Supplementary Material for: Effects of washed microbiota transplantation on serum uric acid levels, symptoms and intestinal barrier function in patients with acute and recurrent gout: a pilot study

Introduction: Gut dysbiosis has been reported to be closely associated with gout. Washed microbiota transplantation (WMT) is considered as an effective way to restore a healthy gut microbiota with less adverse events than the conventional fecal microbiota transplantation. In this study, we aimed to evaluate the effects of WMT on serum uric acid levels, symptoms and the intestinal barrier function in patients with acute and recurrent gout. Methods: We performed a pilot study of WMT for acute and recurrent gout. The primary outcome was the changes in serum uric acid level and gout symptoms. The secondary outcomes included the changes in levels of diamine oxidase (DAO), D-lactic acid and endotoxin. Results: Eleven patients received WMT treatment. The averaged serum uric acid levels in patients with gout reduced after WMT (P = 0.031), accompanied with a decrease in the frequency and duration time of acute gout flares (P < 0.01). The levels of DAO, D-lactic acid and endotoxin were higher in patients than in healthy donors (P < 0.05). After WMT treatment, the levels of DAO and endotoxin decreased (P < 0.05). Conclusions: WMT is effective for reducing serum uric acid levels and improving gout symptoms in patients with gout, and contributes to improve their impaired intestinal barrier function.

引言：已有研究证实，肠道菌群失调（gut dysbiosis）与痛风密切相关。洗涤式菌群移植（washed microbiota transplantation, WMT）被视为恢复健康肠道菌群的有效手段，相较于传统粪便菌群移植（conventional fecal microbiota transplantation），其不良事件发生率更低。本研究旨在评估WMT对急性复发性痛风患者血清尿酸水平、临床症状及肠屏障功能的影响。方法：本研究针对急性复发性痛风患者开展了一项WMT先导性研究。本研究的主要结局指标为血清尿酸水平与痛风症状的变化情况；次要结局指标则包括二胺氧化酶（diamine oxidase, DAO）、D-乳酸及内毒素水平的变化。结果：共计11例患者接受了WMT治疗。痛风患者的平均血清尿酸水平在WMT治疗后显著降低（P=0.031），同时急性痛风发作的频率与持续时长均显著减少（P<0.01）。治疗前，患者的DAO、D-乳酸及内毒素水平均高于健康供体（P<0.05）；经WMT治疗后，患者的DAO及内毒素水平均有所下降（P<0.05）。结论：WMT可有效降低痛风患者的血清尿酸水平、改善痛风临床症状，并有助于改善其受损的肠屏障功能。