[粪便微生物群移植：前景中的适应症]

[Faecal microbiota transplantation: indications in perspective].

van Beurden Y H, Terveer E M, Keller J J, Kuijper E J, Mulder C J J, Vandenbroucke-Grauls C M J E

VU medisch centrum, Amsterdam.

Ned Tijdschr Geneeskd. 2017;161:D1623.

Abstract

As yet, with cure rates around 85%, recurrent Clostridium difficile infection is the only definite indication for faecal microbiota transplantation.- Faecal microbiota transplantation induces clinical remission and endoscopic improvements in 24-30% of patients with ulcerative colitis, compared to 5% (water) to 20% (autologous faeces) in placebo-treated patients. Current research focuses on the identification of 'super donors', and subgroups of patients in which faecal microbiota transplantation is effective.- In patients with metabolic syndrome, faecal microbiota transplantation may increase insulin sensitivity. Weight, body mass index, and energy metabolism are not affected by faecal microbiota transplantation in humans.- In addition to the aforementioned indications, faecal microbiota transplantation is an emerging treatment modality for patients with Crohn's disease, irritable bowel syndrome, graft-versus-host-disease, and carriage of multidrug-resistant micro-organisms. Randomized controlled trials, comparing faecal microbiota transplantation with placebo treatment, are required to determine the effectiveness of faecal microbiota transplantation in these patient groups.

摘要

目前，艰难梭菌感染复发率约为85%，粪便微生物群移植是其唯一明确的适应证。
与接受安慰剂治疗的患者中5%（水）至20%（自体粪便）的缓解率相比，粪便微生物群移植可使24%至30%的溃疡性结肠炎患者实现临床缓解和内镜改善。目前的研究重点是识别“超级供体”以及粪便微生物群移植有效的患者亚组。
对于代谢综合征患者，粪便微生物群移植可能会提高胰岛素敏感性。在人类中，体重、体重指数和能量代谢不受粪便微生物群移植的影响。
除上述适应证外，粪便微生物群移植是治疗克罗恩病、肠易激综合征、移植物抗宿主病和多重耐药微生物携带者的一种新兴治疗方式。需要进行随机对照试验，比较粪便微生物群移植与安慰剂治疗，以确定粪便微生物群移植在这些患者群体中的有效性。