FMT with fiber in ulcerative colitis RCT (New York, USA)

Background: Fecal microbiota transplantation (FMT) is an emerging treatment for ulcerative colitis (UC), but the impact of prebiotic fiber on FMT efficacy for UC is unclear. We performed a randomized, placebo-controlled clinical trial to examine the efficacy of FMT with and without dietary fiber supplementation in patients with UC.</p><p>Methods: 27 patients with mild to moderate UC were randomized to receive a single FMT or placebo via colonoscopy with or without psyllium fiber supplementation for 8 weeks. The primary outcome was clinical response at week 8 assessed by Mayo score. Secondary outcomes included endoscopic improvement and clinical remission. Metagenomic sequencing of fecal DNA was analyzed to determine taxonomic profiles and donor strain engraftment.</p><p>Results: FMT, with or without daily fiber supplementation, induced clinical response, remission, and endoscopic improvement in UC patients compared to placebo, but fiber did not improve clinical outcomes of FMT. Recipient microbiome composition post-FMT shifted towards donor composition in responders and non-responders, but the durability of this change was stronger in responders. Donor-dependent differences accounted for clinical success, magnitude of the shift in recipient microbiome, and successful engraftment of strains correlating with clinical improvement. Fiber supplementation enhanced strain-level engraftment.</p><p>Conclusions: Single-dose FMT demonstrated robust clinical efficacy for mild to moderate UC compared to placebo but revealed no clinical impact of fiber supplementation. These results highlight proof-of-concept that donor selection and prebiotic fiber can shape strain level engraftment.

Classified as human gut / stool shotgun DNA metagenome of adult and elderly by sonnet_x2 with confidence 0.72. Assay shotgun_dna.

• host run.host_tax_id · “9606”
• host run.scientific_name · “human metagenome”
• body site study.description · “single FMT or placebo via colonoscopy”
• life stage study.description · “27 patients with mild to moderate UC”
• life stage sample.attr.host_age · “64 (n=14/127)”

127 runs over 127 samples · mean 6.02 Gbp per run (median 6.11 Gbp, total 763.99 Gbp; 127 runs with a base count) · layout PAIRED 127 · platform ILLUMINA 127 · models Illumina HiSeq X (127) · 92% of runs with a Sandpiper profile · first public 2025-09-21

Gogokhia L first · Tran N · Grier A · Nagayama M · Xiang G · Funez-dePagnier G · Lavergne A · Ericsson C · Ben Maamar S · Zhang M · Battat R · Scherl E · Lukin DJ · Longman RS last

PRJNA1169096.csv.gz (4.1 KB) · parquet (76.2 KB) — all 127 samples, every field with route and confidence · PRJNA1169096_determinations.csv.gz (10.6 KB) — 1,605 evidence rows