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The Impacts of Fecal Microbiota Transplantation from Same Sex on the Symptoms of Ulcerative Colitis Patients Cover

The Impacts of Fecal Microbiota Transplantation from Same Sex on the Symptoms of Ulcerative Colitis Patients

Polish Journal of Microbiology
Volume 72 (2023): Issue 3 (September 2023)
By:
Open Access
|Sep 2023

Figures & Tables

Fig. 1.

Overview of the retrospective cohort study design.This flow chart presents the study's framework, focusing on a retrospective cohort of hospitalized ulcerative colitis patients, categorized upon admission and subsequent fecal microbiota transplantation (FMT) treatment. The study also includes placebo groups partitioned by gender. Four categories were devised: male and female patients receiving FMT and male and female patients receiving a placebo.
Overview of the retrospective cohort study design.This flow chart presents the study's framework, focusing on a retrospective cohort of hospitalized ulcerative colitis patients, categorized upon admission and subsequent fecal microbiota transplantation (FMT) treatment. The study also includes placebo groups partitioned by gender. Four categories were devised: male and female patients receiving FMT and male and female patients receiving a placebo.

Fig. 2 A, B.

Comparative analysis of microbiota characteristics among patient cohorts.A – via a Venn diagram, represents the unique and shared operational taxonomic units (OTUs) for male patients in both experimental and placebo groups. B – similarly represents female patients. Overlapping circles demonstrate shared OTUs.AFP represents female ulcerative colitis patients post-placebo treatment; AM signifies male ulcerative colitis patients post-fecal microbiota transplantation (FMT); AMP indicates male patients post-placebo treatment. AS refers to a subgroup of 20 male ulcerative colitis patients post-FMT, while AU represents a similar subgroup of 20 female patients post-FMT. BF shows data from female ulcerative colitis patients’ pre-FMT, and BFP is for those same female patients pre-placebo treatment. BM and BMP correspond to male ulcerative colitis patients’ pre-FMT and pre-placebo treatment. BS and BU denote subgroups of 20 male and female patients pre-FMT. Finally, FD and MD represent female and male fecal donors, respectively.
Comparative analysis of microbiota characteristics among patient cohorts.A – via a Venn diagram, represents the unique and shared operational taxonomic units (OTUs) for male patients in both experimental and placebo groups. B – similarly represents female patients. Overlapping circles demonstrate shared OTUs.AFP represents female ulcerative colitis patients post-placebo treatment; AM signifies male ulcerative colitis patients post-fecal microbiota transplantation (FMT); AMP indicates male patients post-placebo treatment. AS refers to a subgroup of 20 male ulcerative colitis patients post-FMT, while AU represents a similar subgroup of 20 female patients post-FMT. BF shows data from female ulcerative colitis patients’ pre-FMT, and BFP is for those same female patients pre-placebo treatment. BM and BMP correspond to male ulcerative colitis patients’ pre-FMT and pre-placebo treatment. BS and BU denote subgroups of 20 male and female patients pre-FMT. Finally, FD and MD represent female and male fecal donors, respectively.

Fig. 2 C, D, E, F, G.

Comparative analysis of microbiota characteristics among patient cohorts.C and D – exhibit the rank abundance curves based on relative species abundance and biodiversity components for male and female patients, respectively. E, F, and G – demonstrate the top 10 bacterial families for male and female donors and male and female patients in both experimental and placebo groups, respectively.AFP represents female ulcerative colitis patients post-placebo treatment; AM signifies male ulcerative colitis patients post-fecal microbiota transplantation (FMT); AMP indicates male patients post-placebo treatment. AS refers to a subgroup of 20 male ulcerative colitis patients post-FMT, while AU represents a similar subgroup of 20 female patients post-FMT. BF shows data from female ulcerative colitis patients’ pre-FMT, and BFP is for those same female patients pre-placebo treatment. BM and BMP correspond to male ulcerative colitis patients’ pre-FMT and pre-placebo treatment. BS and BU denote subgroups of 20 male and female patients pre-FMT. Finally, FD and MD represent female and male fecal donors, respectively.
Comparative analysis of microbiota characteristics among patient cohorts.C and D – exhibit the rank abundance curves based on relative species abundance and biodiversity components for male and female patients, respectively. E, F, and G – demonstrate the top 10 bacterial families for male and female donors and male and female patients in both experimental and placebo groups, respectively.AFP represents female ulcerative colitis patients post-placebo treatment; AM signifies male ulcerative colitis patients post-fecal microbiota transplantation (FMT); AMP indicates male patients post-placebo treatment. AS refers to a subgroup of 20 male ulcerative colitis patients post-FMT, while AU represents a similar subgroup of 20 female patients post-FMT. BF shows data from female ulcerative colitis patients’ pre-FMT, and BFP is for those same female patients pre-placebo treatment. BM and BMP correspond to male ulcerative colitis patients’ pre-FMT and pre-placebo treatment. BS and BU denote subgroups of 20 male and female patients pre-FMT. Finally, FD and MD represent female and male fecal donors, respectively.

