Jeon Seong Ran, Chai Jocelyn, Kim Christiana, Lee Christine H
Digestive Disease Centre, Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, South Korea.
University of Victoria, Victoria, British Columbia, Canada.
Curr Infect Dis Rep. 2018 May 26;20(8):21. doi: 10.1007/s11908-018-0627-8.
Fecal microbiota transplantation (FMT) has been investigated as a potential treatment for inflammatory bowel disease (IBD). This review examines current evidence around the efficacy and safety of FMT for patients with IBD.
Randomized controlled trials (RCTs) and meta-analyses have suggested that FMT may facilitate clinical and endoscopic remission in patients with active ulcerative colitis (UC). Although the evidence for FMT in Crohn's disease (CD) is more limited, positive outcomes have been observed in small cohort studies. Most adverse events (AEs) were mild and included transient gastrointestinal symptoms. Serious adverse events (SAEs) did not differ significantly between the FMT and control groups, and a marginal increased rate of IBD flares following FMT was observed. Microbiota analysis following FMT showed increased intestinal bacterial diversity and a shift towards the donor microbial profile in recipients' stools. FMT for patients with IBD is promising as RCTs have shown the benefit of FMT for UC, although the efficacy of FMT for CD is less clear. Further large and well-designed trials are necessary to resolve critical issues such as the donor selection, the ideal route of administration, duration, frequency of FMT, and the long-term sustained efficacy and safety.
粪便微生物群移植（FMT）已被作为炎症性肠病（IBD）的一种潜在治疗方法进行研究。本综述探讨了目前关于FMT治疗IBD患者的疗效和安全性的证据。
随机对照试验（RCT）和荟萃分析表明，FMT可能有助于活动性溃疡性结肠炎（UC）患者实现临床和内镜缓解。尽管FMT在克罗恩病（CD）中的证据更为有限，但在小型队列研究中已观察到积极结果。大多数不良事件（AE）为轻度，包括短暂的胃肠道症状。FMT组和对照组之间的严重不良事件（SAE）没有显著差异，并且观察到FMT后IBD发作率略有增加。FMT后的微生物群分析显示，受者粪便中的肠道细菌多样性增加，且向供体微生物谱转变。对于IBD患者，FMT很有前景，因为RCT已表明FMT对UC有益，尽管FMT对CD的疗效尚不太明确。需要进一步开展大规模且设计良好的试验，以解决诸如供体选择、理想给药途径、FMT持续时间、频率以及长期持续疗效和安全性等关键问题。
