Cold Frederik, Kousgaard Sabrina Just, Halkjaer Sofie Ingdam, Petersen Andreas Munk, Nielsen Hans Linde, Thorlacius-Ussing Ole, Hansen Lars Hestbjerg
Department of Plant and Environmental Sciences, Section for Microbial Ecology and Biotechnology, Copenhagen University, Thorvaldsensvej 40, 1871 Frederiksberg C, Denmark.
Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, 2650 Hvidovre, Denmark.
Microorganisms. 2020 Sep 18;8(9):1433. doi: 10.3390/microorganisms8091433.
The objective was to evaluate available literature on treatment of chronic pouchitis with fecal microbiota transplantation (FMT) focusing on clinical outcomes, safety, and different approaches to FMT preparation and delivery. A systematic review of electronic databases was conducted using Medline, EMBASE, and the Cochrane Central Register of Controlled Trials Library from inception through April 2020. Human studies of all study types reporting results of FMT to treat chronic pouchitis were included. Nine studies, reporting FMT treatment of 69 patients with chronic pouchitis were found eligible for the review. Most studies were case series and cohort studies rated as having fair to poor quality due to high risk of bias and small sample size. Only one randomized controlled trial was included, finding no beneficial effect of FMT. In total clinical response after FMT was reported in 14 (31.8%) out of 44 evaluated patients at various timepoints after FMT, and clinical remission in ten (22.7%) patients. Only minor self-limiting adverse events were reported. FMT varied greatly regarding preparation, length of treatment, and route of delivery. The effects of FMT on symptoms of chronic pouchitis are not established, though some studies show promising results. Future controlled well-designed studies are warranted.
目的是评估关于粪便微生物群移植（FMT）治疗慢性袋炎的现有文献，重点关注临床结果、安全性以及FMT制备和给药的不同方法。使用Medline、EMBASE和Cochrane对照试验中央注册库从建库至2020年4月对电子数据库进行了系统评价。纳入了所有研究类型的人体研究，这些研究报告了FMT治疗慢性袋炎的结果。发现9项报告FMT治疗69例慢性袋炎患者的研究符合该评价的纳入标准。大多数研究为病例系列和队列研究，由于偏倚风险高和样本量小，质量被评为中等至较差。仅纳入了一项随机对照试验，未发现FMT有有益效果。在FMT后的不同时间点，44例评估患者中有14例（31.8%）报告了FMT后的总体临床反应，10例（22.7%）患者实现临床缓解。仅报告了轻微的自限性不良事件。FMT在制备、治疗时长和给药途径方面差异很大。尽管一些研究显示出有前景的结果，但FMT对慢性袋炎症状的影响尚未明确。未来需要进行设计良好的对照研究。
