Lopez Joanna, Grinspan Ari
Dr Lopez is a gastroenterology fellow and Dr Grinspan is an assistant professor of medicine at Icahn School of Medicine at Mount Sinai in New York, New York.
Gastroenterol Hepatol (N Y). 2016 Jun;12(6):374-9.
The gut bacterial microbiome, particularly its role in disease and inflammation, has gained international attention with the successful use of fecal microbiota transplantation (FMT) in the treatment of Clostridium difficile infection. This success has led to studies exploring the role of FMT in other conditions, including inflammatory bowel disease (IBD). Both Crohn's disease and ulcerative colitis are chronic inflammatory conditions of the gastrointestinal system that have multifactorial etiologies. A shift in gut microbial composition in genetically susceptible individuals, an altered immune system, and environmental factors are all hypothesized to have a role in the pathogenesis of IBD. While numerous case reports and cohort studies have described the use of FMT in patients with IBD over the last 2 decades, the development of new sequencing techniques and results from 2 recent randomized, controlled trials have allowed for a better understanding of the relationship between the microbiome and the human host. However, despite these efforts, knowledge remains limited and the role of FMT in the management of IBD remains uncertain. Further investigation is necessary before FMT joins the current armamentarium of treatment options in clinical practice.
肠道细菌微生物群,尤其是其在疾病和炎症中的作用,随着粪便微生物群移植(FMT)成功用于治疗艰难梭菌感染而受到国际关注。这一成功促使人们开展研究,探索FMT在包括炎症性肠病(IBD)在内的其他病症中的作用。克罗恩病和溃疡性结肠炎都是胃肠道系统的慢性炎症性病症,病因是多方面的。基因易感性个体的肠道微生物组成变化、免疫系统改变以及环境因素都被认为在IBD的发病机制中起作用。虽然在过去20年里,众多病例报告和队列研究描述了FMT在IBD患者中的应用,但新测序技术的发展以及最近两项随机对照试验的结果,使人们能更好地理解微生物群与人类宿主之间的关系。然而,尽管有这些努力,相关知识仍然有限,FMT在IBD管理中的作用仍不确定。在FMT加入临床实践中现有的治疗手段之前,有必要进行进一步研究。