Fecal Microbiota Transplantation Is Examined for Treating NAFLD

The use of fecal microbiota transplantation (FMT) in patients with nonalcoholic fatty liver disease (NAFLD) improves intestinal permeability but has no significant impact on other measures of metabolic syndrome, according to a new randomized controlled trial.

Previous research has revealed differences in the intestinal microbiota of patients with NAFLD, which is considered a manifestation of metabolic syndrome, compared with that of healthy controls. Patients with NAFLD also have increased permeability of the gut barrier.

For their study, the researchers hypothesized that FMT from a healthy, nonobese donor might result in better insulin resistance, gut impermeability, and hepatic proton density fat fraction (PDFF) for patients with NAFLD.

They randomized 21 patients with NAFLD at a 3:1 ratio to allogenic (n=15) or autologous (n=6) FMT, delivered endoscopically. The participants were assessed at baseline, 2 weeks, 6 weeks, and 6 months post-FMT for insulin resistance via the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR); for hepatic PDFF by magnetic resonance imaging; and for permeability of the gut by the lactulose:mannitol urine test.

“There were no significant changes in HOMA-IR or hepatic PDFF in patients who received the allogenic or autologous FMT,” the researchers concluded. However, they noted, “Allogenic FMT patients with elevated small intestinal permeability (>0.025 lactulose:mannitol, n=7) at baseline had a significant reduction 6 weeks after allogenic FMT.”

—Rebecca Mashaw

Reference:

Craven L, Rahman A, Parvathy N, et al. Allogenic fecal microbiota transplantation in patients with nonalcoholic fatty liver disease improves abnormal small intestinal permeability: a randomized control trial. Am J Gastroenterol. 2020;115(7):1055-1065. doi:10.14309/ajg.0000000000000661