Fig. 3A, B.

Alpha and beta diversity analysis of gut microbiota among patient cohorts.This figure depicts various indices measuring microbial diversity within and between cohorts. A–D represent diversity indices (Shannon, Simpson, ACE, Chao1) for male patients across experimental and placebo groups. E–H mirror these indices for female patients. I–L illustrate Principal Component Analysis (PCA) and Principal Coordinate Analysis (PCoA) for male and female patients, respectively, comparing overall gut microbiota structure with FMT or placebo treatments. Ellipses represent an 80% confidence level, with color/shape indicating the specific cohort. AM and AF denote male and female ulcerative colitis patients, post-FMT; BF and BM are used to indicate female and male ulcerative colitis patients, respectively, pre-FMT. AFP and AMP represent female and male patients, respectively, post-placebo treatment, while BFP and BMP signify female and male patients, respectively, pre-placebo treatment.
Alpha and beta diversity analysis of gut microbiota among patient cohorts.This figure depicts various indices measuring microbial diversity within and between cohorts. A–D represent diversity indices (Shannon, Simpson, ACE, Chao1) for male patients across experimental and placebo groups. E–H mirror these indices for female patients. I–L illustrate Principal Component Analysis (PCA) and Principal Coordinate Analysis (PCoA) for male and female patients, respectively, comparing overall gut microbiota structure with FMT or placebo treatments. Ellipses represent an 80% confidence level, with color/shape indicating the specific cohort. AM and AF denote male and female ulcerative colitis patients, post-FMT; BF and BM are used to indicate female and male ulcerative colitis patients, respectively, pre-FMT. AFP and AMP represent female and male patients, respectively, post-placebo treatment, while BFP and BMP signify female and male patients, respectively, pre-placebo treatment.

Fig. 3C, D, E, F, G, H.

Alpha and beta diversity analysis of gut microbiota among patient cohorts.
Alpha and beta diversity analysis of gut microbiota among patient cohorts.

Fig. 3I, J, K, L.

Alpha and beta diversity analysis of gut microbiota among patient cohorts.This figure depicts various indices measuring microbial diversity within and between cohorts. A–D represent diversity indices (Shannon, Simpson, ACE, Chao1) for male patients across experimental and placebo groups. E–H mirror these indices for female patients. I–L illustrate Principal Component Analysis (PCA) and Principal Coordinate Analysis (PCoA) for male and female patients, respectively, comparing overall gut microbiota structure with FMT or placebo treatments. Ellipses represent an 80% confidence level, with color/shape indicating the specific cohort.AM and AF denote male and female ulcerative colitis patients, post-FMT; BF and BM are used to indicate female and male ulcerative colitis patients, respectively, pre-FMT. AFP and AMP represent female and male patients, respectively, post-placebo treatment, while BFP and BMP signify female and male patients, respectively, pre-placebo treatment.
Alpha and beta diversity analysis of gut microbiota among patient cohorts.This figure depicts various indices measuring microbial diversity within and between cohorts. A–D represent diversity indices (Shannon, Simpson, ACE, Chao1) for male patients across experimental and placebo groups. E–H mirror these indices for female patients. I–L illustrate Principal Component Analysis (PCA) and Principal Coordinate Analysis (PCoA) for male and female patients, respectively, comparing overall gut microbiota structure with FMT or placebo treatments. Ellipses represent an 80% confidence level, with color/shape indicating the specific cohort.AM and AF denote male and female ulcerative colitis patients, post-FMT; BF and BM are used to indicate female and male ulcerative colitis patients, respectively, pre-FMT. AFP and AMP represent female and male patients, respectively, post-placebo treatment, while BFP and BMP signify female and male patients, respectively, pre-placebo treatment.

Fig. 4A.

