炎症性肠病粪便微生物群移植的现状与启示：过去、现在和未来。

The Current Landscape and Lessons from Fecal Microbiota Transplantation for Inflammatory Bowel Disease: Past, Present, and Future.

机构信息

*Harvard Medical School, Boston, Massachusetts; †Division of Gastroenterology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; ‡OpenBiome, Somerville, Massachusetts; §School of Medicine, Yale University, New Haven, Connecticut; ‖Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, California; ¶Indiana University School of Medicine, Division of Gastroenterology, Department of Medicine, Indianapolis, Indiana; and **Warren Alpert Medical School of Brown University, Miriam Hospital, and Lifespan Hospital System, Providence, Rhode Island.

出版信息

Inflamm Bowel Dis. 2017 Oct;23(10):1710-1717. doi: 10.1097/MIB.0000000000001247.

DOI:10.1097/MIB.0000000000001247

PMID:28858073

Abstract

Fecal microbiota transplantation (FMT) has changed the standard of care for Clostridium difficile infection. However, there is limited data focusing on efficacy and safety profile of FMT in patients with C. difficile infection with underlying inflammatory bowel disease (IBD), including the risk of IBD flare. Recently, there is also emerging evidence supporting the role of FMT to treat IBD including promising randomized trials in ulcerative colitis. However, with heterogeneity across these studies, the clinical application of this emerging therapy has yet to be fully elucidated. Here, we aim to review the current landscape of this rapidly developing field, mapping the efficacy and safety of FMT (1) to treat C. difficile infection in patients with IBD, (2) to treat underlying IBD, and (3) outline ongoing clinical trials and the future of the microbiome space.

摘要

粪便微生物群移植（FMT）改变了艰难梭菌感染的治疗标准。然而，目前针对艰难梭菌感染合并炎症性肠病（IBD）患者的 FMT 的疗效和安全性概况的数据有限，包括 IBD 发作的风险。最近，也有越来越多的证据支持 FMT 治疗 IBD，包括溃疡性结肠炎的有前景的随机试验。然而，由于这些研究存在异质性，这种新兴治疗方法的临床应用尚未完全阐明。在这里，我们旨在综述这个快速发展领域的现状，阐明 FMT 的疗效和安全性：（1）治疗 IBD 患者的艰难梭菌感染，（2）治疗潜在的 IBD，以及（3）概述正在进行的临床试验和微生物组领域的未来。