Metagenome in allo-SCT -/+ FMT

Acute graft-versus-host disease (aGvHD) remains a serious complication of allogeneic stem cell transplantation (alloSCT), with the skin and gastrointestinal tract as the most affected organs. The intestinal microbiome (IM) of patients with aGvHD is characterized by a loss of diversity and compositional alterations, commonly referred to as dysbiosis. Fecal microbiota transplantation (FMT) can restore the microbiome and is already performed as compassionate use in this group of patients. However, fundamental questions remain, particularly regarding the role of microbial metabolites in shaping FMT outcomes. The aim of this project is to characterize fecal samples from aGvHD patients following FMT to examine dynamic shifts in both, the microbiome, and its associated metabolites. Stool samples were collected before and after FMT in aGvHD patients. 16s rRNA gene amplicon sequencing will be utilized for the analysis of microbial alterations, and metagenomic sequencing and targeted mass spectroscopy will be performed to characterize microbial metabolites. The results will be correlated to each other and to clinical data including GvHD grading, antimicrobial therapy, therapy- related mortality, and overall survival.