Fungal trans-kingdom dynamics linked to responsiveness to faecal microbiota transplantation (FMT) therapy in ulcerative colitis

Leonardi I, Paramosothy S, Doron I, et al. Fungal trans-kingdom dynamics linked to responsiveness to faecal microbiota transplantation (FMT) therapy in ulcerative colitis. Cell Host Microbe 2020; 27: 823–829 e823 doi: 10.1016/j.chom.2020.03.006.

Faecal microbiota transplantation (FMT) has become an emerging treatment for UC. Previous meta-analysis including four randomised controlled trials on FMT in UC showed that FMT was associated with higher rates of clinical remission (OR: 2.48; 95% CI 1.18 to 5.21) and endoscopic remission (OR: 2.69; 95% CI 1.07 to 6.74) compared with placebo. However, the reasons why some UC patients responded to FMT better were largely unknown. Previous work by Paramosothy et al had revealed that UC patients who had higher levels of Roseburia, Ruminococcus and Eubacterium at baseline were associated with beneficial response to FMT. In this study, Leonardi et al used the samples from the same study and looked at the intestinal mycobiota using the internal transcribed spacer-1 (ITS-1)-based barcoding approach to deep sequence the ITS-1 region of fungal ribosomal DNA in faecal samples. Interestingly, they found that UC patients with high abundance of gut Candida were associated with clinical response after FMT and decrease in Candida post-FMT was indicative of reduced disease severity, supporting the theory that Candida is linked to proinflammatory activity in IBD. UC patients with high Candida abundance at baseline had increased bacterial alpha-diversity that persisted 8 weeks after FMT and Ruminococcus had a significant positive correlation with Candida abundance, signifying a complex trans-kingdom relationship. This highlights the potential role of personalised medicine in IBD where identifying microbiome signatures at baseline could potentially guide future treatment options. With a better understanding of microbiome, virome and mycobiome signatures, a personalised IBD management strategy is an achievable target.

Kallikrein 5 and proteinase-activated receptor 2 molecules may represent potential novel therapeutic targets in eosinophilic oesophagitis

Azouz N, Klingler A, Pathre P, et al. Functional role of kallikrein 5 and proteinase-activated receptor …