Heatmaps illustrating microbiome analysis results.This figure showcases heatmaps of the top-ranking gut microbiota OTUs among patients before and after FMT or placebo treatments.A – the top 35 OTUs in male patients before and after FMT.AM and AF denote male and female ulcerative colitis patients, respectively, post-FMT; AS refers to a subgroup of 20 male ulcerative colitis patients post-FMT, while AU represents a similar subgroup of 20 female patients post-FMT. BU and BS are used to indicate female and male ulcerative colitis patients, respectively, pre-FMT. AFP and AMP represent female and male patients, respectively, post-placebo treatment, while BFP and BMP signify female and male patients, respectively, pre-placebo treatment.
Heatmaps illustrating microbiome analysis results.This figure showcases heatmaps of the top-ranking gut microbiota OTUs among patients before and after FMT or placebo treatments.A – the top 35 OTUs in male patients before and after FMT.AM and AF denote male and female ulcerative colitis patients, respectively, post-FMT; AS refers to a subgroup of 20 male ulcerative colitis patients post-FMT, while AU represents a similar subgroup of 20 female patients post-FMT. BU and BS are used to indicate female and male ulcerative colitis patients, respectively, pre-FMT. AFP and AMP represent female and male patients, respectively, post-placebo treatment, while BFP and BMP signify female and male patients, respectively, pre-placebo treatment.

Fig. 4B, C.

Heatmaps illustrating microbiome analysis results.This figure showcases heatmaps of the top-ranking gut microbiota OTUs among patients before and after FMT or placebo treatments.B – the male group pre- and post-placebo.C – the female patients with the top 45 OTUs before and after FMT.AM and AF denote male and female ulcerative colitis patients, respectively, post-FMT; AS refers to a subgroup of 20 male ulcerative colitis patients post-FMT, while AU represents a similar subgroup of 20 female patients post-FMT. BU and BS are used to indicate female and male ulcerative colitis patients, respectively, pre-FMT. AFP and AMP represent female and male patients, respectively, post-placebo treatment, while BFP and BMP signify female and male patients, respectively, pre-placebo treatment.
Heatmaps illustrating microbiome analysis results.This figure showcases heatmaps of the top-ranking gut microbiota OTUs among patients before and after FMT or placebo treatments.B – the male group pre- and post-placebo.C – the female patients with the top 45 OTUs before and after FMT.AM and AF denote male and female ulcerative colitis patients, respectively, post-FMT; AS refers to a subgroup of 20 male ulcerative colitis patients post-FMT, while AU represents a similar subgroup of 20 female patients post-FMT. BU and BS are used to indicate female and male ulcerative colitis patients, respectively, pre-FMT. AFP and AMP represent female and male patients, respectively, post-placebo treatment, while BFP and BMP signify female and male patients, respectively, pre-placebo treatment.

Fig. 4C.

Heatmaps illustrating microbiome analysis results.C – the female patients with the top 45 OTUs before and after FMT.
Heatmaps illustrating microbiome analysis results.C – the female patients with the top 45 OTUs before and after FMT.

Fig. 4D.

Heatmaps illustrating microbiome analysis results.This figure showcases heatmaps of the top-ranking gut microbiota OTUs among patients before and after FMT or placebo treatments.D – the female group pre- and post-placebo.AM and AF denote male and female ulcerative colitis patients, respectively, post-FMT; AS refers to a subgroup of 20 male ulcerative colitis patients post-FMT, while AU represents a similar subgroup of 20 female patients post-FMT. BU and BS are used to indicate female and male ulcerative colitis patients, respectively, pre-FMT. AFP and AMP represent female and male patients, respectively, post-placebo treatment, while BFP and BMP signify female and male patients, respectively, pre-placebo treatment.
Heatmaps illustrating microbiome analysis results.This figure showcases heatmaps of the top-ranking gut microbiota OTUs among patients before and after FMT or placebo treatments.D – the female group pre- and post-placebo.AM and AF denote male and female ulcerative colitis patients, respectively, post-FMT; AS refers to a subgroup of 20 male ulcerative colitis patients post-FMT, while AU represents a similar subgroup of 20 female patients post-FMT. BU and BS are used to indicate female and male ulcerative colitis patients, respectively, pre-FMT. AFP and AMP represent female and male patients, respectively, post-placebo treatment, while BFP and BMP signify female and male patients, respectively, pre-placebo treatment.

