The Effect of Intestinal Microbiota Transplantation for Inflammatory Bowel Diseases

Zhongshan Hospital Xiamen University35 enrolled

Overview

There are many limitations in the current treatments of Inflammatory Bowel Diseases(IBD) which includes Ulcerative Colitis（UC) and Crohn's Disease(CD). Some patients have no or little reaction to the traditional drugs. Now the investigators realized that the intestinal microbiota is closely associated with the development of Inflammatory Bowel Diseases. In recent years, a retrospective study showed that the overall efficiency of intestinal microbiota transplantation for IBD was 79%, the overall remission rate was 43%, which opened a new chapter in the treatment of IBD. So the standardized intestinal microbiota transplantation is considered to be simple but effective emerging therapies for the treatment of IBD. In this project the investigators intend to carry out a single-center, randomized, single-blind clinical intervention study. The investigators plan to recruit patients with IBD in China. The patients will be randomly divided into two groups, one group will be given treatment of standardized intestinal microbiota transplantation, the other will be simply treated with traditional drugs, followed up for at least 1 year. The investigators aim to determine the efficiency, durability and safety of Intestinal Microbiota Transplantation for IBD treatment, and further to explore which major bacteria may effect in this project.

In this projects the investigators aim to re-establish a gut balance of intestinal microbiota through Standardized Intestinal Microbiota Transplantation for Ulcerative Colitis(UC) and Crohn's Disease(CD).Investigators have established a standardized isolation, store, and transport steps of fecal bacteria from donated fresh stool in the laboratory. Then the bacteria will be transplanted to mid-gut by nose-jejunum nutrition tube or capsules.Participants in this study will be assigned to receive Standardized Intestinal Microbiota Transplantation three times a week or traditional medicine and would be followed up for at least 1 year. The clinical symptoms, sign, blood tests, endoscopy and questionnaire will be used to assess the efficiency, durability and safety of Standardized Intestinal Microbiota Transplantation at the start and end of the projects. At last, investigators will use 16S-rDNA to estimate the change of intestinal microbiota.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Standard or conventional medicine treatment ineffective of Inflammatory Bowel Diseases(IBD) patients * IBD patients with recurrent symptoms * IBD patients who had drug dependence or recurrence when reduced or discontinued use * Untreated IBD patients who voluntarily received Standardized Intestinal Microbiota Transplantation(IMT) * Written informed consent/assent as appropriate Exclusion Criteria: * IBD patients with contraindications for gastrointestinal endoscopy * IBD patients with indication of surgery * Moderate and severe renal injuty(serum creatinine\>2mg/dL or 177mmol/L), moderate and severe chronic obstructive pulmonary disease, severe hypertension, cerebrovascular accident, congestive heart failure, unstable angina pectoris * Other serious diseases that may interfere the recruitment or affect the survival, such as cancer or acquired immune deficiency syndrome * Mentally or legally disabled person * Preparing for pregnancy * Medical or social condition which in the opinion of the principal investigator would interfere with or prevent regular follow up * Participating in other clinical trials.

Outcomes

Primary Outcomes

The change of the modified Mayo score

Clinical remission defined as modified Mayo score≦2. Change from baseline will be assessed at different timepoint.The endpoint of follow-up is the time of clinical recurrence.

Time frame: 1 month, 3 months, 6months, 12 months

Secondary Outcomes

The change of CDAI

Clinical remission defined as CDAI(Crohn's disease activity index )≦150.Change from baseline will be assessed at different timepoint. The endpoint of follow-up is the time of clinical recurrence.

Time frame: 1 month, 3 months, 6months,12 months

Relief of gastrointestinal symptoms

The onset and duration of gastrointestinal symptoms will be assessed by "Evaluation Score Table of Gastrointestinal Symptoms".Change from baseline will be assessed at different timepoint.

Time frame: 1 months, 3 months, 6 months, 12months

Changes of gut microbiota

Alpha and Beta diversity of GI microbiota by High-throughput sequencing on baseline line and1 month, 3 months, 6months ,12 months after treatment.