Effects of Diet-Modulated Autologous Fecal Microbiota Transplantation on Weight Regain

作者：Ehud Rinott, Ilan Youngster, Anat Yaskolka Meir, Gal Tsaban, Hila Zelicha, Alon Kaplan, Dan Knights, Kieran Michael Tuohy, Francesca Fava, Matthias Scholz, Ziv Oren, Elad Rubin, Amir Tirosh, Assaf Rudich, Matthias Blüher, Michael Stümvoll, Uta Ceglarek, Karine Clément, Omry Koren, Dong D. Wang, Frank B. Hu, Meir J. Stampfer, Iris Shai · 发表于：Gastroenterology · 年份：2020 · DOI：10.1053/j.gastro.2020.08.041 · 被引用次数：196 · 研究领域：Gut microbiota and health、Clostridium difficile and Clostridium perfringens research、Gastrointestinal motility and disorders

BACKGROUND & AIMS: We evaluated the efficacy and safety of diet-modulated autologous fecal microbiota transplantation (aFMT) for treatment of weight regain after the weight-loss phase. METHODS: In the DIRECT PLUS (Dietary Intervention Randomized Controlled Trial Polyphenols-Unprocessed) weight-loss trial (May 2017 through July 2018), abdominally obese or dyslipidemic participants in Israel were randomly assigned to healthy dietary guidelines, Mediterranean diet, and green-Mediterranean diet weight-loss groups. All groups received free gym membership and physical activity guidelines. Both isocaloric Mediterranean groups consumed 28 g/d walnuts (+440 mg/d polyphenols provided). The green-Mediterranean dieters also consumed green tea (3-4 cups/d) and a Wolffia globosa (Mankai strain, 100 g/d) green shake (+800 mg/d polyphenols provided). After 6 months (weight-loss phase), 90 eligible participants (mean age, 52 years; mean weight loss, 8.3 kg) provided a fecal sample that was processed into aFMT by frozen, opaque, and odorless capsules. The participants were then randomly assigned to groups that received 100 capsules containing their own fecal microbiota or placebo until month 14. The primary outcome was regain of the lost weight over the expected weight-regain phase (months 6-14). Secondary outcomes were gastrointestinal symptoms, waist circumference, glycemic status, and changes in the gut microbiome, as measured by metagenomic sequencing and 16s ribosomal RNA. We validated th...