Allegretti Jessica R, Hamilton Matthew J
Jessica R Allegretti, Matthew J Hamilton, Division of Gastroenterology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States.
World J Gastroenterol. 2014 Apr 7;20(13):3468-74. doi: 10.3748/wjg.v20.i13.3468.
Fecal microbiota transplantation (FMT) is considered to be a highly successful therapy for recurrent and refractory Clostridium difficile infection (CDI) based on recent clinical trials. The pathogenesis of inflammatory bowel diseases (IBD) is thought to be due in part to perturbations in the gut microflora that disrupt homeostasis. FMT restores essential components of the microflora which could reverse the inflammatory processes observed in IBD. Case reports and series for the treatment of IBD by FMT have shown promise with regards to treatment success and safety despite the limitations of the reporting. Future studies will determine the optimal delivery and preparation of stool as well as the conditions under which the recipient will derive maximal benefit. The long term consequences of FMT with regards to infection, cancer, auto-immune, and metabolic diseases are not known and will require continued regulation and study. Despite these limitations, FMT may be beneficial for the treatment of ulcerative colitis and Crohn's disease, particularly those with concurrent CDI or with pouchitis.
基于近期临床试验，粪便微生物群移植（FMT）被认为是治疗复发性和难治性艰难梭菌感染（CDI）的一种非常成功的疗法。炎症性肠病（IBD）的发病机制被认为部分归因于肠道微生物群的紊乱，这种紊乱破坏了体内平衡。FMT可恢复微生物群的重要组成部分，这可能会逆转IBD中观察到的炎症过程。尽管报告存在局限性，但关于FMT治疗IBD的病例报告和系列研究在治疗成功率和安全性方面已显示出前景。未来的研究将确定粪便的最佳输送和制备方式，以及受者能获得最大益处的条件。FMT在感染、癌症、自身免疫和代谢性疾病方面的长期后果尚不清楚，需要持续的监管和研究。尽管有这些局限性，FMT可能对溃疡性结肠炎和克罗恩病的治疗有益，特别是那些并发CDI或患有袋炎的患者。
