Background:Ulcerative colitis(UC),a chronic non-specific inflammatory bowel disease,is characterized by a prolonged course and a high tendency to relapse.Currently,there is no specific drug for its treatment.An increasing number of studies have revealed that washed microbiota transplantation(WMT)exhibits certain therapeutic effects on UC.Aims:To investigate the clinical efficacy and safety of WMT in treating UC,and to provide a reference basis for the selection of transplantation routes in the future.Methods:The clinical data of 49 UC patients who underwent WMT at the First Affiliated Hospital of Guangdong Pharmaceutical University from May 2017 to December 2020 were retrospectively analyzed.Among them,19 patients were in the middle digestive tract route group and 30 patients were in the lower digestive tract route group.The modified Mayo score,intestinal barrier function(diamine oxidase,D-lactic acid,and bacterial endotoxin),blood parameters,and adverse reactions were compared between the two groups.Results:The modified Mayo score of both groups were significantly lower after treatment compared with those before treatment(P＜0.05).After treatment,in the middle digestive tract route group,the scores for defecation frequency,endoscopic findings,and physician assessment were all significantly decreased(P＜0.05);in the lower digestive tract route group,the scores for defecation frequency,hematochezia,and physician assessment were significantly decreased(P＜0.05).After treatment,the level of bacterial endotoxin in the middle digestive tract route group was significantly reduced(P＜0.05),while there were no significant differences in the levels of diamine oxidase and D-lactic acid(P＞0.05);in the lower digestive tract route group,there were no significant differences in the levels of diamine oxidase,D-lactic acid,and bacterial endotoxin compared with those before treatment(P＞0.05).After treatment,there were no significant changes in hemoglobin,white blood cell count,platelet count,AST,ALT,albumin,creatinine,and blood urea nitrogen in both groups compared with those before treatment,and no severe adverse reactions occurred.Conclusions:WMT demonstrates good clinical efficacy and safety in the treatment of UC.The middle digestive tract transplantation route is more effective in improving intestinal mucosal inflammation and reducing bacterial endotoxin,while the lower digestive tract transplantation route is more effective in reducing patients'hematochezia.This indicates that hematochezia,endoscopic findings,and bacterial endotoxin can be used as references for the selection of transplantation routes.

Background:Ulcerative colitis(UC),a chronic non-specific inflammatory bowel disease,is characterized by a prolonged course and a high tendency to relapse.Currently,there is no specific drug for its treatment.An increasing number of studies have revealed that washed microbiota transplantation(WMT)exhibits certain therapeutic effects on UC.Aims:To investigate the clinical efficacy and safety of WMT in treating UC,and to provide a reference basis for the selection of transplantation routes in the future.Methods:The clinical data of 49 UC patients who underwent WMT at the First Affiliated Hospital of Guangdong Pharmaceutical University from May 2017 to December 2020 were retrospectively analyzed.Among them,19 patients were in the middle digestive tract route group and 30 patients were in the lower digestive tract route group.The modified Mayo score,intestinal barrier function(diamine oxidase,D-lactic acid,and bacterial endotoxin),blood parameters,and adverse reactions were compared between the two groups.Results:The modified Mayo score of both groups were significantly lower after treatment compared with those before treatment(P＜0.05).After treatment,in the middle digestive tract route group,the scores for defecation frequency,endoscopic findings,and physician assessment were all significantly decreased(P＜0.05);in the lower digestive tract route group,the scores for defecation frequency,hematochezia,and physician assessment were significantly decreased(P＜0.05).After treatment,the level of bacterial endotoxin in the middle digestive tract route group was significantly reduced(P＜0.05),while there were no significant differences in the levels of diamine oxidase and D-lactic acid(P＞0.05);in the lower digestive tract route group,there were no significant differences in the levels of diamine oxidase,D-lactic acid,and bacterial endotoxin compared with those before treatment(P＞0.05).After treatment,there were no significant changes in hemoglobin,white blood cell count,platelet count,AST,ALT,albumin,creatinine,and blood urea nitrogen in both groups compared with those before treatment,and no severe adverse reactions occurred.Conclusions:WMT demonstrates good clinical efficacy and safety in the treatment of UC.The middle digestive tract transplantation route is more effective in improving intestinal mucosal inflammation and reducing bacterial endotoxin,while the lower digestive tract transplantation route is more effective in reducing patients'hematochezia.This indicates that hematochezia,endoscopic findings,and bacterial endotoxin can be used as references for the selection of transplantation routes.