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

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Background: 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. Methods: Five Parkinson's patients with constipation aged 55 to 71 years were enrolled in this prospective open-label 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. Shotgun metagenomic sequencing of fecal samples to compare the microbial communities before and after FMT. Fecal and serum samples from patients before and after FMT at the indicated times were subjected to metabolomics for metabolites. Results: FMT improved constipation and neurological symptoms in Parkinson's patients. Bifidobacterium bifidum, Anaerotruncus colihomini, Acinetobacter sp., Proteobacteria bacterium sp., and uncultured Flavonifractor sp. strains were significantly increased after FMT, while Acinetobacter sp. and other strains decreased. FMT impacts amino acid metabolism and unsaturated fatty acid synthesis in Parkinson's patients. Macrogenomic and metabolomic integrated analysis showed that the changes in metabolites in fecal bacteria-transplanted offspring were highly correlated with specific gut strains. Conclusion: This pilot study demonstrated that FMT was safe and may have the potential to improve constipation and neurological symptoms in patients with Parkinson’s disease.

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