For Patients With Obesity, FMT From a Patient Who Is Lean Appears Safe

It is safe for individuals with obesity to receive a fecal microbiota transplant (FMT) from an individual who is lean, according to new research. In fact, such a transplant may lead to engraftment of donor-specific taxa.¹

Results of the study, which was coauthored by Jessica R. Allegretti, MD, director of the Fecal Microbiota Transplant Program at Brigham and Women’s Hospital, were presented at Digestive Disease Week on Monday, May 20, in San Diego, California.

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The researchers enrolled 22 participants who were metabolically healthy with a body mass index (BMI) of 35 kg/m² or higher. For 12 weeks, half of the participants received fecal matter (30 FMT capsules, followed by 2 doses of 12 capsules) from a single donor who had a BMI of 17 kg/m², while the other half received a placebo.

At baseline, as well as at 6 and 12 weeks, the researchers measured the participants’ levels of the biomarkers gut hormone glucagon-like peptide 1 (GLP-1) and leptin. Stool was collected at baseline, as well as at 1, 4 ,6, 8, and 12 weeks.

Analysis showed no increase in the area under the curve (AUC) of GLP-1 in either group at 12 weeks compared with the measurements at baseline. There were also no early changes in BMI in either group.

An increase in leptin AUC was observed only among participants in the placebo group.

However, there were global signals of donor community engraftment following FMT, which was sustained throughout the study. Among those who received treatment, the researchers recorded an increase in alpha diversity as well as an increased similarity to stool samples from the FMT donor.

Analyses of the participants’ bile acid showed that those in the FMT group also sustained a decrease in taurocholic acid that was similar to the donor.

“Our study adds an encouraging first step in trying to understand the role the gut microbiome is playing in metabolically healthy people with obesity,” Dr Allegretti said in a press release. “This will hopefully lend itself to more targeted therapies in the future.”²

—Colleen Murphy

References:

1. Allegretti JR, Kassam Z, Chiang AL, et al. Fecal microbiota transplantation for the treatment of obesity: a randomized, placebo-controlled pilot trial. Presented at: Digestive Disease Week; May 18-21; San Diego, CA. https://www.gastrojournal.org/article/S0016-5085(19)37112-4/pdf?referrer=https%3A%2F%2Fwww.gastrojournal.org%2Farticle%2FS0016-5085%2819%2937112-4%2Ffulltext. Accessed May 20, 2019.

2. First randomized controlled trial of fecal transplants for obesity shows potential progress [press release]. San Diego, CA: Digestive Disease Week; May 9, 2019. https://ddw.org/news/press-releases/first-randomized-controlled-trial-of-fecal-transplants-for-obesity-shows-potential-progress. Accessed May 20, 2019.