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粪便移植治疗溃疡性结肠炎:现有证据和未来应用。

Fecal transplantation for ulcerative colitis: current evidence and future applications.

机构信息

UOC MEDICINA INTERNA E GASTROENTEROLOGIA, Area Medicina Interna, Gastroenterologia ed Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.

Istituto di Patologia Speciale Medica, Università Cattolica del Sacro Cuore, Roma, Italia.

出版信息

Expert Opin Biol Ther. 2020 Apr;20(4):343-351. doi: 10.1080/14712598.2020.1733964. Epub 2020 Feb 26.

Abstract

: Established evidence suggests that gut microbiota plays a role in ulcerative colitis (UC). Fecal microbiota transplantation (FMT) is clearly recognized as a highly effective treatment for patients with recurrent Clostridium difficile infection and has been investigated also in patients with UC, with promising results.: Literature review was performed to select publications concerning current evidence on the role of gut microbiota in the pathogenesis of UC, and on the effectiveness of FMT in this disorder.: The randomized controlled trials published investigating the use of FMT suggested a potential role for FMT in the treatment of mild to moderate UC. However, given several unanswered questions regarding donor selection, dose, route of administration and duration of therapy, this is not yet recommended as a viable therapy option. FMT has allowed for more in depth investigation with regards to the role the gut microbiota may be playing in UC. This knowledge is critical to identifying where FMT may appropriately fit in the UC treatment paradigm. As our understanding of the role the microbiome plays in this chronic disease, FMT, and then eventually defined microbes, will hopefully serve in a complementary role to conventional IBD therapies.

摘要

现有证据表明,肠道微生物群在溃疡性结肠炎(UC)中起作用。粪便微生物群移植(FMT)被明确认为是治疗复发性艰难梭菌感染的高度有效方法,并且也在 UC 患者中进行了研究,结果有希望。

进行了文献回顾,以选择有关肠道微生物群在 UC 发病机制中的作用以及 FMT 在该疾病中的有效性的现有证据的出版物。

已发表的随机对照试验调查了 FMT 的使用,表明 FMT 在治疗轻度至中度 UC 方面可能具有潜在作用。然而,鉴于关于供体选择、剂量、给药途径和治疗持续时间的几个未解答的问题,目前不建议将其作为可行的治疗选择。FMT 使得可以更深入地研究肠道微生物群在 UC 中可能发挥的作用。这些知识对于确定 FMT 在 UC 治疗模式中的适当位置至关重要。随着我们对微生物组在这种慢性疾病中的作用的理解,FMT,然后最终确定微生物,有望在传统的 IBD 治疗中发挥补充作用。

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