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粪便微生物群移植的操作、筛查及成本

Procedure, Screening, and Cost of Fecal Microbiota Transplantation.

作者信息

Wynn Austin B, Beyer Garet, Richards Megan, Ennis Lisa A

机构信息

Public Health, Environmental Health, Informatics, Information Sciences, Alabama College of Osteopathic Medicine, Dothan, USA.

出版信息

Cureus. 2023 Feb 17;15(2):e35116. doi: 10.7759/cureus.35116. eCollection 2023 Feb.

Abstract

Fecal microbiota transplantation (FMT) is currently considered a potential treatment for various GI-related illnesses, with the goal to replenish natural healthy flora of the GI tract that has been harmed because of antibiotic use or overgrowth of harmful bacteria. Current methods of administering the processed stool include colonoscopy and enema, while an oral capsule is being developed. Each method of administration carries its own set of risks, including adverse reactions to treatment, infection following the invasive administration procedure, and flare-ups of GI-related symptoms. Current oral administration through nasoduodenal tube poses a risk for aspiration which has not been ruled out as the cause of subsequent pneumonia and death in patient trials. The development of an oral capsule could address some of the faults of the current methods, not only making treatment more affordable and accessible but also less of a risk due to its minimally invasive nature. FMT is also a treatment option to attenuate adverse effects associated with antibiotic use, including combatting the emergence of antibiotic resistance, as well as adverse effects related to other medical treatments such as chemotherapy. While FMT is an unexplored treatment option for multiple gastrointestinal disorders and is currently still largely inaccessible for many patients financially, studies have suggested that it could be a more affordable treatment option long-term for patients as aspects of the treatment become more affordable with further research.

摘要

粪便微生物群移植(FMT)目前被认为是治疗各种胃肠道相关疾病的一种潜在方法,其目的是补充因使用抗生素或有害细菌过度生长而受损的胃肠道天然健康菌群。目前施用经处理粪便的方法包括结肠镜检查和灌肠,同时一种口服胶囊正在研发中。每种给药方法都有其自身的一系列风险,包括对治疗的不良反应、侵入性给药程序后的感染以及胃肠道相关症状的发作。目前通过鼻十二指肠管进行口服给药存在误吸风险,在患者试验中,误吸尚未被排除为随后肺炎和死亡的原因。口服胶囊的研发可以解决当前方法的一些缺陷,不仅使治疗更经济实惠且易于获得,而且由于其微创性质,风险也更小。FMT也是一种减轻与抗生素使用相关不良反应的治疗选择,包括对抗抗生素耐药性的出现,以及与其他医疗治疗(如化疗)相关的不良反应。虽然FMT是多种胃肠道疾病的一种未被充分探索的治疗选择,目前许多患者在经济上仍难以获得,但研究表明,随着治疗的各个方面随着进一步研究而变得更经济实惠,从长远来看,它可能是患者更经济实惠的治疗选择。

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