Kelsey Research Foundation, Houston, TX, USA.
University of Texas School of Public Health, 1200 Pressler St, Houston, TX, 77030, USA.
Dig Dis Sci. 2020 Mar;65(3):741-756. doi: 10.1007/s10620-020-06102-y.
Reduction in diversity of the intestinal microbiome (dysbiosis) is being identified in many disease states, and studies are showing important biologic contributions of microbiome to health and disease. Fecal microbiota transplantation (FMT) is being evaluated as a way to reverse dysbiosis in diseases and disorders in an attempt to improve health. The published literature was reviewed to determine the value of FMT in the treatment of medical disorders for which clinical trials have recently been conducted. FMT is effective in treating recurrent C. difficile infection in one or two doses, with many healthy donors providing efficacious fecal-derived products. In inflammatory bowel disease (IBD), FMT may lead to remission in approximately one-third of moderate-to-severe illnesses with one study suggesting that more durable FMT responses may be seen when used once medical remissions have been achieved. Donor products differ in their efficacy in treatment of IBD. Combining donor products has been one way to increase the potential value of FMT in treating chronic disorders. FMT is being explored in a variety of clinical settings affecting different organ systems outside CDI, with positive preliminary signals, in treatment of functional constipation, immunotherapy-induced colitis, neurodegenerative disease, as well as prevention of cancer-related disorders like graft versus host disease and decolonization of patients with recurrent urinary tract infection due to antibiotic-resistant bacteria. Currently, intense research is underway to see how the microbiome products like FMT can be harnessed for health benefits.
肠道微生物组（菌群失调）多样性的减少在许多疾病状态中被发现，研究表明微生物组对健康和疾病有重要的生物学贡献。粪便微生物群移植（FMT）正在被评估为一种逆转疾病和障碍中菌群失调的方法，以试图改善健康。本文综述了已发表的文献，以确定 FMT 在治疗最近进行临床试验的医学疾病中的价值。FMT 在治疗复发性艰难梭菌感染方面，一次或两次剂量就非常有效，许多健康供体提供有效的粪便衍生产品。在炎症性肠病（IBD）中，FMT 可能导致三分之一的中重度疾病缓解，一项研究表明，当用于实现医学缓解时，可能会看到更持久的 FMT 反应。供体产品在治疗 IBD 方面的疗效存在差异。合并供体产品是增加 FMT 治疗慢性疾病潜在价值的一种方法。FMT 正在 CDI 以外的不同器官系统的各种临床环境中进行探索，在治疗功能性便秘、免疫治疗诱导的结肠炎、神经退行性疾病以及预防与癌症相关的疾病方面，如移植物抗宿主病和由于抗生素耐药菌导致的复发性尿路感染的去定植，都有积极的初步信号。目前，正在进行密集的研究，以了解如何利用微生物组产品（如 FMT）来促进健康。
