Faecal transplant shows promise in type 1 diabetes

Faecal microbiota transplantation (FMT) prolongs residual beta cell function in patients with new-onset type 1 diabetes (T1D), according to a study.

A total of 20 adult patients received three consecutive FMTs administered over a period of 4 months. The transplant was autologous in 10 patients and allogenic (donor) in the other 10. Baseline characteristics were similar in the two groups.

At month 12, beta cell function was assessed using stimulated C peptide levels during mixed-meal tests. Results showed that autologous FMT significantly preserved stimulated C peptide levels compared with donor FMT.

Preserved residual beta cell function was linked to several microbiota-derived plasma metabolites and bacterial strains. Specifically, there was an inverse association observed for small intestinal Prevotella (p=0.02) and linear correlation for plasma metabolites 1-arachidonoyl-GPC and 1-myristoyl-2-arachidonoyl-GPC levels (p=0.01 and p=0.042, respectively).

Baseline CD4 +CXCR3+T cell counts, small intestinal Desulfovibrio piger levels, and CCL22 and CCL5 gene expression in duodenal biopsies emerged as predictors of preserved beta cell function following FMT irrespective of donor characteristics.

The present data indicate that FMT halts decline in endogenous insulin production in T1D patients within 12 months after disease onset. This provides insight into the role of gut microbiota in beta cell destruction seen in T1D.