aCentre of Digestive Diseases, Sydney, New South Wales, Australia bAlbert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA cSt Vincent's Hospital Clinical School, Darlinghurst, New South Wales, Australia.
Curr Opin Gastroenterol. 2014 Jan;30(1):97-105. doi: 10.1097/MOG.0000000000000027.
Faecal microbiota transplantation (FMT) has undergone dramatic progression over the past year and continues to evolve as knowledge of the gastrointestinal microbiota (GiMb) develops. This review summarizes therapeutic advances in FMT, latest FMT therapies and presents the potential of FMT therapeutics in other gastrointestinal and extra-intestinal conditions.
The GiMb is now known to have a central role in the pathogenesis of many diseases. The success of FMT in curing Clostridium difficile infection (CDI) is well established and preliminary findings in other gastrointestinal conditions are promising. Published data from over 500 CDI cases suggest that FMT is generally well tolerated with minimal side effects. The commercial potential of FMT is being explored with several products under development, including frozen GiMb extract, which has been shown highly effective in treating relapsing CDI. Such products will likely become more available in coming years and revolutionize the availability and method of delivery of GiMb.
Recent literature unequivocally supports the use of FMT in treating relapsing CDI. Trials are underway to determine the therapeutic potential of FMT in other conditions, particularly inflammatory bowel disease. Therapeutic FMT is a dynamic field with new and emerging indications along with ongoing developments in optimal mode of administration.
粪菌移植(FMT)在过去一年中取得了显著进展,随着对胃肠道微生物组(GiMb)的认识不断发展,它仍在不断演变。本综述总结了 FMT 的治疗进展、最新的 FMT 疗法,并介绍了 FMT 疗法在其他胃肠道和肠道外疾病中的潜力。
现在已知 GiMb 在许多疾病的发病机制中起着核心作用。FMT 治疗艰难梭菌感染(CDI)的成功已得到充分证实,其他胃肠道疾病的初步发现也很有希望。超过 500 例 CDI 病例的发表数据表明,FMT 通常具有良好的耐受性,副作用极小。FMT 的商业潜力正在被探索,包括冷冻 GiMb 提取物在内的几种产品正在开发中,已证明其在治疗复发性 CDI 方面非常有效。此类产品可能在未来几年内更广泛地应用,并彻底改变 GiMb 的获取和给药方式。
最近的文献明确支持 FMT 用于治疗复发性 CDI。正在进行试验以确定 FMT 在其他疾病(特别是炎症性肠病)中的治疗潜力。治疗性 FMT 是一个充满活力的领域,随着最佳给药方式的不断发展,新的和新兴的适应症也在不断涌现。