapidly increasing in incidence and is considered the hepatic manifestation of the metabolic syndrome. The gut microbiome plays a role in metabolism and maintaining gut barrier integrity. Studies have found differences in the microbiota between NAFLD and healthy patients and increased intestinal permeability in patients with NAFLD. Fecal microbiota transplantation (FMT) can be used to alter the gut microbiome. It was hypothesized that an FMT from a thin and healthy donor given to patients with NAFLD would improve insulin resistance (IR), hepatic proton density fat fraction (PDFF), and intestinal permeability.METHODS:Twenty-one patients with NAFLD were recruited and randomized in a ratio of 3:1 to either an allogenic (n = 15) or an autologous (n = 6) FMT delivered by using an endoscope to the distal duodenum. IR was calculated by HOMA-IR, hepatic PDFF was measured by MRI, and intestinal permeability was tested using the lactulose:mannitol urine test. Additional markers of metabolic syndrome and the gut microbiota were examined. Patient visits occurred at baseline, 2, 6 weeks, and 6 months post-FMT.RESULTS:There were no significant changes in HOMA-IR or hepatic PDFF in patients who received the allogenic or autologous FMT. Allogenic FMT patients with elevated small intestinal permeability (>0.025 lactulose:mannitol, n = 7) at baseline had a significant reduction 6 weeks after allogenic FMT.DISCUSSION:FMT did not improve IR as measured by HOMA-IR or hepatic PDFF but did have the potential to reduce small intestinal permeability in patients with NAFLD.

    Original languageEnglish (US)
    Pages (from-to)1055-1065
    Number of pages11
    JournalAmerican Journal of Gastroenterology
    Volume115
    Issue number7
    DOIs
    StatePublished - Jul 1 2020

    All Science Journal Classification (ASJC) codes

    • Hepatology
    • Gastroenterology

    Fingerprint

    Dive into the research topics of 'Allogenic Fecal Microbiota Transplantation in Patients with Nonalcoholic Fatty Liver Disease Improves Abnormal Small Intestinal Permeability: A Randomized Control Trial'. Together they form a unique fingerprint.

    Cite this