Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Gastroenterology. 2013 Nov;145(5):946-53. doi: 10.1053/j.gastro.2013.08.058. Epub 2013 Sep 7.
There has been growing interest in the use of fecal microbiota for the treatment of patients with chronic gastrointestinal infections and inflammatory bowel diseases. Lately, there has also been interest in its therapeutic potential for cardiometabolic, autoimmune, and other extraintestinal conditions that were not previously considered to be associated with the intestinal microbiota. Although it is not clear if changes in the microbiota cause these conditions, we review the most current and best methods for performing fecal microbiota transplantation and summarize clinical observations that have implicated the intestinal microbiota in various diseases. We also discuss case reports of fecal microbiota transplantations for different disorders, including Clostridium difficile infection, irritable bowel syndrome, inflammatory bowel diseases, insulin resistance, multiple sclerosis, and idiopathic thrombocytopenic purpura. There has been increasing focus on the interaction between the intestinal microbiome, obesity, and cardiometabolic diseases, and we explore these relationships and the potential roles of different microbial strains. We might someday be able to mine for intestinal bacterial strains that can be used in the diagnosis or treatment of these diseases.
人们对使用粪便微生物群治疗慢性胃肠道感染和炎症性肠病患者越来越感兴趣。最近,人们对其在治疗心血管代谢、自身免疫和其他以前不认为与肠道微生物群相关的肠道外疾病方面的治疗潜力也产生了兴趣。虽然目前尚不清楚微生物群的变化是否会导致这些疾病,但我们回顾了目前最先进和最好的粪便微生物群移植方法,并总结了肠道微生物群与各种疾病相关的临床观察结果。我们还讨论了粪便微生物群移植治疗不同疾病的病例报告,包括艰难梭菌感染、肠易激综合征、炎症性肠病、胰岛素抵抗、多发性硬化症和特发性血小板减少性紫癜。人们越来越关注肠道微生物组、肥胖和心血管代谢疾病之间的相互作用,我们探讨了这些关系以及不同微生物菌株的潜在作用。有朝一日,我们也许能够挖掘出可用于这些疾病诊断或治疗的肠道细菌菌株。