Fecal microbiota transplantation for the maintenance of remission in patients with ulcerative colitis:A randomized controlled trial

BACKGROUND Fecal microbial transplantation(FMT)is a promising new method for treating active ulcerative colitis(UC),but knowledge regarding FMT for quiescent UC is scarce.AIM To investigate FMT for the maintenance of remission in UC patients.METHODS Forty-eight UC patients were randomized to receive a single-dose FMT or autologous transplant via colonoscopy.The primary endpoint was set to the maintenance of remission,a fecal calprotectin level below 200μg/g,and a clinical Mayo score below three throughout the 12-mo follow-up.As secondary endpoints,we recorded the patient’s quality of life,fecal calprotectin,blood chemistry,and endoscopic findings at 12 mo.RESULTS The main endpoint was achieved by 13 out of 24(54%)patients in the FMT group and by 10 out of 24(41%)patients in the placebo group(log-rank test,P=0.660).Four months after FMT,the quality-of-life scores decreased in the FMT group compared to the placebo group(P=0.017).In addition,the disease-specific quality of life measure was higher in the placebo group than in the FMT group at the same time point(P=0.003).There were no differences in blood chemistry,fecal calprotectin,or endoscopic findings among the study groups at 12 mo.The adverse events were infrequent,mild,and distributed equally between the groups.CONCLUSION There were no differences in the number of relapses between the study groups at the 12-mo follow-up.Thus,our results do not support the use of a single-dose FMT for the maintenance of remission in UC.

Usefulness of ω-3 fatty acid supplementation in addition to mesalazine in maintaining remission in pediatric Crohn's disease: A double-blind, randomized, placebo-controlled study

AIM： To assess the value of long-chain w-3 fatty acids （FAs） supplementation in addition to amino-salicylic-acid （5-ASA） in pediatric patients with Crohn＇s disease （CD）. METHODS： Thirty-eight patients （20 males and 18 females, mean age 10.13 years, range 5-16 years） with CD in remission were randomized into two groups and treated for 12 too. Group Ⅰ （18 patients） received 5-ASA （50 mg/kg/d）＋w-3 FAs as triglycerides in gastroresistant capsules, 3 g/d （eicosapentanoic acid, EPA, 400 mg/g, docosahexaenoic acid, DHA, 200 mg/g）. Group Ⅱ （20 patients） received 5-ASA （50 mg/kg/d）＋olive oil placebo capsules. Patients were evaluated for fatty acid incorporation in red blood cell membranes by gas chromatography at baseline 6 and 12 mo after the treatment. RESULTS： The number of patients who relapsed at 1 year was significantly lower in group I than in group Ⅱ （P〈0.001）. Patients in group I had a significant increase in the incorporation of EPA and DHA （P〈0.001） and a decrease in the presence of arachidonic acids. CONCLUSION： Enteric-coated w-3 FAs in addition to treatment with 5-ASA are effective in maintaining remission of pediatric CD.