Department of Digestive Tract Diseasesx
Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
Curr Drug Targets. 2020;21(14):1440-1447. doi: 10.2174/1389450121666200602125507.
Dysbiosis has been repeatedly observed in inflammatory bowel disease (IBD) and is now recognized as an essential factor in the gut inflammatory process. IBD is a significant burden to health-care systems, mainly due to treatment-related costs. Available treatments have several limitations: up to 30% of patients are primary non-responders, and between 10 and 20% lose response per year, requiring a dose-escalation or a switch to another biologic. Hence, the current IBD treatment is not sufficient, and there is an urgent need to introduce new therapies in the management of these patients. Recently, the correction of dysbiosis has become an attractive approach from a therapeutic point of view. Faecal microbiota transplantation (FMT) appears as a reliable and potentially beneficial therapy in IBD patients. There is developing data that FMT for mild-to-moderately active UC is a safe and efficient therapy for the induction of remission. However, the current studies have different designs and have a short follow up, which makes clinical interpretation significantly difficult. There is a need for RCTs with a well-defined study cohort using FMT for the therapy of CD patients. The location, behavior, and severity of the disease should be taken into account. The goal of this manuscript is to review the data currently available on FMT and IBD, to explain FMT principles and methodology in IBD patients and to discuss some unresolved issues.
肠道菌群失调在炎症性肠病（IBD）中反复被观察到，现在被认为是肠道炎症过程中的一个重要因素。IBD 给医疗保健系统带来了巨大的负担，主要是由于与治疗相关的成本。现有的治疗方法有几个局限性：多达 30%的患者是原发性无应答者，每年有 10%至 20%的患者失去应答，需要增加剂量或改用另一种生物制剂。因此，目前的 IBD 治疗方法并不充分，迫切需要在这些患者的治疗中引入新的疗法。最近，从治疗的角度来看，纠正肠道菌群失调已经成为一种有吸引力的方法。粪便微生物群移植（FMT）在 IBD 患者中似乎是一种可靠且有潜在益处的治疗方法。越来越多的数据表明，对于轻中度活动期 UC，FMT 是诱导缓解的一种安全有效的治疗方法。然而，目前的研究设计不同，随访时间短，这使得临床解释变得非常困难。需要进行 RCT 研究，使用 FMT 对 CD 患者进行治疗，并定义明确的研究队列。应考虑疾病的位置、行为和严重程度。本文的目的是回顾目前关于 FMT 和 IBD 的数据，解释 FMT 在 IBD 患者中的原理和方法，并讨论一些未解决的问题。
