Crohn's Disease Clinical Trial
Official title:
Impact of Fecal transPlantAtion on MiCrobotia and hosT in Crohn's Disease
Crohn's disease is a chronic and relapsing inflammatory bowel disease. Many data show that the intestinal flora is involved in the disease and it has been show that patients with Crohn's disease exhibit an abnormal fecal flora that might play a role in inflammation. The purpose of this study is to determine the effect of the fecal flora transplantation on Crohn's disease.
Introduction : Crohn's disease (CD) is an relapsing inflammatory bowel disease relatively
frequent. Its prevalence is about 1 for 700 in France, affecting predominantly young adults.
Its treatment is based on immunosuppressants that might be associated with potentially severe
complications such as infection and cancers. Moreover, these treatments are expensive. The
gut microbiota being involved in the disease pathogenesis, it can be considered as a
potential therapeutic target.
CD pathogenesis remains poorly understood but involves an inappropriate immune response
toward an unbalanced gut microbiota (called dysbiosis) in predisposed hosts. The complete
replacement of a dysbiotic microbiota by a "healthy" one is thus an attractive strategy.
Fecal transplantation (FT) has been used with success for a long time in the context of
Clostridium difficile.
Hypothesis : Fecal transplantation allow the replacement of a dysbiotic microbiota by a "
healthy " one with favorable impact on CD evolution.
Primary endpoint : In CD patient with colonic or ileo-colonic involvement put in remission
with corticosteroids, Evaluate if FT can modify a dysbiotic fecal microbiota to be closer of
the one of a healthy donor.
Methodology
For the Receiver :
Once corticoid-induced remission will be achieved, the patient will be included and
randomised to receive either FT or sham transplantation during a colonoscopy. The patient
will be evaluated at week 2, 6, 10, 14, 18 and 24. At week 6, a colonoscopy will be
performed.
For the Donor :
Donors will be recruited by poster advertising. When a receiver will be included, 3 donors
will be contacted to attend an inclusion visit including physical examination as well as
blood and stool screening for pathogen. The 3 donors will then come the day of the FT to
donate their stool.
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