Successful weight regain attenuation by autologous fecal microbiota transplantation is associated with non-core gut microbiota changes during weight loss; randomized controlled trial

Omer Kamer, Ehud Rinott, Gal Tsaban, Alon Kaplan, Anat Yaskolka Meir, Hila Zelicha, Dan Knights, Kieran Tuohy, Francesca Fava, Matthias Uwe Scholz, Oren Ziv, Elad Rubin, Matthias Blüher, Michael Stumvoll, Uta Ceglarek, Karine Clément, Omry Koren, Frank B. Hu, Meir J. Stampfer, Dong D. WangIlan Youngster, Iris Shai

Research output: Contribution to journalArticlepeer-review

Abstract

We previously reported that autologous-fecal-microbiota-transplantation (aFMT), following 6 m of lifestyle intervention, attenuated subsequent weight regain and insulin rebound for participants consuming a high-polyphenol green-Mediterranean diet. Here, we explored whether specific changes in the core (abundant) vs. non-core (low-abundance) gut microbiome taxa fractions during the weight-loss phase (0–6 m) were differentially associated with weight maintenance following aFMT. Eighty-two abdominally obese/dyslipidemic participants (age = 52 years; 6 m weightloss = −8.3 kg) who provided fecal samples (0 m, 6 m) were included. Frozen 6 m’s fecal samples were processed into 1 g, opaque and odorless aFMT capsules. Participants were randomly assigned to receive 100 capsules containing their own fecal microbiota or placebo over 8 m-14 m in ten administrations (adherence rate > 90%). Gut microbiome composition was evaluated using shotgun metagenomic sequencing. Non-core taxa were defined as ≤ 66% prevalence across participants. Overall, 450 species were analyzed. At baseline, 13.3% were classified as core, and Firmicutes presented the highest core proportion by phylum. During 6 m weight-loss phase, abundance of non-core species changed more than core species (P <.0001). Subject-specific changes in core and non-core taxa fractions were strongly correlated (Jaccard Index; r = 0.54; P <.001). Following aFMT treatment, only participants with a low 6 m change in core taxa, and a high change in non-core taxa, avoided 8–14 m weight regain (aFMT = −0.58 ± 2.4 kg, corresponding placebo group = 3.18 ± 3.5 kg; P =.02). In a linear regression model, low core/high non-core 6 m change was the only combination that was significantly associated with attenuated 8–14 m weight regain (P =.038; P =.002 for taxa patterns/treatment intervention interaction). High change in non-core, low-abundance taxa during weight-loss might mediate aFMT treatment success for weight loss maintenance. ClinicalTrials.gov: NCT03020186.

Original languageEnglish
Article number2264457
JournalGut Microbes
Volume15
Issue number2
DOIs
StatePublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.

Keywords

  • FMT
  • Low-abundance taxa
  • aFMT
  • core microbiome
  • lifestyle intervention
  • weight regain

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