Biazzo Manuele, Deidda Gabriele
The BioArte Limited, Life Sciences Park, Triq San Giljan, SGN 3000 San Gwann, Malta.
SienabioACTIVE, University of Siena, Via Aldo Moro 1, 53100 Siena, Italy.
J Clin Med. 2022 Jul 15;11(14):4119. doi: 10.3390/jcm11144119.
The human body is home to a variety of micro-organisms. Most of these microbial communities reside in the gut and are referred to as gut microbiota. Over the last decades, compelling evidence showed that a number of human pathologies are associated with microbiota dysbiosis, thereby suggesting that the reinstatement of physiological microflora balance and composition might ameliorate the clinical symptoms. Among possible microbiota-targeted interventions, pre/pro-biotics supplementations were shown to provide effective results, but the main limitation remains in the limited microbial species available as probiotics. Differently, fecal microbiota transplantation involves the transplantation of a solution of fecal matter from a donor into the intestinal tract of a recipient in order to directly change the recipient's gut microbial composition aiming to confer a health benefit. Firstly used in the 4th century in traditional Chinese medicine, nowadays, it has been exploited so far to treat recurrent infections, but accumulating data coming from a number of clinical trials clearly indicate that fecal microbiota transplantation may also carry the therapeutic potential for a number of other conditions ranging from gastrointestinal to liver diseases, from cancer to inflammatory, infectious, autoimmune diseases and brain disorders, obesity, and metabolic syndrome. In this review, we will summarize the commonly used preparation and delivery methods, comprehensively review the evidence obtained in clinical trials in different human conditions and discuss the variability in the results and the pivotal importance of donor selection. The final aim is to stimulate discussion and open new therapeutic perspectives among experts in the use of fecal microbiota transplantation not only in infection but as one of the first strategies to be used to ameliorate a number of human conditions.
人体是多种微生物的宿主。这些微生物群落大多存在于肠道中，被称为肠道微生物群。在过去几十年中，有力的证据表明，许多人类疾病与微生物群失调有关，这表明恢复生理微生物群的平衡和组成可能会改善临床症状。在可能的针对微生物群的干预措施中，补充益生元/益生菌已被证明能产生有效结果，但主要限制在于可用作益生菌的微生物种类有限。不同的是，粪便微生物群移植是将供体的粪便物质溶液移植到受体的肠道中，以直接改变受体的肠道微生物组成，从而带来健康益处。粪便微生物群移植最早于公元4世纪在传统中医中使用，如今，它已被用于治疗复发性感染，但来自多项临床试验的越来越多的数据清楚地表明，粪便微生物群移植对许多其他疾病也可能具有治疗潜力，这些疾病包括胃肠道疾病、肝脏疾病、癌症、炎症性疾病、感染性疾病、自身免疫性疾病和脑部疾病、肥胖症以及代谢综合征。在这篇综述中，我们将总结常用的制备和给药方法，全面回顾在不同人类疾病的临床试验中获得的数据，并讨论结果的变异性以及供体选择的关键重要性。最终目的是激发讨论，并为粪便微生物群移植的专家们开辟新的治疗前景，不仅用于治疗感染，而且作为改善许多人类疾病的首批策略之一。
