IBD Unit, CEMAD Centro Malattie dell'Apparato Digerente, UOC di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
Department of Medicine and Ageing Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.
Gut. 2023 Sep;72(9):1642-1650. doi: 10.1136/gutjnl-2023-329948. Epub 2023 Jun 20.
Several randomised clinical trials (RCTs) performing faecal microbiota transplantation (FMT) for the management of inflammatory bowel disease (IBD), particularly for ulcerative colitis, have recently been published, but with major variations in study design. These include differences in administered dose, route and frequency of delivery, type of placebo and evaluated endpoints. Although the overall outcomes appear to be promising, they are highly dependent on both donor and recipient factors.
To develop concensus-based statements and recommendations for the evaluation, management and potential treatment of IBD using FMT in order to move towards standardised practices.
An international panel of experts convened several times to generate evidence-based guidelines by performing a deep evaluation of currently available and/or published data. Twenty-five experts in IBD, immunology and microbiology collaborated in different working groups to provide statements on the following key issues related to FMT in IBD: (A) pathogenesis and rationale, (B) donor selection and biobanking, (C) FMT practices and (D) consideration of future studies and perspectives. Statements were evaluated and voted on by all members using an electronic Delphi process, culminating in a plenary consensus conference and generation of proposed guidelines.
Our group has provided specific statements and recommendations, based on best available evidence, with the end goal of providing guidance and general criteria required to promote FMT as a recognised strategy for the treatment of IBD.
最近发表了几项关于粪便微生物群移植（FMT）治疗炎症性肠病（IBD），特别是溃疡性结肠炎的随机临床试验（RCT），但研究设计存在重大差异。这些差异包括管理剂量、途径和频率、安慰剂类型和评估终点的差异。尽管总体结果似乎很有希望，但它们高度依赖供体和受体因素。
为了使用 FMT 评估、管理和潜在治疗 IBD，制定基于共识的陈述和建议，以推动标准化实践。
一个国际专家小组多次召开会议，通过对现有和/或已发表数据进行深入评估，制定循证指南。25 名 IBD、免疫学和微生物学专家在不同的工作组中合作，就以下与 IBD 中的 FMT 相关的关键问题提供陈述：（A）发病机制和基本原理，（B）供体选择和生物库，（C）FMT 实践，以及（D）考虑未来的研究和前景。所有成员都使用电子 Delphi 流程对陈述进行评估和投票，最终在全体共识会议上生成拟议的指南。
我们的小组根据最佳现有证据提供了具体的陈述和建议，最终目标是提供指导和一般标准，以促进 FMT 作为治疗 IBD 的公认策略。