Self-rating depression scale (SDS) and self-rating anxiety scale (SAS) before and after FMT (± SD)_

TimeExperimental groupPlacebo group
SDSSASSDSSAS
Males
Before FMT55.29 ± 7.39344.16 ± 5.92957.829 ± 9.20943.377 ± 4.004
3 weeks49.55 ± 6.093 ***###41.01 ± 5.287 #55.113 ± 5.80141.958 ± 7.969
6 weeks45.98 ± 5.4 ****####37.5 ± 4.275 ***###58.437 ± 8.85742.09 ± 7.982
9 weeks42.84 ± 4.051 ****####33.99 ± 3.623 ****####55.386 ± 11.32245.402 ± 6.562
Females
Before FMT54.76 ± 7.41145.09 ± 5.93555.217 ± 9.89144.784 ± 5.301
3 weeks46.79 ± 5.752 ****###39.08 ± 5.17 ***##54.6 ± 10.42744.177 ± 8.28
6 weeks43.41 ± 5.362 ****###34.29 ± 3.909 ****##53.23 ± 6.52746.833 ± 7.012
9 weeks37.66 ± 4.091 ****####28.5 ± 3.781 ****####56.04 ± 5.38449.115 ± 4.044

UC scores before and after FMT (± SD)_

TimeDiarrhea scoreAbdominal pain scoreBloody stoolMucosa scoreMayo score
Males (experimental group)
Before FMT5.294 ± 1.6585.091 ± 1.6965.358 ± 1.5791.772 ± 0.5165.357 ± 1.724
3 weeks4.719 ± 1.612 *##4.598 ± 1.378 *##3.956 ± 1.428 *****####1.533 ± 0.478 *#5.066 ± 1.651
6 weeks4.267 ± 1.457 ***###4.269 ± 1.428 ***###3.932 ± 1.195 *****####1.416 ± 0.441 ***###4.317 ± 1.806 ***###
9 weeks3.965 ± 1.163 ****####4.116 ± 1.053 ****####3.524 ± 0.895 *****####1.259 ± 0.385 ****####4.443 ± 1.242 **##
Males (placebo group)
Before FMT5.511 ± 1.6055.089 ± 2.1265.464 ± 1.2171.837 ± 0.7725.360 ± 1.565
3 weeks5.430 ± 1.9375.246 ± 1.7255.815 ± 1.3911.960 ± 0.6815.405 ± 2.220
6 weeks5.504 ± 1.3515.305 ± 1.8925.194 ± 1.4321.859 ± 0.5465.483 ± 2.218
9 weeks5.566 ± 2.0715.188 ± 1.7625.073 ± 1.2291.772 ± 0.5084.957 ± 1.361
Females (experimental group)
Before FMT4.979 ± 1.7414.812 ± 1.6065.086 ± 1.6961.721 ± 0.5015.665 ± 1.808
3 weeks4.005 ± 1.282 ****###3.381 ± 1.327 ****####3.520 ± 1.254 ****####1.442 ± 0.457 **##4.730 ± 1.473 ***###
6 weeks3.523 ± 1.087 ****###3.12 ± 1.009 ****####3.034 ± 0.925 ****####1.24 ± 0.349 ****####4.503 ± 1.643 ****####
9 weeks2.933 ± 0.787 ****####2.924 ± 0.835 ****####2.396 ± 0.535 ****####1.098 ± 0.309 ****####3.978 ± 1.096 ****####
Females (placebo group)
Before FMT5.318 ± 2.2865.060 ± 1.8955.009 ± 1.5741.653 ± 0.7525.711 ± 1.858
3 weeks5.095 ± 1.9524.512 ± 1.2175.587 ± 2.1931.958 ± 0.3635.287 ± 2.241
6 weeks4.640 ± 1.9705.282 ± 1.4965.079 ± 1.5631.867 ± 0.7435.533 ± 2.010
9 weeks5.459 ± 1.9975.062 ± 1.3905.048 ± 2.1091.713 ± 0.6545.542 ± 1.831

Baseline characteristics of adolescent donors_

ParametersMales (n = 68)Females (n = 68)t-valuesp-values
Age13.91 ± 2.2213.91 ± 2.5630.0100.992
BMI22.59 ± 1.46822.38 ± 1.4160.0010.999
hsCRP (mg/dl)0.487 ± 0.2530.4856 ± 0.2991.2320.999
Triglyceride (mg/dl)73.24 ± 14.4175.41 ± 14.960.8210.771
Total cholesterol (mg/dl)169.6 ± 14.09171.1 ± 13.430.2680.958
HDL-c (mg/dl)64.91 ± 3.15565.38 ± 2.9620.5130.999
LDL-c (mg/dl)94.8 ± 15.295.7 ± 13.670.0020.996

hsCRP levels in ulcerative colitis (UC) patients before and after FMT (± SD)_

TimeExperimental groupPlacebo groupt-valuesp-values
Males
Before FMT3.707 ± 1.2093.634 ± 1.2620.2880.294
3 weeks3.521 ± 1.3124.127 ± 1.3743.2790.001
6 weeks3.511 ± 1.0913.493 ± 0.9660.1340.894
9 weeks3.033 ± 1.184**3.577 ± 1.5811.7530.008
Females
Before FMT3.776 ± 1.3793.426 ± 1.2951.9410.054
3 weeks3.219 ± 1.219*3.791 ± 1.2752.0350.044
6 weeks2.821 ± 1.023****3.474 ± 1.0913.9110.000
9 weeks2.35 ± 0.8592****3.526 ± 1.3656.3590.000

