Fecal microbiota transplantation for Parkinson's patients with constipation A pilot clinical trial

Gut dysbacteriosis is closely related to Parkinson's disease. Fecal microbiota transplantation (FMT) has been proposed as an effective way to reconstruct gut microbiota. We launched a clinical study to examine the safety and efficacy of FMT for Parkinson's disease. Five Parkinson's patients with constipation aged 55 to 71 years were enrolled in this prospective open-plabel study. Patients received FMT on 3 consecutive days through nasojejunal tubes and were followed up for 8 weeks after treatment. The UPDRS-III OFF score was used to evaluate the improvement in neurological symptoms, and the Wexner score was used to evaluate the improvement in constipation. We sequenced the microbial communities before and after FMT with shotgun metagenomic sequencing. Fecal and serum samples from patients at the indicated times were subjected to metabolomics for the screening of metabolites. We discovered that FMT improved constipation and neurological symptoms in Parkinson's patients, accompanied by profound alterations within the commensal microbiota. Among them, abundance of Bifidobacterium bifidum, Anaerotruncus colihomini, Acinetobacter sp., Proteobacteria bacterium sp., and uncultured Flavonifractor sp. strains were significantly increased after FMT, while abundance of Acinetobacter sp. and other strains were decreased. Untargeted metabolomics analysis revealed the impacts on amino acid metabolism and unsaturated fatty acid synthesis by FMT in Parkinson's patients. Additionally, integrated analysis hinted the correlation between metabolomic profiles of FMT recipient with specific bacterial strains. Taken together, this pilot study demonstrated the safety and potential of FMT to improve constipation and neurological symptoms in patients with Parkinson's disease.