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胃肠道微生物群失调与粪便微生物移植在艰难梭菌感染中的应用

Gastrointestinal dysbiosis and the use of fecal microbial transplantation in Clostridium difficile infection.

作者信息

Schenck L Patrick, Beck Paul L, MacDonald Justin A

机构信息

L Patrick Schenck, Gastrointestinal Research Group at the Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary AB T2N 4Z6, Canada.

出版信息

World J Gastrointest Pathophysiol. 2015 Nov 15;6(4):169-80. doi: 10.4291/wjgp.v6.i4.169.

Abstract

The impact of antibiotics on the human gut microbiota is a significant concern. Antibiotic-associated diarrhea has been on the rise for the past few decades with the increasing usage of antibiotics. Clostridium difficile infections (CDI) have become one of the most prominent types of infectious diarrheal disease, with dramatically increased incidence in both the hospital and community setting worldwide. Studies show that variability in the innate host response may in part impact upon CDI severity in patients. That being said, CDI is a disease that shows the most prominent links to alterations to the gut microbiota, in both cause and treatment. With recurrence rates still relatively high, it is important to explore alternative therapies to CDI. Fecal microbiota transplantation (FMT) and other types of bacteriotherapy have become exciting avenues of treatment for CDI. Recent clinical trials have generated excitement for the use of FMT as a therapeutic option for CDI; however, the exact components of the human gut microbiota needed for protection against CDI have remained elusive. Additional investigations on the effects of antibiotics on the human gut microbiota and subsequent CDI will help reduce the socioeconomic burden of CDI and potentially lead to new therapeutic modalities.

摘要

抗生素对人体肠道微生物群的影响是一个重大问题。在过去几十年里,随着抗生素使用的增加,抗生素相关性腹泻一直在上升。艰难梭菌感染(CDI)已成为最突出的感染性腹泻疾病类型之一,在全球范围内的医院和社区环境中发病率都急剧上升。研究表明,宿主先天反应的变异性可能在一定程度上影响患者CDI的严重程度。话虽如此,CDI是一种在病因和治疗方面都与肠道微生物群改变联系最为突出的疾病。由于复发率仍然相对较高,探索CDI的替代疗法很重要。粪便微生物群移植(FMT)和其他类型的细菌疗法已成为治疗CDI的令人兴奋的途径。最近的临床试验激发了人们对使用FMT作为CDI治疗选择的兴趣;然而,预防CDI所需的人体肠道微生物群的确切组成部分仍然难以捉摸。对抗生素对人体肠道微生物群及随后的CDI影响的进一步研究将有助于减轻CDI的社会经济负担,并可能带来新的治疗方式。

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