Impact Factor
  • ISSN 1674-8301
  • CN 32-1810/R
Volume 37 Issue 1
Jan.  2023
Turn off MathJax
Article Contents
Gaochen Lu, Quan Wen, Bota Cui, Qianqian Li, Faming Zhang. Washed microbiota transplantation stopped the deterioration of amyotrophic lateral sclerosis: The first case report and narrative review[J]. The Journal of Biomedical Research, 2023, 37(1): 69-76. doi: 10.7555/JBR.36.20220088
Citation: Gaochen Lu, Quan Wen, Bota Cui, Qianqian Li, Faming Zhang. Washed microbiota transplantation stopped the deterioration of amyotrophic lateral sclerosis: The first case report and narrative review[J]. The Journal of Biomedical Research, 2023, 37(1): 69-76. doi: 10.7555/JBR.36.20220088

Washed microbiota transplantation stopped the deterioration of amyotrophic lateral sclerosis: The first case report and narrative review

doi: 10.7555/JBR.36.20220088
Funds:  This study was funded by the National Natural Science Foundation of China (Grant No. 81873548) and the Nanjing Medical University Fan Daiming Research Funds for Holistic Integrative Medicine.
More Information
  • Corresponding author: Faming Zhang, Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, 121 Jiang Jia Yuan, Nanjing, Jiangsu 210011, China. Tel: +86-25-56662093, E-mail: fzhang@njmu.edu.cn
  • Received: 2022-04-17
  • Revised: 2022-05-24
  • Accepted: 2022-05-27
  • Published: 2022-06-28
  • Issue Date: 2023-01-28
  • Amyotrophic lateral sclerosis (ALS) is known as a progressive paralysis disorder characterized by degeneration of upper and lower motor neurons, and has an average survival time of three to five years. Growing evidence has suggested a bidirectional link between gut microbiota and neurodegeneration. Here we aimed to report one female case with ALS, who benefited from washed microbiota transplantation (WMT), an improved fecal microbiota transplantation (FMT), through a transendoscopic enteral tube during a 12-month follow-up. Notedly, the accidental scalp trauma the patient suffered later was treated with prescribed antibiotics that caused ALS deterioration. The subsequent rescue WMTs successfully stopped the progression of the disease with a quick improvement. The plateaus and reversals occurred during the whole course of WMT. The stool and blood samples from the first WMT to the last were collected for dynamic microbial and metabolomic analysis. We observed the microbial and metabolomic changing trend consistent with the disease status. This case report for the first time shows the direct clinical evidence on using WMT for treating ALS, indicating that WMT may be the novel treatment strategy for controlling this so-called incurable disease.