Baseline characteristics of ulcerative colitis (UC) patients_

ParametersExperimental group (n = 68)Placebo group (n = 68)χ2 or t-valuesp-values
Males
Age45.2 ± 13.647.1 ± 11.40.4020.688
BMI22.5 ± 2.1621.5 ± 3.41.4840.141
Smoker, n (%)18 (43.9%)17 (25.0%)0.0380.844
Drinker, n (%)12 (17.6%)11 (16.2%)0.0520.819
Protein intake (g/day)79.252 ± 14.79182.543 ± 27.5940.4560.377
Fat intake (g/day)89.618 ± 33.17392.609 ± 38.6410.1580.623
Carbohydrate intake (g/day)258.167 ± 70.847264.875 ± 74.1360.5680.326
Vitamin A intake (μg/day)817.949 ± 190.225839.24 ± 196.6330.4790.354
Vitamin C intake (mg/day)99.564 ± 37.648108.344 ± 11.8620.9840.102
Vitamin D intake (μg/day)28.134 ± 14.02530.848 ± 10.0641.0330.096
Calcium intake (mg/day)997.56 ± 202.161018.256 ± 310.1411.5270.058
Iron intake (mg/day)41.123 ± 25.24938.897 ± 35.1021.3200.079
hsCRP (mg/dl)3.707 ± 1.2094.034 ± 1.250.1350.893
Triglyceride (mg/dl)98.2 ± 33.095.4 ± 33.91.3750.172
Total cholesterol (mg/dl)188 ± 21.4191.6 ± 14.30.8410.402
HDL-c (mg/dl)49.7 ± 6.1146.04 ± 7.441.9510.064
LDL-c (mg/dl)123 ± 18129.9 ± 21.31.1520.133
Females
Age40.6 ± 12.936.7 ± 14.01.2200.225
BMI21.6 ± 1.9420.55 ± 1.621.8610.056
Smoker, n (%)20 (48.78%)18 (26.5%)0.1460.702
Drinker, n (%)11 (16.17%)13 (19.12%)0.2020.653
Menopausal status
Premenopausal, n (%)41 (60.29)48 (70.59)
Perimenopausal, n (%)20 (29.41)17 (25)2.3940.302
Postmenopausal, n (%)7 (10.29)3 (4.41)
Protein intake (g/day)75.252 ± 28.79170.543 ± 15.5941.6320.053
Fat intake (g/day)73.618 ± 32.17377.609 ± 16.6410.1050.647
Carbohydrate intake (g/day)247.167 ± 74.847259.875 ± 85.1360.2580.394
Vitamin A intake (μg/day)830.949 ± 184.225870.24 ± 220.6330.7520.214
Vitamin C intake (mg/day)115.564 ± 35.648112.344 ± 32.8620.1210.698
Vitamin D intake (μg/day)12.134 ± 4.97510.848 ± 5.0640.0970.876
Calcium intake (mg/day)1000.56 ± 222.161096.256 ± 307.1410.1180.7063
Iron intake (mg/day)12.123 ± 10.24913.897 ± 6.1020.2370.425
hsCRP (mg/dl)3.776 ± 1.3793.694 ± 1.6630.0230.982
Triglyceride (mg/dl)99.9 ± 31.299.4 ± 33.80.4530.651
Total cholesterol (mg/dl)193 ± 19.3186.4 ± 26.80.7810.436
HDL-c (mg/dl)50.7 ± 549.7 ± 1.50.5040.616
LDL-c (mg/dl)119 ± 18.1119.5 ± 19.80.7530.453
DOI: https://doi.org/10.33073/pjm-2023-025 | Journal eISSN: 2544-4646 | Journal ISSN: 1733-1331
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Language: English
Page range: 247 - 268
Submitted on: Mar 13, 2023
Accepted on: Jun 8, 2023
Published on: Sep 20, 2023
Published by: Polish Society of Microbiologists
In partnership with: Paradigm Publishing Services
Publication frequency: 4 times per year
Keywords:
gut microbiota,
fecal microbiota transplantation,
ulcerative colitis,
a prospective clinical study,
sex differences
Related subjects:
Life sciences,
Microbiology and virology

© 2023 Shu Shang, Jian Zhu, Xi Liu, Wei Wang, Tingting Dai, Li Wang, Baojun Li, published by Polish Society of Microbiologists
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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