Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Division of Integrative Systems Medicine and Digestive Disease, Faculty of Medicine, Imperial College London, London, UK.
Lancet. 2019 Aug 3;394(10196):420-431. doi: 10.1016/S0140-6736(19)31266-8.
Developments in high-throughput microbial genomic sequencing and other systems biology techniques have given novel insight into the potential contribution of the gut microbiota to health and disease. As a result, an increasing number of diseases have been characterised by distinctive changes in the composition and functionality of the gut microbiota; however, whether such changes are cause, consequence, or incidental to the disease in question remains largely uncertain. Restoration of the gut microbiota to a premorbid state is a key novel therapeutic approach of interest, and faecal microbiota transplantation-the transfer of prescreened stool from healthy donors into the gastrointestinal tract of patients-is gaining increasing importance in both the clinical and research settings. At present, faecal microbiota transplantation is only recommended in the treatment of recurrent Clostridioides difficile infection, although a large number of trials are ongoing worldwide exploring other potential therapeutic indications.
高通量微生物基因组测序和其他系统生物学技术的发展,为肠道微生物群对健康和疾病的潜在贡献提供了新的见解。因此,越来越多的疾病的特征是肠道微生物群的组成和功能发生了明显的变化;然而,这些变化是疾病的原因、结果还是偶然因素,在很大程度上仍不确定。将肠道微生物群恢复到发病前的状态是一种新的治疗方法,粪便微生物群移植——将经过预先筛选的健康供体的粪便转移到患者的胃肠道中——在临床和研究环境中越来越受到重视。目前,粪便微生物群移植仅被推荐用于治疗复发性艰难梭菌感染,尽管全世界有大量的试验正在探索其他潜在的治疗适应症。