Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia.
J Infect Dev Ctries. 2020 Oct 31;14(10):1074-1080. doi: 10.3855/jidc.12780.
A growing body of literatures showed the interaction of dysbiotic gut with a wide range of disorders, and the clinical use of fecal microbiota transplantation (FMT) shifted from infectious disease to non-communicable disorders. Despite the promising therapeutic benefits of FMT, the exact mechanisms through which fecal recipients benefit from the fecal intervention are not well understood. However, owing to the advantages of having a healthy gut microbiome, possible mechanisms of actions of FMT has been described. On the one hand, through direct ecological competition, FMT may potentially stimulate decolonization of pathogenic microorganisms and increase host resistance to pathogens. Moreover, following dysbiosis, abnormal microbial colonization of the gastrointestinal tract may also cause excessive or dysregulated immune response, resulting in chronic inflam-mation and the development of mucosal lesions. In this regard, repopulating gut microbiome through FMT helps to restore immune function and reduce host damage. On the other hand, FMT helps to restore essential metabolites used for host metabolism, including short-chain fatty acids (SCFA), antimicrobial peptides (AMP), bacteriocins and bile acids. Therefore, in this review, the existing evidences regarding the mechanisms of action, current opportunities and challenges of FMT will be described.
越来越多的文献表明,肠道失调与广泛的疾病有关,粪便微生物群移植(FMT)的临床应用已从传染病转向非传染性疾病。尽管 FMT 具有有前景的治疗益处,但粪便受者从粪便干预中受益的确切机制尚不清楚。然而,由于拥有健康的肠道微生物组的优势,FMT 的可能作用机制已被描述。一方面,通过直接的生态竞争,FMT 可能潜在地刺激定植病原体的去定植,并增加宿主对病原体的抵抗力。此外,在肠道失调后,胃肠道异常的微生物定植也可能导致过度或失调的免疫反应,导致慢性炎症和粘膜损伤的发展。在这方面,通过 FMT 重新定植肠道微生物组有助于恢复免疫功能并减少宿主损伤。另一方面,FMT 有助于恢复用于宿主代谢的必需代谢物,包括短链脂肪酸(SCFA)、抗菌肽(AMP)、细菌素和胆汁酸。因此,在这篇综述中,将描述 FMT 的作用机制、当前的机会和挑战的现有证据。