  • loading
  • [1]
    Van Es MA, Hardiman O, Chio A, et al. Amyotrophic lateral sclerosis[J]. Lancet, 2017, 390(10107): 2084–2098. doi: 10.1016/S0140-6736(17)31287-4
    Bensimon G, Lacomblez L, Meininger V. A controlled trial of riluzole in amyotrophic lateral sclerosis[J]. N Engl J Med, 1994, 330(9): 585–591. doi: 10.1056/NEJM199403033300901
    The Writing Group, Edaravone (MCI-186) ALS 19 Study Group. Safety and efficacy of edaravone in well defined patients with amyotrophic lateral sclerosis: a randomised, double-blind, placebo-controlled trial[J]. Lancet Neurol, 2017, 16(7): 505–512. doi: 10.1016/S1474-4422(17)30115-1
    Cudkowicz M, Genge A, Maragakis N, et al. Safety and efficacy of oral levosimendan in people with amyotrophic lateral sclerosis (the REFALS study): a randomised, double-blind, placebo-controlled phase 3 trial[J]. Lancet Neurol, 2021, 20(10): 821–831. doi: 10.1016/S1474-4422(21)00242-8
    Paganoni S, Macklin EA, Hendrix S, et al. Trial of sodium phenylbutyrate-taurursodiol for amyotrophic lateral sclerosis[J]. N Engl J Med, 2020, 383(10): 919–930. doi: 10.1056/NEJMoa1916945
    Blacher E, Bashiardes S, Shapiro H, et al. Potential roles of gut microbiome and metabolites in modulating ALS in mice[J]. Nature, 2019, 572(7770): 474–480. doi: 10.1038/s41586-019-1443-5
    Di Gioia D, Bozzi Cionci N, Baffoni L, et al. A prospective longitudinal study on the microbiota composition in amyotrophic lateral sclerosis[J]. BMC Med, 2020, 18(1): 153. doi: 10.1186/s12916-020-01607-9
    Zhang Y, Ogbu D, Garrett S, et al. Aberrant enteric neuromuscular system and dysbiosis in amyotrophic lateral sclerosis[J]. Gut Microbes, 2021, 13(1): 1996848. doi: 10.1080/19490976.2021.1996848
    Zhang T, Lu G, Zhao Z, et al. Washed microbiota transplantation vs. manual fecal microbiota transplantation: clinical findings, animal studies and in vitro screening[J]. Protein Cell, 2020, 11(4): 251–266. doi: 10.1007/s13238-019-00684-8
    Fecal Microbiota Transplantation-Standardization Study Group. Nanjing consensus on methodology of washed microbiota transplantation[J]. Chin Med J (Engl), 2020, 133(19): 2330–2332. doi: 10.1097/CM9.0000000000000954
    He Z, Cui BT, Zhang T, et al. Fecal microbiota transplantation cured epilepsy in a case with Crohn's disease: the first report[J]. World J Gastroenterol, 2017, 23(19): 3565–3568. doi: 10.3748/wjg.v23.i19.3565
    Liu XJ, Wu LH, Xie WR, et al. Faecal microbiota transplantation simultaneously ameliorated patient's essential tremor and irritable bowel syndrome[J]. Psychogeriatrics, 2020, 20(5): 796–798. doi: 10.1111/psyg.12583
    Huang H, Xu H, Luo Q, et al. Fecal microbiota transplantation to treat Parkinson's disease with constipation: a case report[J]. Medicine (Baltimore), 2019, 98(26): e16163. doi: 10.1097/MD.0000000000016163
    Huang HL, Xu HM, Liu YD, et al. First application of fecal microbiota transplantation in adult asperger syndrome with digestive symptoms-a case report[J]. Front Psychiatry, 2022, 13: 695481. doi: 10.3389/fpsyt.2022.695481
    Wang J, Li Q, Huang Q, et al. Washed microbiota transplantation accelerates the recovery of abnormal changes by light-induced stress in tree shrews[J]. Front Cell Infect Microbiol, 2021, 11: 685019. doi: 10.3389/fcimb.2021.685019
    Lu G, Wang W, Li P, et al. Washed preparation of faecal microbiota changes the transplantation related safety, quantitative method and delivery[J]. Microb Biotechnol, 2022, doi: 10.1111/1751-7915.14074. [Epub ahead of print].
    Niccolai E, Di Pilato V, Nannini G, et al. The gut microbiota-immunity axis in ALS: a role in deciphering disease heterogeneity?[J]. Biomedicines, 2021, 9(7): 753. doi: 10.3390/biomedicines9070753
    Hertzberg VS, Singh H, Fournier CN, et al. Gut microbiome differences between amyotrophic lateral sclerosis patients and spouse controls[J]. Amyotroph Lateral Scler Frontotemporal Degener, 2022, 23(1-2): 91–99. doi: 10.1080/21678421.2021.1904994
    Rowin J, Xia Y, Jung B, et al. Gut inflammation and dysbiosis in human motor neuron disease[J]. Physiol Rep, 2017, 5(18): e13443. doi: 10.14814/phy2.13443
    Bedlack RS, Vaughan T, Wicks P, et al. How common are ALS plateaus and reversals?[J]. Neurology, 2016, 86(9): 808–812. doi: 10.1212/WNL.0000000000002251
    Van Eijk RPA, Van Den Berg LH. Comment: Plateaus and reversals in ALS disease course or limitations of trial design?[J]. Neurology, 2016, 86(9): 811. doi: 10.1212/WNL.0000000000002365
    Cox LM, Calcagno N, Gauthier C, et al. The microbiota restrains neurodegenerative microglia in a model of amyotrophic lateral sclerosis[J]. Microbiome, 2022, 10(1): 47. doi: 10.1186/s40168-022-01232-z
    Mandrioli J, Amedei A, Cammarota G, et al. FETR-ALS Study Protocol: A Randomized Clinical Trial of Fecal Microbiota Transplantation in Amyotrophic Lateral Sclerosis[J]. Front Neurol. 2019, 10: 1021.
  • 加载中


    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索


    Article Metrics

    Article views (5718) PDF downloads(440) Cited by()
    Proportional views
    Relative Articles


    DownLoad:  Full-Size Img  PowerPoint