The Effect of Intestinal Microbiota Transplantation for Inflammatory Bowel Diseases

Not Applicable

Completed

Brief Summary: 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.

Detailed Description: 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.

Recruitment & Eligibility

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.

Arm && Interventions

Group	Intervention	Description
Standardized IMT	Intestinal Microbiota Transplantation	The patients will receive Standardized Intestinal Microbiota Transplantation(Standardized IMT). The IMT was given to mid-gut by nose-jejunum nutrition tube or capsules. It was given three times a week.

Primary Outcome Measures

Name	Time	Method
The change of the modified Mayo score	1 month, 3 months, 6months, 12 months	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.

Secondary Outcome Measures

Name	Time	Method
Changes of gut microbiota	1 months, 3 months, 6 months, 12months	Alpha and Beta diversity of GI microbiota by High-throughput sequencing on baseline line and1 month, 3 months, 6months ,12 months after treatment.
Relief of gastrointestinal symptoms	1 months, 3 months, 6 months, 12months	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.
The change of CDAI	1 month, 3 months, 6months,12 months	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.

Locations (1): Zhongshan Hospital Affiliated to Xiamen University
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Xiamen, Fujian, China